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Examining the Effects of False Positive Lung Cancer Screening Results on Subsequent Lung Cancer Screening Adherence¹

Department of Psychiatry and Center for Research in Diverse Populations [M. E. F.], Department of Biostatistics and Research Epidemiology [S. L. H.], Josephine Ford Cancer Center, Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial [L. F.], and Cancer Epidemiology, Prevention and Control, Josephine Ford Cancer Center [C. C. J.], Henry Ford Health Sciences Center, Detroit, Michigan 48202

Objective: The study goal was to examine the effects of an initial false positive chest X-ray screening result on subsequent lung cancer screening adherence.

Methods: Adherence rates among 4705 individuals in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial at the Henry Ford Health System site with an abnormal/suspicious chest X-ray screening result in the first study year that was subsequently determined to be noncancerous (false positive result, n = 1137 exams) were compared with adherence rates among individuals with an initial negative chest X-ray screening result (n = 3568 exams).

Results: Univariate results showed a >50% increase in subsequent nonadherence among individuals with false positive screening results compared with those with negative screening results (17.2% versus 10.3% nonadherence rate, respectively; P < 0.001). Multivariable results showed that statistically significant predictors of nonadherence were false positive cases with current smoking status (P < 0.001) and false positive cases with past smoking status (P < 0.001). Additional predictors of subsequent nonadherence were being African-American (P < 0.01), being female (P < 0.001), and having a high school education or less (P < 0.01).

Conclusion: Our results demonstrate that the impact of previous screening results, smoking status, race, gender, and education on subsequent screening adherence needs to be weighed carefully, particularly for smokers, an at-risk group, when conducting lung cancer screening intervention studies and perhaps should be considered in clinical practice as well.

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