Risk of breast cancer after false‐positive results in mammographic screening. (25th February 2016)

• Record Type: Journal Article
• Authors: Román, Marta; Castells, Xavier; Hofvind, Solveig; von Euler‐Chelpin, My
• Is Part Of: Cancer medicine. Volume 5:Number 6(2016:Jun.)
• Page Start: 1298
• Page End: 1306
• Publication Date: 2016-02-25
• Subjects: Breast neoplasms -- false‐positive reactions -- mammography -- mass screening -- risk factors; 616.994005
• DOI: 10.1002/cam4.646
• Languages: English
• ISSNs: 2045-7634

Abstract

Abstract : In this joint analysis based on individual level data from the population‐based screening programs in Copenhagen and Funen in Denmark, Norway, and Spain, we estimated that women with false‐positive screening results had a twofold risk of a later screen detected breast cancer compared to women with negative screening results. The increased risk should be considered when exploring the possibilities of stratified screening strategies. Abstract: Women with false‐positive results are commonly referred back to routine screening. Questions remain regarding their long‐term outcome of breast cancer. We assessed the risk of screen‐detected breast cancer in women with false‐positive results. We conducted a joint analysis using individual level data from the population‐based screening programs in Copenhagen and Funen in Denmark, Norway, and Spain. Overall, 150, 383 screened women from Denmark (1991–2008), 612, 138 from Norway (1996–2010), and 1, 172, 572 from Spain (1990–2006) were included. Poisson regression was used to estimate the relative risk (RR) of screen‐detected cancer for women with false‐positive versus negative results. We analyzed information from 1, 935, 093 women 50–69 years who underwent 6, 094, 515 screening exams. During an average 5.8 years of follow‐up, 230, 609 (11.9%) women received a false‐positive result and 27, 849 (1.4%) were diagnosed with screen‐detected cancer. The adjusted RR of screen‐detected cancer after a false‐positive result was 2.01 (95% CI: 1.93–2.09). Women who tested false‐positive at first screen had a RR of 1.86 (95% CI: 1.77–1.96), whereas those who tested false‐positive at third screening had a RR of 2.42 (95% CI: 2.21–2.64). The RR of breast cancer at the screening test after the false‐positive result was 3.95 (95% CI: 3.71–4.21), whereas it decreased to 1.25 (95% CI: 1.17–1.34) three or more screens after the false‐positive result. Women with false‐positive results had a twofold risk of screen‐detected breast cancer compared to women with negative tests. The risk remained significantly higher three or more screens after the false‐positive result. The increased risk should be considered when discussing stratified screening strategies.