Scaf-Klomp W, Sanderman R, van de Wiel H B, Otter R, van den Heuvel W J
Northern Centre for Health Care Research, University of Groningen, The Netherlands.
J Epidemiol Community Health. 1997 Dec;51(6):705-10. doi: 10.1136/jech.51.6.705.
To assess the psychological impact of mammographic screening on women with non-malignant outcomes after attending the Netherlands' National Breast Cancer Screening Programme.
During one year all women with false positive test results (95) in a screening area were invited for the study. Each false positive was matched with two women with normal mammograms with respect to age and municipality. A random reference group of 400 was drawn from the female population in an area not yet included in the screening programme. Experiences with screening and psychological status of subjects were assessed 8-10 weeks after screening (T1) and again after six months (T2), by interviews as well as questionnaires. References completed two questionnaires with a six months' interval.
74 (78%) women with false positive outcomes and 113 (59%) women with negative outcomes participated at T1, of these 65 (88%) and 105 (93%) at T2, respectively; 238 references returned questionnaires at T1 (59%), of these 143 (60%) at T2.
At 8-10 weeks after the screening, the women who received false positive test results scored higher on most of the variables indicating psychological disfunctioning than women with normal mammograms, but did not notably differ on the same variables from the non-screened reference group. Women with normal mammograms had the lowest scores on all the variables in the study at both assessments. The same situation was observed six months later. Although 61% of the women who received false positive mammograms reported that they had experienced the "false alarm" as a stressful event, this experience had apparently no adverse effects on their psychological functioning, as assessed 8-10 weeks after screening.
Overall, breast screening is not likely to generate adverse psychological effects in "healthy" women, even if the outcome is false positive. Differences in psychological functioning between false positives and negatives are more likely ascribable to feelings of relief in the negative group than to raised anxiety and distress in the false positive group.
评估荷兰国家乳腺癌筛查计划中，乳房X光筛查对非恶性检查结果女性的心理影响。
在一年时间里，邀请了筛查区域内所有检测结果为假阳性的95名女性参与研究。每个假阳性女性在年龄和所在城市方面与两名乳房X光检查正常的女性进行匹配。从尚未纳入筛查计划地区的女性人群中随机抽取400人作为参照组。通过访谈和问卷调查，在筛查后8 - 10周（T1）以及六个月后（T2）评估受试者的筛查经历和心理状态。参照组每隔六个月填写两份问卷。
74名（78%）检测结果为假阳性的女性和113名（59%）检测结果为阴性的女性在T1时参与研究，其中分别有65名（88%）和105名（93%）在T2时参与；238名参照组人员在T1时返回问卷（59%），其中143名（60%）在T2时返回问卷。
在筛查后8 - 10周，检测结果为假阳性的女性在大多数表明心理功能失调的变量上得分高于乳房X光检查正常的女性，但在相同变量上与未接受筛查的参照组没有显著差异。在两项评估中，乳房X光检查正常的女性在研究中的所有变量上得分最低。六个月后观察到相同情况。尽管61%检测结果为假阳性的女性报告称她们将“假警报”视为压力事件，但在筛查后8 - 10周评估时，这种经历显然对她们的心理功能没有不良影响。
总体而言，乳房筛查不太可能对“健康”女性产生不良心理影响，即使结果为假阳性。假阳性和阴性女性在心理功能上的差异更可能归因于阴性组的宽慰感，而非假阳性组焦虑和痛苦情绪的增加。
