Bond Mary, Pavey Toby, Welch Karen, Cooper Chris, Garside Ruth, Dean Sarah, Hyde Christopher J
PenTAG, University of Exeter, Peninsula Medical School, Exeter, Devon, UK.
Evid Based Med. 2013 Apr;18(2):54-61. doi: 10.1136/eb-2012-100608. Epub 2012 Aug 2.
To identify the psychological effects of false-positive screening mammograms in the UK.
Systematic review of all controlled studies and qualitative studies of women with a false-positive screening mammogram. The control group participants had normal mammograms. All psychological outcomes including returning for routine screening were permitted. All studies had a narrative synthesis.
The searches returned seven includable studies (7/4423). Heterogeneity was such that meta-analysis was not possible. Studies using disease-specific measures found that, compared to normal results, there could be enduring psychological distress that lasted up to 3 years; the level of distress was related to the degree of invasiveness of the assessment. At 3 years the relative risks were, further mammography, 1.28 (95% CI 0.82 to 2.00), fine needle aspiration 1.80 (95% CI 1.17 to 2.77), biopsy 2.07 (95% CI 1.22 to 3.52) and early recall 1.82 (95% CI 1.22 to 2.72). Studies that used generic measures of anxiety and depression found no such impact up to 3 months after screening. Evidence suggests that women with false-positive mammograms have an increased likelihood of failing to reattend for routine screening, relative risk 0.97 (95% CI 0.96 to 0.98) compared with women with normal mammograms.
Having a false-positive screening mammogram can cause breast cancer-specific distress for up to 3 years. The degree of distress is related to the invasiveness of the assessment. Women with false-positive mammograms are less likely to return for routine assessment than those with normal ones.
确定英国乳腺钼靶筛查假阳性结果的心理影响。
对所有关于乳腺钼靶筛查假阳性女性的对照研究和定性研究进行系统综述。对照组参与者的乳腺钼靶检查结果正常。允许纳入所有心理结果，包括是否返回进行常规筛查。所有研究均进行叙述性综合分析。
检索得到7项可纳入研究（7/4423）。异质性较大，无法进行荟萃分析。使用疾病特异性测量方法的研究发现，与正常结果相比，可能会出现持续长达3年的心理困扰；困扰程度与评估的侵入性程度有关。3年后的相对风险分别为：进一步乳腺钼靶检查1.28（95%可信区间0.82至2.00），细针穿刺1.80（95%可信区间1.17至2.77），活检2.07（95%可信区间1.22至3.52），早期召回1.82（95%可信区间1.22至2.72）。使用焦虑和抑郁通用测量方法的研究发现，筛查后3个月内没有此类影响。有证据表明，与乳腺钼靶检查结果正常的女性相比，乳腺钼靶筛查假阳性的女性再次参加常规筛查的可能性降低，相对风险为0.97（95%可信区间0.96至0.98）。
乳腺钼靶筛查假阳性结果可导致长达3年的乳腺癌特异性困扰。困扰程度与评估的侵入性有关。乳腺钼靶筛查假阳性的女性比结果正常的女性返回进行常规评估的可能性更小。
