False-positive results in mammographic screening for breast cancer in Europe: a literature review and survey of service screening programmes

TY - JOUR

T1 - False-positive results in mammographic screening for breast cancer in Europe

T2 - a literature review and survey of service screening programmes

AU - Hofvind, Solveig

AU - Ponti, Antonio

AU - Patnick, Julietta

AU - Ascunce, Nieves

AU - Njor, Sisse Helle

AU - Broeders, Mireille

AU - Giordano, Livia

AU - Frigerio, Alfonso

AU - Törnberg, Sven

AU - Van Hal, G

AU - Martens, P

AU - Májek, O

AU - Danes, J

AU - von Euler-Chelpin, M

AU - Aasmaa, A

AU - Anttila, A

AU - Becker, N

AU - Péntek, Z

AU - Budai, A

AU - Mádai, S

AU - Fitzpatrick, P

AU - Mooney, T

AU - Zappa, M

AU - Ventura, L

AU - Scharpantgen, A

AU - Hofvind, S

AU - Seroczynski, P

AU - Morais, A

AU - Rodrigues, V

AU - Bento, M J

AU - Gomes de Carvalho, J

AU - Natal, C

AU - Prieto, M

AU - Sánchez-Contador Escudero, C

AU - Zubizarreta Alberti, R

AU - Fernández Llanes, S B

AU - Ascunce, N

AU - Ederra Sanza, M

AU - Sarriugarte Irigoien, G

AU - Salas Trejo, D

AU - Ibáñez Cabanell, J

AU - Wiege, M

AU - Ohlsson, G

AU - Törnberg, S

AU - Korzeniewska, M

AU - de Wolf, C

AU - Fracheboud, J

AU - Patnick, J

AU - Lancucki, L

AU - Ducarroz, S

AU - EUNICE Project and Euroscreen Working Groups

PY - 2012/9

Y1 - 2012/9

N2 - Objective To estimate the cumulative risk of a false-positive screening result in European mammographic screening programmes, and examine the rates and procedures of further assessment. Methods A literature review was conducted to identify studies of the cumulative risk of a false-positive result in European screening programmes (390,000 women). We then examined aggregate data, cross-sectional information about further assessment procedures among women with positive results in 20 mammographic screening programmes from 17 countries (1.7 million initial screens, 5.9 million subsequent screens), collected by the European Network for Information on Cancer project (EUNICE). Results The estimated cumulative risk of a false-positive screening result in women aged 50-69 undergoing 10 biennial screening tests varied from 8% to 21% in the three studies examined (pooled estimate 19.7%). The cumulative risk of an invasive procedure with benign outcome ranged from 1.8% to 6.3% (pooled estimate 2.9%). The risk of undergoing surgical intervention with benign outcome was 0.9% (one study only). From the EUNICE project, the proportions of all screening examinations in the programmes resulting in needle biopsy were 2.2% and 1.1% for initial and subsequent screens, respectively, though the rates differed between countries; the corresponding rates of surgical interventions among women without breast cancer were 0.19% and 0.07%. Conclusion The specific investigative procedures following a recall should be considered when examining the cumulative risk of a false-positive screening result. Most women with a positive screening test undergo a non-invasive assessment procedure. Only a small proportion of recalled women undergo needle biopsy, and even fewer undergo surgical intervention.

AB - Objective To estimate the cumulative risk of a false-positive screening result in European mammographic screening programmes, and examine the rates and procedures of further assessment. Methods A literature review was conducted to identify studies of the cumulative risk of a false-positive result in European screening programmes (390,000 women). We then examined aggregate data, cross-sectional information about further assessment procedures among women with positive results in 20 mammographic screening programmes from 17 countries (1.7 million initial screens, 5.9 million subsequent screens), collected by the European Network for Information on Cancer project (EUNICE). Results The estimated cumulative risk of a false-positive screening result in women aged 50-69 undergoing 10 biennial screening tests varied from 8% to 21% in the three studies examined (pooled estimate 19.7%). The cumulative risk of an invasive procedure with benign outcome ranged from 1.8% to 6.3% (pooled estimate 2.9%). The risk of undergoing surgical intervention with benign outcome was 0.9% (one study only). From the EUNICE project, the proportions of all screening examinations in the programmes resulting in needle biopsy were 2.2% and 1.1% for initial and subsequent screens, respectively, though the rates differed between countries; the corresponding rates of surgical interventions among women without breast cancer were 0.19% and 0.07%. Conclusion The specific investigative procedures following a recall should be considered when examining the cumulative risk of a false-positive screening result. Most women with a positive screening test undergo a non-invasive assessment procedure. Only a small proportion of recalled women undergo needle biopsy, and even fewer undergo surgical intervention.

KW - Breast Neoplasms

KW - False Positive Reactions

KW - Female

KW - Humans

KW - Mammography

KW - Mass Screening

U2 - 10.1258/jms.2012.012083

DO - 10.1258/jms.2012.012083

M3 - Journal article

C2 - 22972811

SN - 0969-1413

VL - 19 Suppl 1

SP - 57

EP - 66

JO - Journal of Medical Screening

JF - Journal of Medical Screening

ER -