Abstract
Background
In the United States, approximately 10.7% of all screening mammograms lead to a false-positive result, but the overall impact of false-positives on psychological well-being is poorly understood.
Materials and methods
Data were analyzed from the 2000 U.S. National Health Interview Survey (NHIS), the most recent national survey that included a cancer control module. Study subjects were 9,755 women who ever had a mammogram, of which 1,450 had experienced a false-positive result. Psychological distress was assessed using the validated K6 questionnaire and logistic regression was used to discern any association with previous false-positive mammograms.
Results
In a multivariate analysis, women who had indicated a previous false-positive mammogram were more likely to report feeling sad (OR = 1.18, 95% CI, 1.03–1.35), restless (OR = 1.23, 95% CI, 1.08–1.40), worthless (OR = 1.27, 95% CI, 1.04–1.54), and finding that everything was an effort (OR = 1.27, 95% CI, 1.10–1.47). These women were also more likely to have seen a mental health professional in the 12 months preceding the survey (OR = 1.28, 95% CI, 1.03–1.58) and had a higher composite score on all items of the K6 scale (P < 0.0001), a reflection of increased psychological distress. Analyses by age and race revealed that, among women who had experienced false-positives, younger women were more likely to feel that everything was an effort, and blacks were more likely to feel restless.
Conclusion
In a random sampling of the U.S. population, women who had previously experienced false-positive mammograms were more likely to report symptoms of anxiety and depression.
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References
Ghafoor A, Jemal A, Ward E et al (2003) Trends in breast cancer by race and ethnicity. CA Cancer J Clin 53(6):342–355
Jatoi I. (1999) Breast cancer screening. Am J Surg 177:518–524
Fletcher SW, Elmore JG (2003) Mammographic screening for breast cancer. N Engl J Med 348:1672–1680
Elmore JG, Barton MB, Moceri VM, Polk S, Arena PJ, Fletcher SW (1998) Ten-year risk of false-positive screening mammograms and clinical breast examinations. N Engl J␣Med 338:1089–1096
Gram IT, Slenker SE (1992) Cancer anxiety and attitudes toward mammography among screening attenders, nonattenders, and women never invited. Am J Public Health 82:249–251
Lerman C, Trock B, Rimer BK et al (1991) Psychological and behavioral implications of abnormal mammograms. Ann Intern Med 114:657–661
Lowe JB, Balanda KP, Del Mar C, Hawes E (1999) Psychological distress in women with abnormal findings in mass mammography screening. Cancer 85:1114–1118
Brett J, Bankhead C, Henderson B, Watson E, Austoker J␣(2005) The psychological impact of mammographic screening. Syst Rev Psycho-Oncol 14(11):917–938
Asbetz P, Aro AR, Sutton S (2003) Experience with breast cancer pre-screening perceived susceptibility and the psychological impact of screening. Psycho-Oncology 12:305–318
Dolan NC, Feinglass J, Priyanath A et al (2001) Measuring satisfaction with mammography results reporting. J Gen Intern Med 16:157–162
National Center for Health Statistics. NCHS Research Data Center. Available at http://www.cdc.gov/nchs/r&d/rdc.html
Kessler RC, Barker PR, Colpe LJ et al (2003) Screening for serious mental illness in the general population. Arch Gen Psychiatr 60:184–189
Massey JT, Moore TF, Parsons VL, Tadros W (1989) Design and estimation of the National Health Interview Survey, 1985–1994. National Center for Health Statistics. Vital Health Stat 2(110)
Fontaine KR, Heo M, Allison DB (2001) Body weight and cancer screening among women. J Womens Health Gend Based Med 10:463–470
American College of Radiology. (1998) Illustrated Breast Imaging Reporting and Data System (BI-RADS), 3rd edn. American College of Radiology, Reston, VA
Fletcher SW, Elmore SG (2005) False positive mammograms—can the USA learn from Europe? Lancet 365(9453):7–8
