The cumulative risk of false-positive Results in the Norwegian Breast Cancer Screening Program: Updated Results

Marta Roman, Rebecca A. Hubbard, Sofie Sebuodegard, Diana L Miglioretti, Xavier Castells, Solveig Hofvind

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background Some false-positive Results are inevitable in mammographic screening, but the impact of false-positive findings on the program and the participants is a disadvantage of screening. The objective of the current study was to estimate the cumulative risk of a false-positive result over 10 biennial screening examinations and the cumulative risk of undergoing an invasive procedure with a benign outcome in women screened between the ages of 50 years to 69 years. Methods A retrospective cohort study was performed in 231,310 women aged 50 years to 51 years at the time of first mammography screening who underwent 715,311 screening mammograms in the Norwegian Breast Cancer Screening Program from 1996 through 2010. Generalized linear mixed models were used to estimate the probability of a false-positive screening result and to compute the cumulative false-positive risk for up to 10 biennial screening examinations. Results The cumulative false-positive risk after 20 years of biennial screening for women who initiated screening aged 50 years to 51 years was 20.0% (95% confidence interval [95% CI], 19.7%-20.4%). The cumulative risk of undergoing an invasive procedure with a benign outcome for the same group of women was 4.1% (95% CI, 3.9%-4.3%). The cumulative risk of undergoing a fine-needle aspiration cytology, core needle biopsy, or open biopsy with a benign outcome was 1.4% (95% CI, 1.3%-1.5%), 2.0% (95% CI, 1.9%-2.1%), and 0.16% (95% CI, 0.13%-0.19%), respectively. Conclusions One in every 5 women will be recalled for further assessment with a negative outcome if they attend biennial mammographic screening between ages 50 years to 69 years. The risk of an invasive procedure with a benign outcome is approximately 4%. It is important to communicate the existence and extent of this risk to the target group and to reduce to a minimum the waiting times between screening and further assessment.

Original languageEnglish (US)
Pages (from-to)3952-3958
Number of pages7
JournalCancer
Volume119
Issue number22
DOIs
StatePublished - Nov 15 2013

Fingerprint

Early Detection of Cancer
Breast Neoplasms
Confidence Intervals
Large-Core Needle Biopsy
Mammography
Fine Needle Biopsy
Cell Biology
Linear Models
Cohort Studies
Retrospective Studies
Biopsy

Keywords

  • breast neoplasms
  • false-positive Results
  • female
  • mammography
  • mass screening

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

The cumulative risk of false-positive Results in the Norwegian Breast Cancer Screening Program : Updated Results. / Roman, Marta; Hubbard, Rebecca A.; Sebuodegard, Sofie; Miglioretti, Diana L; Castells, Xavier; Hofvind, Solveig.

In: Cancer, Vol. 119, No. 22, 15.11.2013, p. 3952-3958.

Research output: Contribution to journalArticle

Roman, Marta ; Hubbard, Rebecca A. ; Sebuodegard, Sofie ; Miglioretti, Diana L ; Castells, Xavier ; Hofvind, Solveig. / The cumulative risk of false-positive Results in the Norwegian Breast Cancer Screening Program : Updated Results. In: Cancer. 2013 ; Vol. 119, No. 22. pp. 3952-3958.
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title = "The cumulative risk of false-positive Results in the Norwegian Breast Cancer Screening Program: Updated Results",
abstract = "Background Some false-positive Results are inevitable in mammographic screening, but the impact of false-positive findings on the program and the participants is a disadvantage of screening. The objective of the current study was to estimate the cumulative risk of a false-positive result over 10 biennial screening examinations and the cumulative risk of undergoing an invasive procedure with a benign outcome in women screened between the ages of 50 years to 69 years. Methods A retrospective cohort study was performed in 231,310 women aged 50 years to 51 years at the time of first mammography screening who underwent 715,311 screening mammograms in the Norwegian Breast Cancer Screening Program from 1996 through 2010. Generalized linear mixed models were used to estimate the probability of a false-positive screening result and to compute the cumulative false-positive risk for up to 10 biennial screening examinations. Results The cumulative false-positive risk after 20 years of biennial screening for women who initiated screening aged 50 years to 51 years was 20.0{\%} (95{\%} confidence interval [95{\%} CI], 19.7{\%}-20.4{\%}). The cumulative risk of undergoing an invasive procedure with a benign outcome for the same group of women was 4.1{\%} (95{\%} CI, 3.9{\%}-4.3{\%}). The cumulative risk of undergoing a fine-needle aspiration cytology, core needle biopsy, or open biopsy with a benign outcome was 1.4{\%} (95{\%} CI, 1.3{\%}-1.5{\%}), 2.0{\%} (95{\%} CI, 1.9{\%}-2.1{\%}), and 0.16{\%} (95{\%} CI, 0.13{\%}-0.19{\%}), respectively. Conclusions One in every 5 women will be recalled for further assessment with a negative outcome if they attend biennial mammographic screening between ages 50 years to 69 years. The risk of an invasive procedure with a benign outcome is approximately 4{\%}. It is important to communicate the existence and extent of this risk to the target group and to reduce to a minimum the waiting times between screening and further assessment.",
keywords = "breast neoplasms, false-positive Results, female, mammography, mass screening",
author = "Marta Roman and Hubbard, {Rebecca A.} and Sofie Sebuodegard and Miglioretti, {Diana L} and Xavier Castells and Solveig Hofvind",
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T1 - The cumulative risk of false-positive Results in the Norwegian Breast Cancer Screening Program

