Increased risk of breast cancer in women with false-positive test: the role of misclassification

TY - JOUR

T1 - Increased risk of breast cancer in women with false-positive test

T2 - the role of misclassification

AU - von Euler-Chelpin, My

AU - Kuchiki, Megumi

AU - Vejborg, Ilse

N1 - Copyright © 2014 Elsevier Ltd. All rights reserved.

PY - 2014/10/1

Y1 - 2014/10/1

N2 - INTRODUCTION: Studies have shown that women with a false-positive result from mammography screening have an excess risk for breast cancer compared with women who only have negative results. We aimed to assess the excess risk of cancer after a false-positive result excluding cases of misclassification, i.e. women who were actually false-negatives instead of false-positives.METHOD: We used data from the Copenhagen Mammography Screening Programme, Denmark. The study population was the 295 women, out of 4743 recalled women from a total of 58,003 participants, with a false-positive test during the screening period 1991-2005 and who later developed breast cancer. Cancers that developed in the same location as the finding that initially caused the recall was studied in-depth in order to establish whether there had been misclassification.RESULTS: Seventy-two cases were found to be misclassified. When the women with misclassified tests had been excluded, there was an excess risk of breast cancer of 27% (RR=1.27, 95% confidence interval (CI), 1.11-1.46) among the women with a false-positive test compared to women with only negative tests. Women with a false-positive test determined at assessment had an excess risk of 27%, while false-positives determined at surgery had an excess risk of 30%.CONCLUSIONS: The results indicate that the increased risk is not explained only by misclassification. The excess risk remains for false-positives determined at assessment as well as at surgery, which favours some biological susceptibility. Further research into the true excess risk of false positives is warranted.

AB - INTRODUCTION: Studies have shown that women with a false-positive result from mammography screening have an excess risk for breast cancer compared with women who only have negative results. We aimed to assess the excess risk of cancer after a false-positive result excluding cases of misclassification, i.e. women who were actually false-negatives instead of false-positives.METHOD: We used data from the Copenhagen Mammography Screening Programme, Denmark. The study population was the 295 women, out of 4743 recalled women from a total of 58,003 participants, with a false-positive test during the screening period 1991-2005 and who later developed breast cancer. Cancers that developed in the same location as the finding that initially caused the recall was studied in-depth in order to establish whether there had been misclassification.RESULTS: Seventy-two cases were found to be misclassified. When the women with misclassified tests had been excluded, there was an excess risk of breast cancer of 27% (RR=1.27, 95% confidence interval (CI), 1.11-1.46) among the women with a false-positive test compared to women with only negative tests. Women with a false-positive test determined at assessment had an excess risk of 27%, while false-positives determined at surgery had an excess risk of 30%.CONCLUSIONS: The results indicate that the increased risk is not explained only by misclassification. The excess risk remains for false-positives determined at assessment as well as at surgery, which favours some biological susceptibility. Further research into the true excess risk of false positives is warranted.

U2 - 10.1016/j.canep.2014.06.006

DO - 10.1016/j.canep.2014.06.006

M3 - Journal article

C2 - 25035157

SN - 1877-7821

VL - 38

SP - 619

EP - 622

JO - Cancer Epidemiology

JF - Cancer Epidemiology

IS - 5

ER -