False-positive mammograms have negative effects
NEW YORK (Reuters Health) - Women who are told their mammogram shows a possible cancer that turns out to be a false alarm are likely to suffer anxiety for a long time, according to a new study.
"U.S. women who get a false-positive are more likely to come back for their next routine screen," lead author Dr. Noel T. Brewer, of the University of North Carolina at Chapel Hill, told Reuters Health. "On the face of it, this seems like a good thing, but scaring women for long periods of time to get them to screen again does not seem like the best approach."
Brewer and colleagues conducted an analysis of 23 studies showing the effects of false-positive results of mammography on women. The studies involved a total of 313,967 women aged 40 and older.
Women who were given a false-positive mammogram result performed breast self-exams more frequently than other women, the investigators report in the Annals of Internal Medicine.
American women who had received false-positive results were more likely to return for routine screening, Canadian women were less likely, and European women were statistically uninfluenced by a false-positive result in their adherence to follow-up exams.
The Chapel Hill team found higher levels of anxiety and distress among women who received false-positive mammograms. "These effects last for many years," Brewer noted. "Although their anxiety is not generalized or at the level that requires medical intervention, it is an unnecessary consequence of poor medical care."
False-positives are "harming women's well-being," Brewer said. "The U.S. needs to substantially improve its mammography screening practices."
Drs. Joann G. Elmore and John H. Choe of the University of Washington, Seattle, comment in an accompanying editorial that breast cancer screening decisions are a "complex knot of social, political and economic forces."
"No simple screening recommendation applies to all women in their forties," they note. Listening to patients and good communication about the limitations and benefits of these "imperfect tests" is necessary.
SOURCE: Annals of Internal Medicine, April 3, 2007.