False-positive Screening Mammograms and Biopsies Among Women Participating in a Canadian Provincial Breast Screening Program

Objective: To determine the association between initial screen result and returning for a second screen in an organised breast screening programme for women with a biennial screening recommendation. Setting: Women who attended the Ontario Breast Screening Program (OBSP). Methods: A retrospective cohort study was conducted of 140,723 Ontario women aged 50 years ond older who had an initial screen at the OBSP between 1 July 1990 and 31 December 1995 and were followed until 30 June 1998. Rescreening rates at 36 months and risk ratio estimates were calculated using survival methods. Age of women, year of screen, region (within Ontario) and initial screen result were compared. For initial screen results, returning for a second screen was examined by integration of screening centre with an assessment programme and by modality of referral. Results: Women with a false-positive result were less likely to return for a second screen as were women aged 70 and older and those living in regions of Ontario with fewer OBSP screening centres. However, there were minimal differences in reattendance behaviour by initial screen result for women screened at the OBSP centre with an assessment programme. Conclusions: Integration of breast screening and assessment services improved reattendance of women with false-positive screen results within an organised screening programme.

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Effects of False-Positive Results in a Breast Screening Program on Anxiety, Depression and Health-Related Quality of Life

Cancer Nursing ◽

10.1097/ncc.0b013e3182341ddb ◽

2012 ◽

Vol 35 (5) ◽

pp. E26-E34 ◽

Cited By ~ 13

Author(s):

Bjorg Hafslund ◽

Birgitte Espehaug ◽

Monica W. Nortvedt

Keyword(s):

Quality Of Life ◽

False Positive ◽

Breast Screening ◽

Screening Program ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Anxiety Depression ◽

Positive Results

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The Burden of False-Positive Results in Analog and Digital Screening Mammography: Experience of the Nova Scotia Breast Screening Program

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2014.03.002 ◽

2014 ◽

Vol 65 (4) ◽

pp. 315-320 ◽

Cited By ~ 6

Author(s):

Jennifer I. Payne ◽

Tetyana Martin ◽

Judy S. Caines ◽

Ryan Duggan

Keyword(s):

False Positive ◽

Screening Program ◽

Task Force ◽

Age Groups ◽

Preventive Health Care ◽

Screening Mammography ◽

Age Group ◽

Patients Âgés ◽

Screening Performance ◽

Screening Mammograms

Purpose The Canadian Task Force on Preventive Health Care released recommendations for breast cancer screening, in part, based on harms associated with screening. The purpose of this study was to describe the rate of false-positive (FP) screening mammograms and to describe the extent of the investigations after an FP. Methods A cohort was identified that consisted of all screening mammograms performed through the Screening Program (2000-2011) with patients ages 40-69 years at screening. Rates of FP screening mammograms were calculated as well as rates of further investigations required, including additional imaging, needle core biopsy, and surgery. Analyses were stratified by 10-year age group, screening status (first vs rescreen), and technology. Results A total of 608,088 screening mammograms were included. The FP rate varied by age group, and decreased with increasing age (digital, 40-49 years old, FP = 8.0%; 50-59 years old, FP = 6.3%; 60-69 years old, FP = 4.6%). The FP rate also varied by screening status (digital, first screen, FP = 12.0%; rescreen, FP = 5.6%), and this difference was consistent across age groups. The need for further investigation varied by age group, with invasive procedures being more heavily used as women age (digital, rescreen group, surgery: 40-49 years old, 1.1%; 50-59 years old 1.6%, 60-69 years old, 1.8%). Conclusions Both the FP screening mammogram rate and the degree to which further investigation was required varied by age group and screening status. Reporting on these rates should form part of the evaluation of screening performance.

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False-positive result and reattendance in the Ontario Breast Screening Program

Journal of Medical Screening ◽

10.1258/096914103769011021 ◽

2003 ◽

Vol 10 (3) ◽

pp. 129-133 ◽

Cited By ~ 12

Author(s):

A M Chiarelli ◽

V Moravan ◽

E Halapy ◽

V Majpruz ◽

V Mai ◽

...

Keyword(s):

Positive Result ◽

False Positive ◽

Breast Screening ◽

Screening Program ◽

False Positive Result

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The Impact of Radiologist Screening Mammogram Reading Volume on Performance in the Ontario Breast Screening Program

Canadian Association of Radiologists Journal ◽

10.1177/08465371211031186 ◽

2021 ◽

pp. 084653712110311

Author(s):

Meghan J. Walker ◽

Krystal Hartman ◽

Vicky Majpruz ◽

Yvonne W. Leung ◽

Samantha Fienberg ◽

...