Rimer BK, Bluman LG (1997) The psychosocial consequences of mammography. J Natl Cancer Inst Monogr 22:131–138
Gilbert FJ, Cordiner CM, Affleck IR et al (1998) Breast screening: the psychological sequelae of false-positive recall in women with and without a family history of breast cancer. Eur J Cancer 34:2010–2014
Cockburn J, Staples M, Hurley SF, De Luise T (1994) Psychological consequences of screening mammography. J Med Screen 1:7–12
Walker LG, Cordiner CM, Gilbert FJ et al (1994) How distressing is attendance for routine breast screening? Psycho-Oncology 3:299–304
Sutton S, Saidi G, Bickler G, Hunter J (1995) Does routine screening for breast cancer raise anxiety? Results from a three-wave prospective study in England. J Epidemiol Commun Health 49:413–418
Olsson P, Armelius K, Nordahl G et al (1999) Women with false positive screening mammograms: how do they cope? J␣Med Screen 6:89–93
Aro AR, Absetz SP, van Elderen TM et al (2000) False-positive findings in mammography screening induces short-term distress—breast cancer-specific concern prevails longer. Eur J Cancer 36(9):1089–1097
Lampic C, Thurfjell E, Bergh J, Sjoden PO (2001) Short- and long-term anxiety and depression in women recalled after breast cancer screening. Eur J Cancer 37(4):463–469
Scalf-Klomp W, Sanderman R, van de Wiel HB et al (1997) Distressed or relieved? Psychological side effects of breast cancer screening in The Netherlands. J Epidemiol Com Health 51:705–710
Chen CC, David A, Thampson K et al (2002) Coping strategies and psychiatric morbidity in women attending breast assessments clinics. J Psychosom Res 40:265–270
Meystre-Agustoni G, Paccaud F, Jeannin A, Dubois-Arber R (2001) Anxiety in a cohort of Swiss women participating in a mammographic screening programme. J Med Screen 8:213–219
Haas J, Kaplan C, McMillan A, Esserman LJ (2001) Does timely assessment affect the anxiety associated with an abnormal mammogram result? J Women Health Gen – B Med 10(6):599–605
Lindfors KK, O’Connor J, Parker RA (2001) False-positive screening mammograms: effect of immedicate versus later work-up on patient stress. Radiology 218:247–253
Loken K, Steine S, Laerum E (1998) Mammography: influence of departmental practice and women’s characteristics on patient satisfaction: comparison of six departments in Norway. Quality in Health Care 7:136–141
Barton MB, Moore S, Polk S et al (2001) Increased patient concern after false-positive mammograms: clinician documentation and subsequent ambulatory visits. J Gen Intern Med 163(3):150–166
Barton MB, Morley DS, Moore S et al (2004) Decreasing women’s anxieties after abnormal mammograms: a controlled trial. J Natl Cancer Inst 96(7):529–538
Burman ML, Taplin SH, Herta DF, Elmore JG (1999) Effect of false-positive mammograms on interval breast cancer screening in a health maintenance organization. Ann Intern Med 131:1–6
Pisano ED, Earp JA, Schell M, Vokaty K, Denham A (1998) Screening behavior of women after a false-positive mammogram. Radiology 208:245–249
Berry DA, Cronin KA, Plevritis SK et al (2005) Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med 353:1784–1792
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The opinions and assertions contained in this article represent the private views of the authors and should not be construed as reflecting the official views of the U.S. Departments of the Army, Navy, or Defense, or the Agency for Healthcare Research and Quality, or the Department of Health and Human Services
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Jatoi, I., Zhu, K., Shah, M. et al. Psychological Distress in U.S. Women Who Have Experienced False-Positive Mammograms. Breast Cancer Res Treat 100, 191–200 (2006). https://doi.org/10.1007/s10549-006-9236-6
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DOI: https://doi.org/10.1007/s10549-006-9236-6