DISTRESSED OR RELIEVED - PSYCHOLOGICAL SIDE-EFFECTS OF BREAST-CANCER SCREENING IN THE NETHERLANDS

Study objectives-To assess the psychological impact of mammographic sc reening on women with non-malignant outcomes after attending the Nethe rlands' National Breast Cancer Screening Programme. Design-During one year all women with false positive test results (95) in a screening ar ea were invited for the study. Each false positive was matched with tw o women with normal mammograms with respect to age and municipality. A random reference group of 400 was drawn from the female population in an area not yet included in the screening programme. Experiences with screening and psychological status of subjects were assessed 8-10 wee ks after screening (T1) and again after six months (T2), by interviews as well as questionnaires. References completed two questionnaires wi th a six months' interval. Participants-74 (78%) women with false posi tive outcomes and 113 (59%) women with negative outcomes participated at T1, of these 65 (88%) and 105 (93%) at T2, respectively; 238 refere nces returned questionnaires at T1 (59%), of these 143 (60%) at T2. Ma in results-At 8-10 weeks after the screening, the women who received f alse positive test results scored higher on most of the variables indi cating psychological disfunctioning than women with normal mammograms, but did not notably differ on the same variables from the non-screene d reference group. Women with normal mammograms had the lowest scores on all the variables in the study at both assessments. The same situat ion was observed six months later. Although 61% of the women who recei ved false positive mammograms reported that they had experienced the ' 'false alarm'' as a stressful event, this experience had apparently no adverse effects on their psychological functioning, as assessed 8-10 weeks after screening. Conclusions-Overall, breast screening is not li kely to generate adverse psychological effects in ''healthy'' women, e ven if the outcome is false positive. Differences in psychological fun ctioning between false positives and negatives are more likely ascriba ble to feelings of relief in the negative group than to raised anxiety and distress in the false positive group.