Abstract 2585: Mammography screening adherence after a false positive test result
Authors: Marsh Mary W. , Benefield Thad , Greenwood-Hickman Mikael Anne , Jones Laura , Meyer Anne Marie , Henderson Louise M. 
Published: July 2016

Mammography screening has been shown to be effective in reducing breast cancer mortality, but it also generates a significant number of false positive test results. We sought to compare mammography guideline adherence after a false positive versus a true negative screening mammogram, looking for differences by age, race, family history of breast cancer, time since prior mammogram, and mammographic breast density.

Linked data from the Carolina Mammography Registry and privately insured beneficiaries in North Carolina from 2004-2009 were used to evaluate screening adherence among 14,071 women aged 40 to 64 years who had a screening mammogram with a false positive or true negative result. Women were classified as being adherent to mammography screening guidelines if they obtained a screening mammogram in the 9 to 24 months after their index screening mammogram. We compared characteristics of women with a false positive versus true negative screening mammogram result using the chi-square test. To determine if the index mammogram result (false positive or true negative) was predictive of subsequent adherence to screening mammography, we employed a random effects logistic regression, adjusting for age, race, menopausal status, first-degree family history of breast cancer, personal history of breast biopsy, mammographic breast density, time since prior mammogram, and comorbidities. We tested for interactions of these characteristics with the index mammogram result using backwards selection and considered interaction terms with p-values &lt;0.05 significant.

Of the 14,071 screening mammograms 92.1% were true negative and 7.9% were false positive. Women with a false positive were more likely to be younger, pre-menopausal, have dense breasts, and have had their last mammogram 3 or more years ago. Women with a false positive result were also less adherent to screening mammography in the subsequent 24 months compared to women with a true negative result (81.8% vs. 84.2%, p-value = 0.031). Women with a prior mammogram within 1 to 3 years and a false positive result were less likely to be adherent (adjusted odds ratio (OR) = 0.77, 95% CI: 0.64-0.94) than women with a true negative result. In contrast, for women who had a prior mammogram 3 or more years ago, those with a false positive result were more likely to be adherent (adjusted OR = 1.80, 95% CI: 1.13-2.87) than those with a true negative result.

Our findings suggest that a false positive screening mammogram may reduce the likelihood of a woman returning for her next planned screening mammogram if her prior mammogram was within 1 to 3 years, but it may increase her likelihood to return if her prior mammogram was more than 3 years prior. Future studies should expand beyond observational data to incorporate qualitative interview data with women to better understand the psychological distress experienced after a false positive screening mammogram result.

Citation Format: Mary W. Marsh, Thad Benefield, Mikael Anne Greenwood-Hickman, Laura Jones, Anne Marie Meyer, Louise M. Henderson. Mammography screening adherence after a false positive test result. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 2585.