title: Influence of false-positive mammography results on subsequent screening: do physician recommendations buffer negative effects?
abstract: OBJECTIVE
  Cancer screening guidelines often include discussion about the unintended negative consequences of routine screening. This prospective study examined effects of false-positive mammography results on women's adherence to subsequent breast cancer screening and psychological well-being. We also assessed whether barriers to screening exacerbated the effects of false-positive results.
  
  
  METHODS
  We conducted secondary analyses of data from telephone interviews and medical claims records for 2406 insured women. The primary outcome was adherence to screening guidelines, defined as adherent (10-14 months), delayed (15-34 months), or no subsequent mammogram on record.
  
  
  RESULTS
  About 8% of women reported that their most recent screening mammograms produced false-positive results. In the absence of self-reported advice from their physicians to be screened, women were more likely to have no subsequent mammograms on record if they received false-positive results than if they received normal results (18% vs. 7%, OR = 3.17, 95% CI = 1.30, 7.70). Receipt of false-positive results was not associated with this outcome for women who said their physicians had advised regular screening in the past year (7% vs. 10%, OR = 0.74, 95% CI = 0.38, 1.45). False-positive results were associated with greater breast cancer worry (P < .01), thinking more about the benefits of screening (P < .001), and belief that abnormal test results do not mean women have cancer (P < .01), regardless of physicians' screening recommendations.
  
  
  CONCLUSIONS
  False-positive mammography results, coupled with reports that women's physicians did not advise regular screening, could lead to non-adherence to future screening. Abnormal mammograms that do not result in cancer diagnoses are opportunities for physicians to stress the importance of regular screening.
authors.affiliation: Gillings School of Global Public Health, 325 Rosenau Hall CB# 7440, Chapel Hill, North Carolina 27599, USA. jessica_defrank@unc.edu
authors.forename: Jessica T
authors.initials: JT
authors.lastname: DeFrank
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Rimer
authors.forename: J Michael
authors.initials: JM
authors.lastname: Bowling
authors.forename: Jo Anne
authors.initials: JA
authors.lastname: Earp
authors.forename: Erica S
authors.initials: ES
authors.lastname: Breslau
authors.forename: Noel T
authors.initials: NT
authors.lastname: Brewer
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000523:psychology; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000523:psychology; D057210:Delayed Diagnosis / Q000706:statistics & numerical data; D037001:Directive Counseling; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008327:Mammography / Q000523:psychology* / Q000592:standards / Q000706:statistics & numerical data; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data; D010819:Physician's Role / Q000523:psychology