Health
Breast cancer screenings may decline for women who receive false-positive test results, says study
High rates of false positive test results may be keeping women from sticking to recommended mammogram screenings for breast cancer, a new study has found.
Researchers from UC Davis Comprehensive Cancer Center in Sacramento, California, reviewed more than 3.5 million screening mammograms performed among more than one million women between 2005 and 2017.
Women who received a true-negative result were more likely to return for future screenings, with a 77% compliance rate.
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By comparison, among those who received a false positive, only 61% returned for another mammogram in six months, and 67% returned for a recommended biopsy. (A false positive occurs when a mammogram shows an abnormal result that is investigated further, but does not lead to a cancer diagnosis.)
The women, who ranged in age from 40 to 73, had not previously received a breast cancer diagnosis.
High rates of false positives may be keeping women from sticking to recommended mammogram screenings for breast cancer, a new study has found. (iStock)
The study findings were published in the Annals of Internal Medicine on Sept. 3.
Surprising findings
“We found that women were less likely to return for another screening mammogram if they were recalled for additional imaging that did not result in a cancer diagnosis, especially if that recall resulted in a recommendation for a short-interval follow-up or biopsy or if they experienced false-positive exams on two consecutive screening mammograms,” lead study author Dr. Diana Miglioretti, a professor and division chief of biostatistics in the UC Davis School of Medicine’s Department of Public Health Sciences, told Fox News Digital.
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Miglioretti said she was surprised by the findings, as surveys have suggested that women believe they would be just as likely to continue screening even after a false-positive result.
“However, something about the experience seems to influence their actual behavior, and despite their intentions to return, some do not,” she added.
A false positive occurs when a mammogram shows an abnormal result that is investigated further, but does not lead to a cancer diagnosis. (iStock)
Another surprising element, Miglioretti said, was that a false-positive recommendation for a short-interval follow-up — meaning the patient needs to return in six months for diagnostic imaging to evaluate changes in the abnormal finding — had the greatest impact on a woman’s likelihood of not returning for future screenings.
“I initially expected that the probability of returning would be lowest for those who had undergone a benign biopsy,” she said.
“Approximately 10% of screening mammograms require diagnostic work-up, and most women called back for further imaging do not have breast cancer.”
“However, even after following women for five years after a false-positive result, women who received a short-interval follow-up recommendation were the least likely to return for future screening mammograms.”
Asian and Hispanic/Latinx women were least likely to return for future screenings after a false positive.
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“This is extremely concerning, as recent trends have conveyed a much faster rate of growth in breast cancer rates in this demographic than in other ethnic and racial groups,” Dr. Tingting Tan, MD, PhD, a medical oncologist and hematologist at City of Hope Newport Beach in California, told Fox News Digital.
(Tan was not involved in the study.)
“There is a 52% rise in breast cancer rates in the last two decades among Asian-American and Pacific Islander women under the age of 50.”
What to know about false positives
A false positive occurs when a mammogram shows an abnormal result that is investigated further, but does not lead to a cancer diagnosis.
“Following the mammogram, the results will either come back as clear (known as a true negative) or will be flagged for additional testing,” Tan said.
Some common causes of false positives include dense breast tissue, small calcium deposits in the breast, overlapping breast tissue that creates shadows or normal variations in breast tissue. (iStock)
Some common causes of false positives, according to UC Davis, include dense breast tissue, small calcium deposits in the breast, overlapping breast tissue that creates shadows, or normal variations in breast tissue.
False-positive results occur in 10% to 12% of mammograms for women between 40 and 49 years of age, UC Davis noted.
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Within a decade of annual screenings, up to 60% of women experience at least one false positive result.
As a breast cancer specialist, Tan said she often hears the term “scanxiety” to describe the fear that is associated with imaging.
“Even a slight possibility of being diagnosed with cancer can be debilitating, and we understand that the follow-up check-ups after an abnormal mammogram can take an emotional toll,” she said.
“If women have concerns about their false-positive result or are unclear of what it means, they should talk with their doctor,” an expert advised. (iStock)
“While it can be distressing to not have a true negative from that initial mammogram, patients should not worry if their doctor orders a breast ultrasound following a mammogram, as it is a very common procedure.”
Asking questions and having open communication with health care providers can help to ease stress and anxiety when there is follow-up to an abnormal screening, Tan added.
Importance of continued screenings
Based on these findings, the researchers emphasized that women who receive false-positive results should continue screening every one to two years.
“A false positive — particularly if it leads to a diagnosis of benign breast disease — is associated with a small increase in developing breast cancer in the future,” Miglioretti said.
“If women have concerns about their false-positive result or are unclear of what it means, they should talk with their doctor.”
