Breast cancer screening: Evidence for false reassurance?
Article first published online: 16 MAY 2008
Copyright © 2008 Wiley-Liss, Inc.
International Journal of Cancer
Volume 123, Issue 3, pages 680–686, 1 August 2008
How to Cite
de Gelder, R., van As, E., Tilanus-Linthorst, M. M.A., Bartels, C. C.M., Boer, R., Draisma, G. and de Koning, H. J. (2008), Breast cancer screening: Evidence for false reassurance?. Int. J. Cancer, 123: 680–686. doi: 10.1002/ijc.23540
- Issue published online: 28 MAY 2008
- Article first published online: 16 MAY 2008
- Manuscript Accepted: 22 JAN 2008
- Manuscript Received: 25 OCT 2007
- ZonMw. Grant Number: 2001.0001
- breast cancer;
- false reassurance;
- risk perception
Tumour stage distribution at repeated mammography screening is, unexpectedly, often not more favourable than stage distribution at first screenings. False reassurance, i.e., delayed symptom presentation due to having participated in earlier screening rounds, might be associated with this, and unfavourably affect prognosis. To assess the role of false reassurance in mammography screening, a consecutive group of 155 breast cancer patients visiting a breast clinic in Rotterdam (The Netherlands) completed a questionnaire on screening history and self-observed breast abnormalities. The length of time between the initial discovery of breast abnormalities and first consultation of a general practitioner (“symptom–GP period”) was compared between patients with (“screening group”) and without a previous screening history (“control group”), using Kaplan–Meier survival curves and log-rank testing. Of the 155 patients, 84 (54%) had participated in the Dutch screening programme at least once before tumour detection; 32 (38%) of whom had noticed symptoms. They did not significantly differ from control patients (n = 42) in symptom–GP period (symptom–GP period ≥30 days: 31.2% in the symptomatic screened group, 31.0% in the control group; p = 0.9). Only 2 out of 53 patients (3.8%) with screen-detected cancer had noticed symptoms prior to screening, reporting symptom–GP periods of 2.5 and 4 years. The median period between the first GP- and breast clinic visit was 7.0 days (95% C.I. 5.9–8.1) in symptomatic screened patients and 6.0 days (95% C.I. 4.0–8.0) in control patients. Our results show that false reassurance played, at most, only a minor role in breast cancer screening. © 2008 Wiley-Liss, Inc.