Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, School of Medicine, Davis, California, and Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, Washington (D.L.M.).
Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, Washington (L.A., E.J.A.B.).
Ann Intern Med. 2024 Oct;177(10):1297-1307. doi: 10.7326/M24-0123. Epub 2024 Sep 3.
False-positive results on screening mammography may affect women's willingness to return for future screening.
To evaluate the association between screening mammography results and the probability of subsequent screening.
Cohort study.
177 facilities participating in the Breast Cancer Surveillance Consortium (BCSC).
3 529 825 screening mammograms (3 184 482 true negatives and 345 343 false positives) performed from 2005 to 2017 among 1 053 672 women aged 40 to 73 years without a breast cancer diagnosis.
Mammography results (true-negative result or false-positive recall with a recommendation for immediate additional imaging only, short-interval follow-up, or biopsy) from 1 or 2 screening mammograms. Absolute differences in the probability of returning for screening within 9 to 30 months of false-positive versus true-negative screening results were estimated, adjusting for race, ethnicity, age, time since last mammogram, BCSC registry, and clustering within women and facilities.
Women were more likely to return after a true-negative result (76.9% [95% CI, 75.1% to 78.6%]) than after a false-positive recall for additional imaging only (adjusted absolute difference, -1.9 percentage points [CI, -3.1 to -0.7 percentage points]), short-interval follow-up (-15.9 percentage points [CI, -19.7 to -12.0 percentage points]), or biopsy (-10.0 percentage points [CI, -14.2 to -5.9 percentage points]). Asian and Hispanic/Latinx women had the largest decreases in the probability of returning after a false positive with a recommendation for short-interval follow-up (-20 to -25 percentage points) or biopsy (-13 to -14 percentage points) versus a true negative. Among women with 2 screening mammograms within 5 years, a false-positive result on the second was associated with a decreased probability of returning for a third regardless of the first screening result.
Women could receive care at non-BCSC facilities.
Women were less likely to return to screening after false-positive mammography results, especially with recommendations for short-interval follow-up or biopsy, raising concerns about continued participation in routine screening among these women at increased breast cancer risk.
National Cancer Institute.
筛查性乳房 X 光检查的假阳性结果可能会影响女性对未来筛查的意愿。
评估筛查性乳房 X 光检查结果与后续筛查概率之间的关联。
队列研究。
177 个参与乳腺癌监测联合会（BCSC）的设施。
2005 年至 2017 年间，1053672 名年龄在 40 至 73 岁之间、无乳腺癌诊断的女性接受了 3529825 次筛查性乳房 X 光检查（3184482 次真阴性和 345343 次假阳性）。
1 次或 2 次筛查性乳房 X 光检查的乳房 X 光检查结果（真阴性结果或假阳性召回，仅建议立即进行额外影像学检查、短期随访或活检）。在调整了种族、族裔、年龄、上次乳房 X 光检查时间、BCSC 登记处以及女性和设施内的聚类因素后，估计了假阳性与真阴性筛查结果相比，在 9 至 30 个月内返回筛查的概率的绝对差异。
与仅进行额外影像学检查（调整后的绝对差异，-1.9 个百分点[CI，-3.1 至-0.7 个百分点]）、短期随访（-15.9 个百分点[CI，-19.7 至-12.0 个百分点]）或活检（-10.0 个百分点[CI，-14.2 至-5.9 个百分点]）相比，女性更有可能在真阴性结果后返回（76.9%[95%CI，75.1%至 78.6%]）。与真阴性相比，亚洲和西班牙裔/拉丁裔女性在因短间隔随访（-20%至-25%）或活检（-13%至-14%）而推荐进行假阳性检查后，返回的概率大幅下降。在 5 年内接受了 2 次筛查性乳房 X 光检查的女性中，无论第一次筛查结果如何，第二次假阳性结果与第三次返回进行筛查的可能性降低有关。
女性可能在 BCSC 以外的机构接受治疗。
女性在出现假阳性乳房 X 光检查结果后，不太可能返回进行筛查，尤其是在建议进行短期随访或活检的情况下，这引起了人们对这些处于增加乳腺癌风险的女性持续参与常规筛查的担忧。
美国国家癌症研究所。