Keyword(s):

Cancer Detection ◽

Breast Screening ◽

Screening Program ◽

Call Rate ◽

Multivariate Logistic Regression ◽

Performance Targets ◽

Screening Mammograms ◽

Reading Volume ◽

The Impact ◽

The Relationship

Purpose: Although some studies have shown increasing radiologists’ mammography volumes improves performance, there is a lack of evidence specific to digital mammography and breast screening program performance targets. This study evaluates the relationship between digital screening volume and meeting performance targets. Methods: This retrospective cohort study included 493 radiologists in the Ontario Breast Screening Program who interpreted 1,762,173 screening mammograms in participants ages 50-90 between 2014 and 2016. Associations between annual screening volume and meeting performance targets for abnormal call rate, positive predictive value (PPV), invasive cancer detection rate (CDR), sensitivity, and specificity were modeled using mixed-effects multivariate logistic regression. Results: Most radiologists read 500-999 (36.7%) or 1,000-1,999 (31.0%) screens annually, and 18.5% read ≥2,000. Radiologists who read ≥2,000 annually were more likely to meet abnormal call rate (OR = 3.85; 95% CI: 1.17-12.61), PPV (OR = 5.36; 95% CI: 2.53-11.34), invasive CDR (OR = 4.14; 95% CI: 1.50-11.46), and specificity (OR = 4.07; 95% CI: 1.89-8.79) targets versus those who read 100-499 screens. Radiologists reading 1,000-1,999 screens annually were more likely to meet PPV (OR = 2.32; 95% CI: 1.22-4.40), invasive CDR (OR = 3.36; 95% CI: 1.49-7.59) and specificity (OR = 2.00; 95% CI: 1.04-3.84) targets versus those who read 100-499 screens. No significant differences were observed for sensitivity. Conclusions: Annual reading volume requirements of 1,000 in Canada are supported as screening volume above 1,000 was strongly associated with achieving performance targets for nearly all measures. Increasing the minimum volume to 2,000 may further reduce the potential limitations of screening due to false positives, leading to improvements in overall breast screening program quality.

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Single Reading with Computer-aided Detection and Double Reading of Screening Mammograms in the United Kingdom National Breast Screening Program

Radiology ◽

10.1148/radiol.2411051092 ◽

2006 ◽

Vol 241 (1) ◽

pp. 47-53 ◽

Cited By ~ 65

Author(s):

Fiona J. Gilbert ◽

Susan M. Astley ◽

Magnus A. McGee ◽

Maureen G. C. Gillan ◽

Caroline R. M. Boggis ◽

...

Keyword(s):

United Kingdom ◽

Breast Screening ◽

Screening Program ◽

Computer Aided Detection ◽

Double Reading ◽

The United Kingdom ◽

National Breast ◽

Single Reading ◽

Computer Aided ◽

Screening Mammograms

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Subsequent attendance in a breast cancer screening program after a false-positive result in the Local Health Authority of Bologna (Italy)

Scientific Reports ◽

10.1038/s41598-021-87864-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Lorena Squillace ◽

Lorenzo Pizzi ◽

Flavia Rallo ◽

Carmen Bazzani ◽

Gianni Saguatti ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Positive Result ◽

Breast Cancer Screening ◽

Health Authority ◽

False Positive ◽

Screening Program ◽

Local Health Authority ◽

Local Health ◽

False Positive Result

AbstractWe conducted a cross-sectional study to assess the likelihood of returning for routine breast cancer screening among women who have experienced a false-positive result (FPR) and to describe the possible individual and organizational factors that could influence subsequent attendance to the screening program. Several information were collected on demographic and clinical characteristics data. Electronic data from 2014 to 2016 related to breast screening program of the Local Health Authority (LHA) of Bologna (Italy) of women between 45 and 74 years old were reviewed. A total of 4847 women experienced an FPR during mammographic screening and were recalled to subsequent round; 80.2% adhered to the screening. Mean age was 54.2 ± 8.4 years old. Women resulted to be less likely to adhere to screening if they were not-Italian (p = 0.001), if they lived in the Bologna district (p < 0.001), if they had to wait more than 5 days from II level test to end of diagnostic procedures (p = 0.001), if the diagnostic tests were performed in a hospital with the less volume of activity and higher recall rate (RR) (p < 0.001) and if they had no previous participation to screening tests (p < 0.001). Our results are consistent with previous studies, and encourages the implementation and innovation of the organizational characteristics for breast cancer screening. The success of screening programs requires an efficient indicators monitoring strategy to develop and evaluate continuous improvement processes.

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