© 1998 Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom
research-article |
Do women who undergo further investigation for breast screening suffer adverse psychological consequences? A multi-centre follow-up study comparing different breast creening result groups five months after their last breast screening appointment
Jo Brett, Researcher
Joan Austoker, Reader in Public Health and Primary Care, Oxford University; Director of CRC Primary Care Education Research Unit
Giok Ong, Research Associate
CRC Primary Care Education Research Group, Division of Public Health and Primary Health Care, University of Oxford, Institute of Health Sciences Old Road, Headington, Oxford OX3 7LF
Address correspondence to Dr Joan Austoker.
BACKGROUND: In 1995–1996 about 53500 women aged 50–64 attending for routine breast screening were called back for further investigation after an initial mammogram. Even when women were found to be clear after further investigation, significant adverse psychological consequences (PCs) can remain one month later. This follow-up study investigates whether residual emotional effects persisted five months after women received a clear result.
METHODS: Women who had previously completed a questionnaire one month after their last breast screening appointment, at which they had a clear result, were invited to complete a further postal questionnaire four months later (five months after their last appointment). We compare women who received a clear result after assessment without fine needle aspiration cytology (FNAC), after assessment with FNAC, after a benign biopsy, and those who had been placed on early recall, with those who received a clear result after mammography (reference group).
RESULTS: The response rate was 76 per cent (215/284). All groups of women who went on for further investigation suffered significantly greater adverse psychological consequences (PCs) at five months than women who were given a clear result after mammography. Compared with 10 per cent (5/52) of women who received a clear result after a basic mammogram, adverse psychological consequences were experienced by 59 per cent (27/46, 
<0.00001) of the women who were placed on six month early recall, 61 per cent (14/23, <0.0001) of women who had benign surgical biopsy, 44 per cent (18/41, <0.0001) of women who received a clear result after assessment (with FNAC), and 45 per cent (23/51, <0.0001) of women who received a clear result after assessment (without FNAC). Whereas all groups who had gone on for further investigations had experienced a significant decrease in PCs between one month and five months, those who were placed on six month early recall showed no significant difference in PCs between these two time periods. Other factors relating to adverse experiences as a result of breast screening are reported.
CONCLUSIONS: Conclusion Despite receiving a clear final result, women who undergo further investigation suffer significantly greater adverse psychological consequences five months after their last screening appointment than women who receive a clear result after mammography.
Keywords: breast screening, false-positive reactions, mass screening, psychology, follow-up
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. M. Chiarelli, V. Majpruz, P. Brown, M. Theriault, R. Shumak, and V. Mai The Contribution of Clinical Breast Examination to the Accuracy of Breast Screening J Natl Cancer Inst, September 16, 2009; 101(18): 1236 - 1243. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. T. Chlebowski, G. Anderson, M. Pettinger, D. Lane, R. D. Langer, M. A. Gillian, B. W. Walsh, C. Chen, A. McTiernan, and for the Women's Health Initiative Investigators Estrogen Plus Progestin and Breast Cancer Detection by Means of Mammography and Breast Biopsy Arch Intern Med, February 25, 2008; 168(4): 370 - 377. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Tyndel, J. Austoker, B. J. Henderson, K. Brain, C. Bankhead, A. Clements, and E. K. Watson What Is the Psychological Impact of Mammographic Screening on Younger Women With a Family History of Breast Cancer? Findings From a Prospective Cohort Study by the PIMMS Management Group J. Clin. Oncol., September 1, 2007; 25(25): 3823 - 3830. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. T. Brewer, T. Salz, and S. E. Lillie Systematic Review: The Long-Term Effects of False-Positive Mammograms Ann Intern Med, April 3, 2007; 146(7): 502 - 510. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Armstrong, E. Moye, S. Williams, J. A. Berlin, and E. E. Reynolds Screening Mammography in Women 40 to 49 Years of Age: A Systematic Review for the American College of Physicians Ann Intern Med, April 3, 2007; 146(7): 516 - 526. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. E. Simon, A. Steptoe, and J. Wardle Socioeconomic Status Differences in Coping With a Stressful Medical Procedure Psychosom Med, March 1, 2005; 67(2): 270 - 276. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Giordano, M. Rowinski, G. Gaudenzi, and N. Segnan What information do breast cancer screening programmes provide to Italian women? Eur J Public Health, February 1, 2005; 15(1): 66 - 69. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. B. Barton, D. S. Morley, S. Moore, J. D. Allen, K. P. Kleinman, K. M. Emmons, and S. W. Fletcher Decreasing Women's Anxieties After Abnormal Mammograms: A Controlled Trial J Natl Cancer Inst, April 7, 2004; 96(7): 529 - 538. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Cullen, M. D. Schwartz, W. F. Lawrence, J. V. Selby, and J. S. Mandelblatt Short-Term Impact of Cancer Prevention and Screening Activities on Quality of Life J. Clin. Oncol., March 1, 2004; 22(5): 943 - 952. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Gurevich, G. M. Devins, C. Wilson, D. McCready, C. R. Marmar, and G. M. Rodin Stress Response Syndromes in Women Undergoing Mammography: A Comparison of Women With and Without a History of Breast Cancer Psychosom Med, January 1, 2004; 66(1): 104 - 112. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Arndt, T. Sturmer, C. Stegmaier, H. Ziegler, A. Becker, and H. Brenner Provider Delay Among Patients With Breast Cancer in Germany: A Population-Based Study J. Clin. Oncol., April 15, 2003; 21(8): 1440 - 1446. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. G. Kessler, M. R. Andersen, and R. Etzioni Much Ado About Mammography Variability J Natl Cancer Inst, September 18, 2002; 94(18): 1346 - 1347. [Full Text] [PDF]
|
|
|
|
 |
|
 I. A. Olivotto, C. Bancej, V. Goel, J. Snider, R. G. McAuley, B. Irvine, L. Kan, D. Mirsky, M. J. Sabine, R. McGilly, et al. Waiting times from abnormal breast screen to diagnosis in 7 Canadian provinces Can. Med. Assoc. J., August 1, 2001; 165(3): 277 - 283. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Baxter Preventive health care, 2001 update: Should women be routinely taught breast self-examination to screen for breast cancer? Can. Med. Assoc. J., June 1, 2001; 164(13): 1837 - 1846. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Lucassen, E. Watson, and D. Eccles Evidence based case report: Advice about mammography for a young woman with a family history of breast cancer BMJ, April 28, 2001; 322(7293): 1040 - 1042. [Full Text]
|
|
|
|
|
|
R. M Wilson Screening for breast and cervical cancer as a common cause for litigation BMJ, May 20, 2000; 320(7246): 1352 - 1353. [Full Text]
|
|
|
|
|
|
J. Austoker Gaining informed consent for screening BMJ, September 18, 1999; 319(7212): 722 - 723. [Full Text]
|
|