False-Positive Cancer Screening Results May Increase Likelihood of Future Screenings

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False-positive results from cancer screenings are a relatively common occurrence.
False-positive results from cancer screenings are a relatively common occurrence.

False-positive results in cancer screenings may lead to greater patient willingness to be up-to-date and undergo more future screenings, according to a study published in Cancer.

False-positive results from cancer screenings are relatively common; approximately 50% of women and 10% to 12% of men receive a false-positive outcome for mammography and prostate-specific antigen (PSA) tests, respectively, and 23% of patients have a negative result from confirmatory colonoscopies after a false-positive fecal occult blood test (FOBT). With the high prevalence of false-positive results, the implications in regards to patient likelihood to undergo future screenings requires further investigation.

For this logistic regression analysis, researchers accessed electronic medical records of 92,405 patients between the ages of 50 and 75 across 450,484 person years who underwent breast, prostate, or colorectal screening tests from 2006 to 2015, and analyzed how many false-positive results were reported. The authors also took into consideration covariates such as prior screening history, clinical information, demographics, and comorbidities, to find associations between false-positive screening test results and participation in future cancer screenings.

Nearly 30% of women and 3% of men received previous false-positive mammography or PSA-screening results, respectively, and 2% had prior colorectal cancer false-positive results.

Results showed that women who had false-positive findings on mammography were more likely to be up-to-date with screenings for both breast and colorectal cancer. Contrastingly, women who received a false-positive result in fecal occult blood tests were less likely to undergo future breast cancer screenings.

Men who had false-positive prostate screenings were more likely to be up-to-date with colorectal screenings.

Both adjusted and unadjusted analysis models revealed that previous false-positive breast or prostate cancer tests were strongly associated with being up to date with screenings.

The authors concluded that “future research should seek to confirm the current study results, explore reasons for the possible long-lasting influence of false-positive findings, consider whether providers should be alerted to monitor cancer screenings after a false-positive result (eg, mammography after a false-positive FOBT), and address ways for health care providers to minimize negative impact on patients.”

Reference

Taksler GB, Keating NL, Rothberg MB. Implications of false-positive results for future cancer screenings[published online April 23, 2018]. Cancer. doi: 10.1002/cncr.31271
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