title: False-positive mammographic screening: factors influencing re-attendance over a decade of screening.
abstract: BACKGROUND
  International studies on the effect of false-positive mammographic screening results on subsequent re-attendance at screening are inconsistent.
  
  
  METHODS
  BreastCheck, the national breast screening programme for the Republic of Ireland, screens women two-yearly. Re-attendance for subsequent screening is approximately 90%.
  
  
  OBJECTIVE
  The aim of this research was to quantify the impact of false-positive mammographic screening results on subsequent re-attendance, using the BreastCheck clinical database with a decade of screening and to determine if age group, assessment procedure, initial or subsequent screening, location of appointment for next screening round and time from recall to non-malignant diagnosis predicted re-attendance.
  
  
  RESULTS
  From programme commencement in 2000 to the end of 2007, 13,352 screening tests resulted in assessment; 11,765 participants were aged 50-62 years and of these 9746 received false-positive results (positive predictive value 17.2%). Following a false-positive recall to assessment, re-attendance at subsequent screening differed significantly by procedure type (open biopsy 80.3%; core biopsy only 90.2%; no tissue sampling 91.4%; P < 0.0001). Re-attendance differed significantly by timing of false-positive assessment in a woman's screening history (first versus subsequent screening, 89.5% versus 93.5%, P < 0.0001) and by location of next screening appointment (screening centre 89.8% versus mobile unit 91.3%, P < 0.01). The longer the period between recall to assessment and non-malignant diagnosis the less likely women were to re-attend. After logistic regression, first screening, older age, open surgical biopsy, re-invitation to screening centre and a longer period between recall and non-malignant diagnosis were significant negative predictors of re-attendance.
  
  
  CONCLUSIONS
  Since April 2008 BreastCheck has employed full field digital mammography throughout the programme, with a resulting increase in recalls; re-attendance will be closely monitored.
authors.affiliation: National Cancer Screening Service, King's Inn House, 200 Parnell Street, Dublin 1, Ireland. patricia.fitzpatrick@cancerscreening.ie
authors.forename: P
authors.initials: P
authors.lastname: Fitzpatrick
authors.forename: P
authors.initials: P
authors.lastname: Fleming
authors.forename: S
authors.initials: S
authors.lastname: O'Neill
authors.forename: D
authors.initials: D
authors.lastname: Kiernan
authors.forename: T
authors.initials: T
authors.lastname: Mooney
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*