Abstract PO-257: Prevalence and correlates of false-positive results in screening mammography among uninsured women in a community outreach program

Abstract

Abstract Introduction: False-positive mammographic screening results are one of the most important harms of breast cancer screening, and their prevalence in the insured population range from 8.7% to 16.3% during the first screening encounter. However, false-positive results have been rarely investigated among uninsured minority women screened through community outreach programs. For this study, we analyzed data from the Breast Screening and Patient Navigation (BSPAN) program participants with an aim to report prevalence and assess correlates of false-positive results in screening mammograms, stratified by age. Methods: BSPAN, created by Moncrief Cancer Institute, contracts with the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and uses a hub-and-spoke model to provide patient navigation and no-cost breast cancer screening and diagnostic services to under- and uninsured predominantly minority women in North Texas. We defined false-positive result as a positive screening mammogram (BI-RADS 0, 3, 4 or 5) followed by a negative diagnostic mammogram (BI-RADS 1, 2 or 3) or a negative biopsy within 9 months of the screen. We used multivariable logistic regression to assess associations of demographic and clinical covariates with false positive results for each age group (40-49 years and 50-64 years, which coincides with age eligibility for NBCCEDP). Results: BSPAN provided screening services to 21,022 women between 2012 and 2019. Prevalence of false-positive results in these women was 11.8% in the 40-49 age group and 9.6% in the 50-64 age group. Multivariable logistic regression demonstrated that, in the 40-49 age group, women who were non-menopausal, did not use hormone replacement therapy, and had prior mammograms had higher odds of false-positive results than those who were menopausal, used hormone replacement therapy and had no prior mammograms, respectively. In the 50-64 age group, women with a prior diagnostic mammogram had higher odds of false-positive results than those without a prior diagnostic mammogram. Discussion: This study establishes contemporary evidence regarding prevalence and correlates of false-positive rates in the unique BSPAN population, where women were predominantly Hispanic, under- and uninsured receiving no-cost screening and diagnostic services through a real-world outreach program. Our findings demonstrate that uninsured women who receive no-cost mammograms are similar to insured women in two aspects: prevalence of false-positive rates in our study is comparable to those among insured population, and we found higher false positive rates among younger women, compared to older women. Impact: Equitable screening outcomes in underserved population emphasizes the need for efforts to reduce false-positive screening rates among uninsured women served through community outreach programs. Citation Format: Rasmi G. Nair, Simon J. Craddock Lee, Hong Zhu, Firouzeh K. Arjmandi, Emily Berry, Keith E. Argenbright, Jasmin A. Tiro, Celette S Skinner. Prevalence and correlates of false-positive results in screening mammography among uninsured women in a community outreach program [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-257.