Patients With False‐Positive Screening Results More Amenable to Future Screening

May 2, 2018
John Schieszer
John Schieszer

A Cleveland Clinic team found patients with false-positive results subsequently become more involved in cancer screening programs.

There may be a benefit from receiving a false-positive cancer screening result. A new analysis of electronic medical records (EMRs) indicates that, while having a false-positive outcome is frightening, it is associated with a higher rate of future screening. In a study published in Cancer, Glen Taksler, PhD, and colleagues from the Cleveland Clinic found that patients who previously had a false-positive breast or prostate cancer screening test were more likely to obtain future recommended cancer screenings and to appreciate their importance.

False-positive cancer screening test results are common. The authors noted that over 10 years, about 50 to 60 in 100 women who get annual mammograms, 23 in 100 people who get regular stool tests, and 10 to 12 in 100 men who get regular prostate cancer testing will have false-positive results. Such results may affect individuals’ willingness to continue screening for cancer in the future, causing them to be either more diligent or more reluctant about getting screened.

“False-positive results from cancer screenings are common, but not much is known about what happens afterward. We wanted to learn more about the possible long-term consequences,” said Dr. Taksler, an Assistant Professor of Medicine at the Cleveland Clinic Lerner College of Medicine and on the staff of the Cleveland Clinic Medicine Institute, Cleveland.

Taksler and his colleagues obtained 10 years of EMR data to analyze the association between prior receipt of a false-positive cancer screening test result and future participation in routine cancer screenings. The analysis included 92,405 individuals aged 50 to 75 years.

Women with a false-positive mammogram were at least 43% more likely to obtain future breast cancer screenings (adjusted odds ratio [AOR], 1.43; 95% CI, 1.34 – 1.51). The study showed the same women were at least 25% more likely to obtain future colorectal cancer screenings (AOR range, 1.25 – 1.47, depending on breast biopsy; both P < .001).

Men with a false-positive prostate cancer screening were at least 22% more likely to obtain future colorectal cancer screenings (AOR, 1.22 [P = .039] for men who did not undergo prostate imaging/biopsy; AOR, 1.60 [P = .028] for men managed with imaging/biopsy).

Overall results were stronger for individuals with a greater number of false-positive results (all P ≤ .005). However, an exception was found: Women with previous false-positive fecal occult blood testing were less likely to be up-to-date with their breast cancer screening.

“Unfortunately, we don’t know why patients were more likely to obtain future cancer screenings over the longer term, which is why we need more research. This research was part of a broader study to consider the need to individualize preventive care recommendations for patients, based on their unique risk factors and experiences,” Taksler told Cancer Network.

According to Taksler, other researchers have reported results that conflict with these findings. In studies with a short-term follow-up, false-positive results adversely affected quality of life. “Other researchers who have considered that question tended to find a temporary decrease in quality of life, which usually resolved after a few months. In this study, we looked at longer-term consequences over 7 years,” he said.