(after the application): Although screening mammography is clearly beneficial in reducing breast cancer mortality, false positive mammogram results are common, with an estimated cumulative risk of approximately 50 percent after 10 years of annual screening. Several studies suggest that false positive mammograms can lead to adverse psychological and social effects. These effects may be substantial enough in some women to negatively effect daily functioning. Such patients may be experiencing a labeling phenomenon such as that described previously in newly diagnosed hypertensive patients. Better understanding of these issues would permit the development of strategies for reducing the adverse effects of screening mammography or the identification of populations for whom mammography might not be advised. The purpose of this project is to analyze two established population-based databases to determine whether such a labeling effect is present following a false positive mammogram.
The specific aims will be: 1. To identify a population of women that has undergone screening mammography and can be followed prospectively for at least one year, and to categorize these women according to false positive or true negative mammogram status. 2. To compare two groups of women, those with false positive mammograms and those with true negative mammograms, at the end of one year with regard to days-off work, perceived health status, physician visits and medical expenditures. 3. To perform secondary analyses of the outcomes looking at associations with race, age, socioeconomic status, and comorbidity. Cohorts will be constructed independently from the Medical Expenditure Panel Survey (MEPS) and the cancer-free control group of the Surveillance Epidemiology and End Results (SEER) /Medicare-linked databases.(SEER Controls). Days-off work, perceived health status, and utilization will be evaluated using the MEPS patients. More detailed health care utilization and race/ socioeconomic subgroup analysis will be conducted using the SEER controls.
