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BACKGROUND METHODS

RESULTS: Psychological Consequences Questionnaire


CONCLUSIONS
This project was funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme (project number 09/145/01) and will be published in full in Health
Technology Assessment. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health
Mary Bond
1
, Toby Pavey
1
, Karen Welch
2
, Chris Cooper
1
, Ruth Garside
1
, Sarah Dean
1
, Chris Hyde
1

1: University of Exeter, 2: Karen Welch Information Consultancy
Screening introduced in 1988
Women aged 47-73 invited every 3 years
1.73 million screened in 2010/11 England
65,000 (4%) recalled
13,100 (20%) cancer diagnoses
52,700 false-positives (80% recalls & 3% screened)
The Psychological Consequences of False-Positive Screening
Mammograms in the UK: A Systematic Review
Systematic review
False-positive vs. normal mammograms
All controlled studies & qualitative research
At least one month from all clear
Comprehensive electronic database, internet and
reference & citation searches
Psychological & qualitative outcomes
Dual independent screening
Critical appraisal
Narrative synthesis
4,423 Titles & abstracts after deduplication
95 Paper retrieved
10 Primary studies included (17 papers)
1 RCT
9 Observational
0 Published qualitative studies
0 Studies of ethnic or socio-economic groups
SEARCH RESULTS
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Further_mammography
Ong et al. T1
Brett et al. T1
Brett et al. T2
Brett & Austoker T1
Brett & Austoker T3
FNA
Ong et al. T1
Brett et al. T1
Brett et al. T2
Brett & Austoker T1
Brett & Austoker T3
Biopsy
Ong et al. T1
Brett et al. T1
Brett et al. T2
Brett & Austoker T1
Brett & Austoker T3
Early_recall
Ong et al. T1
Brett et al. T1
Brett et al. T2
Brett & Austoker T1
Brett & Austoker T3
ID
Study
1.71 (1.24, 2.35)
3.29 (1.73, 6.23)
4.69 (1.93, 11.38)
1.92 (1.31, 2.83)
1.28 (0.82, 2.00)
1.97 (1.44, 2.69)
3.66 (1.94, 6.93)
4.57 (1.85, 11.26)
2.08 (1.40, 3.09)
1.80 (1.17, 2.77)
2.96 (2.19, 4.01)
5.28 (2.87, 9.68)
6.33 (2.59, 15.50)
2.72 (1.77, 4.17)
2.07 (1.22, 3.52)
2.13 (1.58, 2.87)
4.02 (2.15, 7.50)
6.10 (2.56, 14.54)
2.36 (1.64, 3.40)
1.82 (1.22, 2.72)
RR (95% CI)
1.71 (1.24, 2.35)
3.29 (1.73, 6.23)
4.69 (1.93, 11.38)
1.92 (1.31, 2.83)
1.28 (0.82, 2.00)
1.97 (1.44, 2.69)
3.66 (1.94, 6.93)
4.57 (1.85, 11.26)
2.08 (1.40, 3.09)
1.80 (1.17, 2.77)
2.96 (2.19, 4.01)
5.28 (2.87, 9.68)
6.33 (2.59, 15.50)
2.72 (1.77, 4.17)
2.07 (1.22, 3.52)
2.13 (1.58, 2.87)
4.02 (2.15, 7.50)
6.10 (2.56, 14.54)
2.36 (1.64, 3.40)
1.82 (1.22, 2.72)
RR (95% CI)

1 .81 2 4 8 12
RESULTS: HADS & GHQ-28
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Bull &Campbell: 6 weeks after assessment
HADS depression =borderline
HADS depression =abnormal
HADS anxiety=borderline
HADS anxiety=abnormal
Ellman et al.: 3 months after screening
GHQ-28 sub-clinical/mild
GHQ-28 mild/moderate
ID
Study
1.71 (0.77, 3.78)
2.61 (0.60, 11.44)
1.16 (0.58, 2.30)
1.46 (0.31, 6.90)
0.82 (0.49, 1.36)
1.19 (0.70, 2.00)
RR (95% CI)
1.71 (0.77, 3.78)
2.61 (0.60, 11.44)
1.16 (0.58, 2.30)
1.46 (0.31, 6.90)
0.82 (0.49, 1.36)
1.19 (0.70, 2.00)
RR (95% CI)

1 .3 1 3 6 11
RESULTS: Going next time
McCann et al
O'Sullivan et al.
Brett and Austoker
Orton et al.
ID
Study
0.97 (0.96, 0.98)
0.99 (0.91, 1.08)
0.92 (0.86, 0.98)
1.03 (0.95, 1.13)
RR (95% CI)
0.97 (0.96, 0.98)
0.99 (0.91, 1.08)
0.92 (0.86, 0.98)
1.03 (0.95, 1.13)
RR (95% CI)

1 .86 .92 1 1.08 1.13
False-positive mammograms can cause breast cancer
specific distress for up to three years

Distress may be related to the assessment process

General anxiety and depression are less likely

Women with a FPM are 2% - 4% less likely to attend
their next round of screening
Contact: M.bond@exeter.ac.uk
T1: 1 month after the all clear, T2: 5 months after the all clear, T3: 35 months after the all clear