T2 - Updated Results

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AU - Hofvind, Solveig

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N2 - Background Some false-positive Results are inevitable in mammographic screening, but the impact of false-positive findings on the program and the participants is a disadvantage of screening. The objective of the current study was to estimate the cumulative risk of a false-positive result over 10 biennial screening examinations and the cumulative risk of undergoing an invasive procedure with a benign outcome in women screened between the ages of 50 years to 69 years. Methods A retrospective cohort study was performed in 231,310 women aged 50 years to 51 years at the time of first mammography screening who underwent 715,311 screening mammograms in the Norwegian Breast Cancer Screening Program from 1996 through 2010. Generalized linear mixed models were used to estimate the probability of a false-positive screening result and to compute the cumulative false-positive risk for up to 10 biennial screening examinations. Results The cumulative false-positive risk after 20 years of biennial screening for women who initiated screening aged 50 years to 51 years was 20.0% (95% confidence interval [95% CI], 19.7%-20.4%). The cumulative risk of undergoing an invasive procedure with a benign outcome for the same group of women was 4.1% (95% CI, 3.9%-4.3%). The cumulative risk of undergoing a fine-needle aspiration cytology, core needle biopsy, or open biopsy with a benign outcome was 1.4% (95% CI, 1.3%-1.5%), 2.0% (95% CI, 1.9%-2.1%), and 0.16% (95% CI, 0.13%-0.19%), respectively. Conclusions One in every 5 women will be recalled for further assessment with a negative outcome if they attend biennial mammographic screening between ages 50 years to 69 years. The risk of an invasive procedure with a benign outcome is approximately 4%. It is important to communicate the existence and extent of this risk to the target group and to reduce to a minimum the waiting times between screening and further assessment.

AB - Background Some false-positive Results are inevitable in mammographic screening, but the impact of false-positive findings on the program and the participants is a disadvantage of screening. The objective of the current study was to estimate the cumulative risk of a false-positive result over 10 biennial screening examinations and the cumulative risk of undergoing an invasive procedure with a benign outcome in women screened between the ages of 50 years to 69 years. Methods A retrospective cohort study was performed in 231,310 women aged 50 years to 51 years at the time of first mammography screening who underwent 715,311 screening mammograms in the Norwegian Breast Cancer Screening Program from 1996 through 2010. Generalized linear mixed models were used to estimate the probability of a false-positive screening result and to compute the cumulative false-positive risk for up to 10 biennial screening examinations. Results The cumulative false-positive risk after 20 years of biennial screening for women who initiated screening aged 50 years to 51 years was 20.0% (95% confidence interval [95% CI], 19.7%-20.4%). The cumulative risk of undergoing an invasive procedure with a benign outcome for the same group of women was 4.1% (95% CI, 3.9%-4.3%). The cumulative risk of undergoing a fine-needle aspiration cytology, core needle biopsy, or open biopsy with a benign outcome was 1.4% (95% CI, 1.3%-1.5%), 2.0% (95% CI, 1.9%-2.1%), and 0.16% (95% CI, 0.13%-0.19%), respectively. Conclusions One in every 5 women will be recalled for further assessment with a negative outcome if they attend biennial mammographic screening between ages 50 years to 69 years. The risk of an invasive procedure with a benign outcome is approximately 4%. It is important to communicate the existence and extent of this risk to the target group and to reduce to a minimum the waiting times between screening and further assessment.

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