A model of the influence of false-positive mammography screening results on subsequent screening

Abstract

Decades of empirical research have demonstrated psychological and behavioural consequences of false-positive medical tests. To organise this literature and offer novel predictions, we propose a model of how false-positive mammography results affect return for subsequent mammography screening. We propose that false-positive mammography results alter how women think about themselves (e.g., increasing their perceived likelihood of getting breast cancer) and the screening test (e.g., believing mammography test results are less accurate). We further hypothesise that thoughts elicited by the false-positive experience will, in turn, affect future use of screening mammography. In addition, we discuss methodological considerations for statistical analyses of these mediational pathways and propose two classes of potential moderators. While our model focuses on mammography screening, it may be applicable to psychological and behavioural responses to other screening tests. The model is especially timely as false-positive medical test results are increasingly common, due to efforts to increase uptake of cancer screening, new technologies that improve existing tests’ ability to detect disease at the cost of increased false alarms, and growing numbers of new medical tests.

Keywords:

• cancer screening
• mammography
• psychological outcomes
• false-positive
• health behaviour

Acknowledgements

The authors thank Mike Bowling, Erica Breslau, Jo Anne Earp, Barbara Rimer and Talya Salz for input on this article. At the time of this research, Jessica DeFrank, PhD, was funded by the UNC University Cancer Research Fund and the UNC Cancer Care and Quality Training Programme (NCI R25 Grant, CA116339).