Women should also be aware that a screening test often requires further diagnostic evaluation to confirm that a finding is normal, the doctor added.
“A false positive — particularly if it leads to a diagnosis of benign breast disease — is associated with a small increase in developing breast cancer in the future.”
“This is a standard part of the screening process,” Miglioretti told Fox News Digital.
“Approximately 10% of screening mammograms require diagnostic work-up, and most women called back for further imaging do not have breast cancer.”
Tan emphasized the importance of mammograms as the “gold standard” for breast screening.
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“Mammograms can catch cancer at early stages, before symptoms,” she told Fox News Digital.
“They are proven to decrease mortality, which is why almost every patient will begin with a screening mammogram.”
Potential limitations of the study
The researchers only evaluated false positives on the two prior screening mammograms for each woman, the researchers noted.
“Cancer is highly complex, and it is essential to see a radiologist who specializes in reading mammograms,” an expert advised. (iStock)
“Women could have had false-positive mammograms prior to that,” Miglioretti noted.
The study was also limited to 177 facilities participating in the Breast Cancer Surveillance Consortium (BCSC), which means some women could have received care at non-BCSC facilities.
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“Cancer is highly complex, and it is essential to see a radiologist who specializes in reading mammograms,” Tan advised.
“Early detection is key for better outcomes, which is why it is so important to know your breast cancer risk and to get your regular screenings.”
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A study of World Trade Center responders found that PTSD is associated with molecular changes linked to accelerated biological aging and a higher risk of chronic disease.
The study, led by Stony Brook University in New York, could offer new clues to the long-term physical health effects of post-traumatic stress disorder.
The researchers tested blood samples from 393 WTC responders, collected approximately 18 years after the September 11, 2001, attacks, according to a university press release.
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Out of the sampled responders, 232 were diagnosed with PTSD and 161 were not. Between the two groups, 114 proteins and seven metabolites were significantly different.
Firefighter Gerard McGibbon, of Engine 283 in Brownsville, Brooklyn, prays after the World Trade Center buildings collapsed on September 11, 2001. (Mario Tama/Getty Images)
In particular, the researchers detected changes in blood markers linked to brain function, immune activity, energy metabolism, protection against cell damage and how cells communicate and repair tissues.
Also reported were signs of accelerated biological aging in multiple organs — including the heart, kidneys, liver and lungs — among responders with PTSD.
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These discoveries could help explain why people with long-term PTSD are at greater risk for chronic conditions such as heart disease, lung disease, cognitive decline and other age-related illnesses.
“This study found that chronic PTSD is associated with long-lasting biological changes throughout the body, affecting multiple organs and biological systems decades after their traumatic exposure,” lead study author Benjamin Luft, director and principal investigator at the Stony Brook WTC Wellness Program, told Fox News Digital.
“Traumatic experiences can produce lasting biological changes that persist for decades.”
The study reinforces the view that PTSD is a “whole-body illness” rather than simply a mental health disorder, he noted.
“Traumatic experiences can produce lasting biological changes that persist for decades,” Luft said. “These changes appear to accelerate aspects of biological aging and may increase the risk of many chronic diseases.”
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Several proteins that are critical for healthy brain function were also altered in those with PTSD, the researchers found.
“Many of these proteins play critical roles in helping brain cells communicate with one another, repair damage and maintain healthy connections that support memory and thinking,” Luft said.
A New York firefighter is pictured amid the rubble of the World Trade Center following the 9/11 attacks in 2001. (Universal History Archive/Universal Images Group via Getty Images)
The study – which was funded in part by the CDC, the National Institute for Occupational Safety and the National Institutes of Health – was published in Nature Communications.
Luft said the findings should be viewed with “cautious optimism.”
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“The research provides compelling evidence that PTSD is associated with long-lasting biological changes throughout the body, including signs of accelerated aging, altered metabolism and changes in proteins involved in brain health,” he said.
“These findings strengthen the growing recognition that PTSD is not simply a mental health disorder, but a condition that can have lasting effects on physical health as well.”
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Dr. Marc Siegel, Fox News senior medical analyst, was not involved in the study but called the results “fascinating.”
“This speaks to the complex reality that PTSD is not an isolated psychiatric event due to emotional trauma alone, but that it is also tied in with physical trauma,” he told Fox News Digital. “The stress is both emotional and physical, and leads directly to immune dysregulation and aging processes.”
“These findings strengthen the growing recognition that PTSD is not simply a mental health disorder, but a condition that can have lasting effects on physical health as well,” the researcher said. (iStock)
“The chronic diseases that resulted from high exposure in the aftermath of the 9/11 World Trade Center attacks were conjoined in terms of the impact on physical and emotional well-being, longevity and effects on multiple organ systems, as well as core metabolic and immunological processes,” the doctor added.
