False positive screening for cancer found to be frequent and costly

Cancer screening tests can frequently produce false positive outcomes that may result not only in anxiety but also additional economic costs as well, according to research conducted by scientists at the Henry Ford Health System, Detroit, Mich., and published in the December issue of Cancer Epidemiology, Biomarkers & Prevention.

Among 1,087 individuals participating in a cancer screening trial who received a battery of tests for prostate, ovarian, colorectal and lung cancer, 43 percent had at least one false positive test result, according to Jennifer Elston Lafata, Ph.D., director of the Center for Health Services Research at the Henry Ford Health System and the lead author on the study.

“As new cancer screening tests are developed it is important to consider not only their potential clinical benefits, but also their potential for adverse effects,” said Lafata, director of the Center for Health Services Research at the Henry Ford Health System. “One such adverse effect is the medical care costs associated with false positive cancer screening test results. Although such costs are often overlooked, we’ve shown they can be quite substantial.”

Specifically, men who incurred a false positive result for either prostate, lung or colorectal cancer averaged $1,171 in additional medical care expenditures compared to men with all negative screens. More than half, 51 percent, of the men in the study had at least one false positive test. For women, 36 percent had false positive screening results. Women with a false positive screen for ovarian, colorectal or lung cancer experienced $1,024 more in follow-up medical care expenses compared to women with all negative results.

The study was funded by the National Cancer Institute and is part of a larger trial of the effectiveness of screening for prostate, lung, colorectal and ovarian cancers. “The results of this smaller study add to the growing body of evidence highlighting the importance of understanding not only the likely benefits of cancer screening, but also how the accuracy of screening tests impacts patients and medical care expenditures, and thus the overall cost-effectiveness of different screening alternatives,” Lafata said.

“Although the clinical evidence for the use of these and many other new screening tests is still being developed, many such screening tests are already widely used in practice thereby resulting in what can be substantial additional medical care costs without known benefits.”

Henry Ford Medical Group researchers who collaborated with Lafata in the study included Janine Simpkins, M.A., Lois Lamerato, Ph.D., Laila Poisson, M.S., George Divine, Ph.D., and Christine Cole Johnson, Ph.D.