Effect of false-positive mammograms on interval breast cancer screening in a health maintenance organization
Effect of false-positive mammograms on interval breast cancer screening in a health maintenance organization
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DOI：
10.7326/0003-4819-131-1-199907060-00002
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发表时间：
1999-07-06
影响因子：
39.2
通讯作者：
Elmore, JG
中科院分区：
文献类型：
--
作者：
Burman, ML;Taplin, SH;Elmore, JG
背景：尽管乳腺癌筛查对死亡率有好处，但并非所有女性都定期接受乳房X光检查。年龄、社会经济地位和医生建议等因素与更多地使用筛查相关。然而，我们不知道是否有一个异常的乳房X光检查影响未来的筛查。目的：为了检查假阳性乳房X光检查对坚持下一个推荐的筛查乳房X光检查的影响。设计：前瞻性队列研究。设置：在华盛顿州的健康维护组织团体健康合作社的乳腺癌筛查计划。患者：5059例40岁或以上、无乳腺癌或乳腺手术史、假阳性（n = 813）或真阴性的女性（n = 4246）1990年8月1日至1992年7月31日期间的指数筛查乳房X线照片。筛查率和比值比推荐的间隔筛查后42个月的指数mammoglyca.Results：调整后的差异，年龄，以前使用的乳房X线摄影，乳腺癌家族史;外源性激素的使用;初潮年龄、首次分娩年龄和绝经年龄，假阳性指数乳房X线照片的女性比真阴性指数乳房X线照片的女性更有可能获得下一次推荐的筛查乳房X线照片（比值比，1.21 [95% CI，1.01至1.45]）。在之前未接受过乳房X光检查的女性中，乳房X光检查假阳性与在下一个推荐间隔内坚持筛查的可能性之间的关系最强（比值比，1.66 [CI，1.26至2.17]）。结论：乳房X光检查假阳性不会对下一个推荐间隔内的筛查行为产生不利影响。乳房X光检查呈假阳性的妇女，特别是那些以前没有乳房X光检查的妇女，更有可能返回进行下一次预定的筛查。
Background: Despite the mortality benefits of breast cancer screening, not all women receive regular mammography. Such factors as age, socioeconomic status, and physician recommendation have been associated with greater use of screening. However, we do not know whether having an abnormal mammogram affects future screening.Objective: To examine the effect of a false-positive mammogram on adherence to the next recommended screening mammogram.Design: Prospective cohort study.Setting: The breast cancer screening program at Group Health Cooperative, a health maintenance organization in Washington state.Patients: 5059 women 40 years of age or older with no history of breast cancer or breast surgery who had false-positive (n = 813) or true-negative (n = 4246) index screening mammograms between 1 August 1990 and 31 July 1992.Measurements: Screening rates and odds ratios for recommended interval screening up to 42 months after the index mammogram.Results: After adjustment for differences in age; previous use of mammography; family history of breast cancer; exogenous hormone use; and age at menarche, first childbirth, and menopause, women with false-positive index mammograms were more likely than those with true-negative index mammograms to obtain their next recommended screening mammogram (odds ratio, 1.21 [95% CI, 1.01 to 1.45]). The relation between a false-positive mammogram and the likelihood of adherence to screening in the next recommended interval was strongest among women who had not previously undergone mammography (odds ratio, 1.66 [CI, 1.26 to 2.17]).Conclusions: Having a false-positive mammogram did not adversely affect screening behavior in the next recommended interval. Women with false-positive mammograms, especially those without previous mammography, were more likely to return for the next scheduled screening.