Cumulative risks of false positive recall and screen-detected breast cancer after multiple screening examinations

Lindy M. Kregting*, Nicolien T. van Ravesteyn, Sarocha Chootipongchaivat, Eveline A.M. Heijnsdijk, Johannes D.M. Otten, Mireille J.M. Broeders, Harry J. de Koning

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)


Women tend to make a decision about participation in breast cancer screening and adhere to this for future invitations. Therefore, our study aimed to provide high-quality information on cumulative risks of false-positive (FP) recall and screen-detected breast cancer over multiple screening examinations. Individual Dutch screening registry data (2005-2018) were gathered on subsequent screening examinations of 92 902 women age 49 to 51 years in 2005. Survival analyses were used to calculate cumulative risks of a FP and a true-positive (TP) result after seven examinations. Data from 66 472 women age 58 to 59 years were used to extrapolate to 11 examinations. Participation, detection and additional FP rates were calculated for women who previously received FP results compared to women with true negative (TN) results. After 7 examinations, the cumulative risk of a TP result was 3.7% and the cumulative risk of a FP result was 9.1%. After 11 examinations, this increased to 7.1% and 13.5%, respectively. Following a FP result, participation was lower (71%-81%) than following a TN result (>90%). In women with a FP result, more TP results (factor 1.59 [95% CI: 1.44-1.72]), more interval cancers (factor 1.66 [95% CI: 1.41-1.91]) and more FP results (factor 1.96 [95% CI: 1.87-2.05]) were found than in women with TN results. In conclusion, due to a low recall rate in the Netherlands, the cumulative risk of a FP recall is relatively low, while the cumulative risk of a TP result is comparable. Breast cancer diagnoses and FP results were more common in women with FP results than in women with TN results, while participation was lower.

Original languageEnglish
Pages (from-to)312-319
Number of pages8
JournalInternational Journal of Cancer
Issue number2
Early online date10 Apr 2023
Publication statusPublished - Jul 2023

Bibliographical note

Funding Information:
This research was funded by the Centre for Population Screening (CvB) of the Dutch National Institute for Public Health and the Environment (RIVM). The CvB was not in any way involved in the study design, analysis or interpretation of the data, nor in the writing of the report or in the decision to submit the article for publication.

Publisher Copyright:
© 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.


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