Systematic review: the long-term effects of false-positive mammograms

Ann Intern Med. 2007 Apr 3;146(7):502-10. doi: 10.7326/0003-4819-146-7-200704030-00006.


Background: Although abnormal screening mammograms deleteriously affect the psychological well-being of women during the time immediately surrounding the tests, their long-term effects are poorly understood.

Purpose: To characterize the long-term effects of false-positive screening mammograms on the behavior and well-being of women 40 years of age or older.

Data sources: English-language studies from the MEDLINE, Web of Science, EMBASE, CINAHL, PsycINFO, and ERIC databases through August 2006.

Study selection: Studies were identified that examined the effects of false-positive results of routine screening mammography on women's behavior, well-being, or beliefs.

Data extraction: Two investigators independently coded study characteristics, quality, and effect sizes.

Data synthesis: 23 eligible studies (n = 313,967) were identified. A random-effects meta-analysis showed that U.S. women who received false-positive results on screening mammography were more likely to return for routine screening than those who received normal results (risk ratio, 1.07 [95% CI, 1.02 to 1.12]). The effect was not statistically significant among European women (risk ratio, 0.97 [CI, 0.93 to 1.01]), and Canadian women were less likely to return for routine screening because of false-positive results (risk ratio, 0.63 [CI, 0.50 to 0.80]). Women who received false-positive results conducted more frequent breast self-examinations and had higher, but not apparently pathologically elevated, levels of distress and anxiety and thought more about breast cancer than did those with normal results.

Limitations: Correlational study designs, a small number of studies, a lack of clinical validation for many measures, and possible heterogeneity.

Conclusions: Some women with false-positive results on mammography may have differences in whether they return for mammography, occurrence of breast self-examinations, and levels of anxiety compared with women with normal results. Future research should examine how false-positive results on mammography affect other outcomes, such as trust and health care use.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Anxiety / etiology
  • Attitude to Health
  • Breast Neoplasms / diagnosis
  • Breast Self-Examination / statistics & numerical data
  • Depression / etiology
  • False Positive Reactions
  • Fear
  • Female
  • Health Behavior*
  • Humans
  • Mammography / psychology*
  • Mammography / statistics & numerical data
  • Mass Screening / psychology*
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Stress, Psychological / etiology*
  • Time Factors