Marcia L. Burman, MD; Stephen H. Taplin, MD, MPH; Douglas F. Herta, MPA; Joann G. Elmore, MD, MPH
Grant Support: By Department of Veterans Affairs Ambulatory Care Fellowship Program (Dr. Burman), grant CA6371 from the National Cancer Institute (Dr. Taplin and Mr. Herta), and a Robert Wood Johnson Foundation Generalist Physician Faculty Award (Dr. Elmore).
Requests for Reprints: Marcia L. Burman, MD, Health Services Research and Development, Mailstop 152, Veterans Affairs Puget Sound Health Care System (Seattle Division), 1660 South Columbian Way, Seattle, WA 98108; e-mail, email@example.com.
Current Author Addresses: Dr. Burman: Health Services Research and Development, Mailstop 152, Veterans Affairs Puget Sound Health Care System (Seattle Division), 1660 South Columbian Way, Seattle, WA 98108.
Dr. Taplin and Mr. Herta: Department of Preventive Care, Group Health Cooperative of Puget Sound, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101-1448.
Dr. Elmore: Division of General Internal Medicine, Box 356420, Department of Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195.
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.
To examine the effect of a false-positive mammogram on adherence to the next recommended screening mammogram.
Prospective cohort study.
The breast cancer screening program at Group Health Cooperative, a health maintenance organization in Washington state.
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.
Screening rates and odds ratios for recommended interval screening up to 42 months after the index mammogram.
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]).
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.
Table 1. Clinical Characteristics of the Study Sample at the Time of Index Mammogram
Table 2. Crude and Adjusted Odds Ratios for Subsequent Breast Cancer Screening
Table 3. Adjusted Odds Ratios for Subsequent Breast Cancer Screening by Previous Use of Mammography
Table 4. Adjusted Odds Ratios for Subsequent Breast Cancer Screening by Age at Index Mammogram
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Burman ML, Taplin SH, Herta DF, Elmore JG. Effect of False-Positive Mammograms on Interval Breast Cancer Screening in a Health Maintenance Organization. Ann Intern Med. ;131:1–6. doi: 10.7326/0003-4819-131-1-199907060-00002
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Published: Ann Intern Med. 1999;131(1):1-6.
Breast Cancer, Cancer Screening/Prevention, Hematology/Oncology, Prevention/Screening.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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