Long-term psychosocial consequences of false-positive screening mammography: a cohort study with follow-up of 12–14 years in Denmark

Abstract

ObjectiveTo compare the long-term psychosocial consequences of mammography screening among women with breast cancer, normal results and false-positive results.DesignA matched cohort study with follow-up of 12–14 years.SettingDenmark from 2004 to 2019.Participants1170 women who participated in the Danish mammography screening programme in 2004–2005.InterventionMammography screening for women aged 50–69 years.Outcome measuresWe assessed the psychosocial consequences with the Consequences Of Screening–Breast Cancer, a condition-specific questionnaire that is psychometrically validated and encompasses 14 psychosocial dimensions.ResultsAcross all 14 psychosocial outcomes, women with false-positive results averagely reported higher psychosocial consequences compared with women with normal findings. Mean differences were statistically insignificant except for the existential values scale: 0.61 (95% CI (0.15 to 1.06), p=0.009). Additionally, women with false-positive results and women diagnosed with breast cancer were affected in a dose–response manner, where women diagnosed with breast cancer were more affected than women with false-positive results.ConclusionOur study suggests that a false-positive mammogram is associated with increased psychosocial consequences 12–14 years after the screening. This study adds to the harms of mammography screening. The findings should be used to inform decision-making among the invited women and political and governmental decisions about mammography screening programmes.

Emotion constructs and outcome measures following false positive breast screening test results: A systematic review of reporting clarity and selection rationale

“…There is ongoing need to evaluate the psychological harms associated with screening, as is happening in the latest research, 43 and given recent advancements in novel cancer testing, diagnostics and technology that may one day be routinely implemented. 44,45…”

“…There is ongoing need to evaluate the psychological harms associated with screening, as is happening in the latest research, 43 and given recent advancements in novel cancer testing, diagnostics and technology that may one day be routinely implemented 44,45 . This goes beyond outcomes associated with false positive screening test results and includes true positive, false negative and abnormal test results, as well as other changes in cancer screening and early detection practices.…”

Validation of the psychosocial consequences of screening in lung cancer questionnaire in the international lung screen trial Australian cohort

“…There have been studies demonstrating negative psychosocial impacts in other cancer screening programs with FP results. In breast cancer screening, more negative psychosocial consequences were noted in women who received FP results, with one study reporting persistent psychosocial consequences 12 to 14years after screening in women with FP mammograms [ 10 , 24 ]. In colorectal cancer screening programs, one Danish study reported short-term and long-term psychosocial consequences of receiving a FP or diagnosis of polyps compared to a negative screening result using a condition-specific questionnaire [ 25 ].…”