title: The economic impact of false-positive cancer screens.
abstract: OBJECTIVE
  Despite the promotion and widespread use of routine cancer screening, little is known about the economic consequences of false-positive screening results. We evaluated the medical and nonmedical costs associated with false-positive prostate, lung, colorectal, and ovarian cancer screens.
  
  
  METHODS
  We identified 1,087 Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial participants enrolled in a large managed care organization. Medical care use and costs were compiled from automated sources and trial data. Nonmedical care costs to patients with a false-positive lung cancer screen were obtained by telephone interview (n = 98).
  
  
  RESULTS
  Forty-three percent of the study sample incurred at least one false-positive cancer screen. The majority of these patients (83%) received follow-up care. Prior to and after controlling for participant characteristics, significantly higher medical care expenditures in the year following screening were found among those with a false-positive screen. The adjusted mean difference was $1,024 for women and $1,171 for men. Among lung cancer screening patients, few nonmedical care costs were identified beyond the time (mean, 1.5 hours) spent receiving care.
  
  
  CONCLUSIONS
  The results here indicate that false-positive results among some available cancer screening tests are relatively common, that patients incurring a false-positive screen tend to receive follow-up testing, and that such follow-up is not without associated medical costs. Along with trials evaluating the health benefits of available cancer screening modalities, investigations into potential undesirable consequences of cancer screening are also warranted.
authors.affiliation: Center for Health Services Research, Henry Ford Health System, 1 Ford Place, 3A, Detroit, MI 48202, USA. jlafata1@hfhs.org
authors.forename: Jennifer Elston
authors.initials: JE
authors.lastname: Lafata
authors.forename: Janine
authors.initials: J
authors.lastname: Simpkins
authors.forename: Lois
authors.initials: L
authors.lastname: Lamerato
authors.forename: Laila
authors.initials: L
authors.lastname: Poisson
authors.forename: George
authors.initials: G
authors.lastname: Divine
authors.forename: Christine Cole
authors.initials: CC
authors.lastname: Johnson
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000191:economics*; D003365:Costs and Cost Analysis; D005189:False Positive Reactions; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000191:economics*; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000191:economics*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000191:economics*