Longitudinal study of the influence of false-positive mammography results on psychological outcomes and subsequent screening behavior

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  • March 21, 2019
Creator
  • DeFrank, Jessica T.
    • Affiliation: Gillings School of Global Public Health, Department of Health Behavior
Abstract
  • If screened regularly, over one-half of U.S. women will have abnormal mammography results that require additional follow-up but in which cancer is not detected (false-positive result). This dissertation presents and tests a model, informed by theoretical and empirical evidence, of the relationship between receipt of false-positive mammography results and adherence to subsequent mammography screening. To test study hypotheses, I analyzed longitudinal data (n=2406), gathered through medical claims records and telephone interviews, as part of the PRISM (Personally Relevant Information on Screening Mammography) intervention trial to increase repeat mammography adherence among insured North Carolina women. About 8% of women received false-positive mammography results within 14 months of their interviews. Among women who said their physicians had not advised them to get mammograms in the past year, those who received false-positive results were more likely to have no subsequent mammogram on record compared to women whose results were normal (18% vs. 7%, OR=3.17, 95% CI=1.30,7.71). However, among women who reported physician recommendations, receipt of false-positive results was not associated with adherence to subsequent screening. Receipt of false-positive results was associated with greater breast cancer worry (p<.001), the belief that mammography test results were less accurate (p=.003), and thinking more about the benefits of regular screening (p<.001), regardless of physician recommendations. In mediation analyses, none of these variables explained the association between false-positive test results and subsequent screening behavior. Findings suggest that women who receive false-positive mammography results, coupled with lack of physician recommendations for screening, are at risk for non-adherence to future screening. Abnormal mammograms that do not result in a cancer diagnosis are opportunities for physicians to emphasize the importance of regular screening. Findings provided only partial support for the proposed model, perhaps due to characteristics of the PRISM study design, where all women received annual reminders for their mammograms and received mammograms prior to study enrollment.
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  • In Copyright
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  • "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Health Behavior and Health Education."
Advisor
  • Brewer, Noel T.
Degree granting institution
  • University of North Carolina at Chapel Hill
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Place of publication
  • Chapel Hill, NC
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  • Open access
Date uploaded
  • March 18, 2013

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