The economic impact of false-positive cancer screens.
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.
Lafata
Jennifer Elston
JE
Center for Health Services Research, Henry Ford Health System, 1 Ford Place, 3A, Detroit, MI 48202, USA. jlafata1@hfhs.org
Simpkins
Janine
J
Lamerato
Lois
L
Poisson
Laila
L
Divine
George
G
Johnson
Christine Cole
CC
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*