Women who are recalled for further investigation for breast screening: psychological consequences 3 years after recall and factors affecting re-attendance
Women who are recalled for further investigation for breast screening: psychological consequences 3 years after recall and factors affecting re-attendance
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DOI：
10.1093/pubmed/23.4.292
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发表时间：
2001-12-01
期刊：
影响因子：
--
通讯作者：
Austoker, J
中科院分区：
文献类型：
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作者：
Brett, J;Austoker, J
背景 1995-1996 年开始了一项研究，调查“假阳性”女性的经历，即在常规乳房筛查后接受进一步调查并获得明确的最终结果的女性。研究发现，与初次基础乳房 X 光检查后获得明确结果的女性相比，这些女性在评估后 1 个月、5 个月和 11 个月时经历的不良心理后果明显更大。本研究在 3 年后（35 个月大）对这些“假阳性”女性进行跟踪调查，之后她们将被邀请进行下一次常规乳房筛查。它调查了先前的乳腺筛查经历对此时假阳性女性报告的不良心理后果的影响，并探讨了可能与当前不良心理后果相关的因素。报告影响即将到来的预约的出席率的因素，并监测未出席率。 方法 3 年前最后一次乳房筛查后 1 个月、5 个月和 11 个月完成问卷调查的女性，被邀请在 3 年后被邀请参加下一次常规乳房 X 光检查之前完成邮寄问卷。本次预约的出席情况受到监控。我们向未参加者发送了一份简短的调查问卷，以确定他们未参加的原因。结果 答复率为 77% (387/505)。在上次常规乳腺筛查中，在评估时、手术活检后或 6 个月提前召回预约后，在细针抽吸 (FNA) 后获得明确结果的女性，与在上次常规乳腺筛查中初次乳房 X 光检查后获得明确结果的女性相比，在 3 年后返回常规乳腺筛查前第 1 个月遭受了明显更大的不良心理后果。与上次乳房 X 光检查后获得明确结果的女性相比，她们遭受心理后果的可能性高出 1.7 至 2 倍。未经 FNA 评估而获得明确结果的女性比在乳房 X 光检查后获得明确结果的女性报告的心理后果更高，但差异并不显着（相对风险 1.28，95% 置信区间 0.82-2.00）。 3 年前接受过评估的人中，有 15% 没有参加下一次常规乳房筛查预约，而在乳房 X 光检查后获得明确结果的人中，这一比例为 8% (p = 0.035)。报告了与不良心理后果相关的因素。 结论 尽管在 3 年前的上一次常规乳腺筛查中获得了最终明确结果，但接受 FNA、手术活检或进行早期回忆的女性在下一次常规乳腺筛查预约前 1 个月遭受的不良心理后果明显比上次常规乳腺筛查中初次乳房 X 光检查后获得明确结果的女性要严重。接受进一步调查并不一定会促使女性参加下一次例行检查，其中 15% 的女性在 3 年后没有回来接受例行筛查。
Background In 1995-1996 a study was commenced investigating the experience of 'false-positive' women, i.e. who had undergone further investigations following routine breast screening and received a clear final result. These women were found to experience significantly greater adverse psychological consequences at 1 month, 5 months and 11 months after assessment compared with women who received a clear result after the initial basic mammogram. The present study follows up these 'false-positive' women 3 years later (at 35 months) just before being invited for their next routine breast screening. It investigates the effect of the previous experience of breast screening on adverse psychological consequences reported by false-positive women at this time, and explores factors that may be associated with the current adverse psychological consequences. Factors influencing attendance for the forthcoming appointment are reported, and the non-attendance rate is monitored.Methods Women who had previously completed a questionnaire I month, 5 months and 11 months after their last breast screening 3 years ago, were invited to complete a postal questionnaire just before being invited to attend for their next routine mammogram 3 years later. Attendance for this appointment was monitored. A brief questionnaire was sent to non-attenders to ascertain their reasons for not attending.Results The response rate was 77 per cent (387/505). Women who, at their last routine breast screening, had received a clear result after fine needle aspiration (FNA) at assessment, after a surgical biopsy or after a 6 month early recall appointment, all suffered significantly greater adverse psychological consequences at I month before returning for routine breast screening 3 years later than women who had received a clear result after the initial mammogram at their last routine breast screening. They were between 1.7 and 2 times more likely to suffer psychological consequences than women who received a clear result after their last mammogram. Women who had received a clear result at assessment without undergoing FNA reported higher psychological consequences than those who received a clear result after mammography, but the difference was not significant (relative risk 1.28, 95 per cent confidence interval 0.82-2.00). Fifteen per cent of those who had undergone assessment 3 years earlier did not attend their next routine breast screening appointment compared with 8 per cent of those who received a clear result after mammography (p = 0.035). Factors associated with adverse psychological consequences are reported.Conclusion Despite having received a final clear result during their previous routine breast screening 3 years ago, women who had undergone FNA, surgical biopsy or been placed on early recall suffered significantly greater adverse psychological consequences at 1 month before their next routine breast screening appointment than women who had received a clear result after their initial mammogram at their last routine breast screening. Having undergone further investigations did not necessarily motivate women to attend for their next routine appointment, with 15 per cent of these women not returning for routine screening 3 years on.