Study limitations
There were some limitations to the findings, the researchers noted.
“Because all measurements were taken at one point in time, the research can only show an association — not that PTSD directly caused the changes,” Luft noted.
“We are currently doing studies in these patients examining multiple time points to see whether the changes in specific proteins and metabolites precede clinical changes.”
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Also, because the study was done on a unique population – World Trade Center responders who experienced very specific trauma and environmental exposures – the findings may not apply to everyone with PTSD, “such as combat veterans, survivors of abuse or people who experienced other types of trauma.”
Several proteins that are critical for healthy brain function were also altered in those with PTSD, the researchers found. (iStock)
Women are not well-represented in the study, comprising only 10% of responders.
“Blood tests cannot tell us exactly what is happening inside the brain,” Luft said. “Although many of the altered proteins are related to brain function, blood measurements are only an indirect reflection of processes occurring in the brain.”
Looking ahead
Additional studies are needed to determine whether these blood markers can predict disease progression or treatment response.
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“From a public health and policy perspective, the study reinforces the importance of recognizing PTSD as a chronic medical condition with significant long-term health implications,” Luft said.
“Investing in early diagnosis, comprehensive treatment and long-term follow-up for trauma survivors, including our first responders and veterans, may improve quality of life while reducing the burden of chronic disease.”
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The leading causes of death have changed dramatically since America’s founding 250 years ago, highlighting how far medicine has come.
Diseases that once devastated communities have largely given way to chronic conditions, data shows, reflecting centuries of breakthroughs in public health, prevention and treatment.
“The amount of changes that have happened over the past 250 years are immeasurable when it comes to life expectancy and disease,” Kenneth J. Perry, M.D., an emergency physician in Charleston, South Carolina, told Fox News Digital.
5 OF AMERICA’S GREATEST MEDICAL BREAKTHROUGHS REVEALED AS THE NATION MARKS 250 YEARS
“Our life expectancy as a country increased from roughly 30 years at the time of the country’s founding to close to 80 years today.”
Check out the following details.
An illustration of an 18th century hospital. The leading causes of death have changed dramatically since America’s founding 250 years ago. (Hulton Archive/Getty Images)
What killed Americans in 1776?
Although there were no official national mortality records in 1776, historians agree that the following illnesses were responsible for the largest number of deaths.
- Smallpox: This viral disease, which causes fever and a blistering rash, had about a 30% fatality rate before the first vaccine became available in 1796. Historians estimate the North American epidemic killed at least 100,000 to 130,000 people over several years.
- Tuberculosis: Also known as consumption, this bacterial infection primarily attacks the lungs. It was one of the leading chronic causes of adult death in the colonies, according to the National Library of Medicine (NLM).
- Pneumonia: A lung infection that fills air sacs with fluid or pus, pneumonia was frequently fatal in 1776 because no antibiotics or effective treatments existed, per the National Institutes of Health (NIH).
- Dysentery and diarrheal diseases: Intestinal infections, which caused severe diarrhea and dehydration, were common in 1776 because of poor sanitation and contaminated food and water, especially in military camps, per NIH and NLM.
- Malaria: This mosquito-borne parasitic disease causes recurrent fever and chills. It was endemic throughout much of the Southern colonies, the CDC states.
- Yellow fever: A mosquito-borne viral disease, yellow fever can cause liver failure and bleeding. Periodic epidemics struck colonial port cities in the late 1700s, NLM records show.
- Typhoid fever: This bacterial infection spreads through contaminated food and water. Recurring outbreaks were common in places where sanitation was poor, historians confirm.
- Childbirth complications: Maternal deaths from hemorrhage, infection or obstructed labor were common in 1776. This was a major cause of death among women of childbearing age, the NLM states.
- Wound infections: In colonial times, cuts or injuries often led to bacterial infections. These could prove fatal because antisepsis therapies, germ theory and antibiotics did not yet exist.
- Infant mortality: It was extremely common for children to die before age 1, with roughly 10% to 30% of infants not living to their first birthday in many colonial communities, historical records show.
These conditions had much higher fatality rates in 1776 because Americans had no antibiotics, few vaccines, no understanding of germ theory, no sterile surgical techniques and limited access to hospitals, experts note.
Yellow fever epidemic in Philadelphia, 1793. Carriages rumbled through the streets to pick up the dying and the dead. (Getty Images)
There was also a lack of safe drinking water, modern sewage systems and refrigeration — making it more likely for foodborne and waterborne illnesses to spread.
Patients also did not yet have access to blood transfusions, anesthesia and other lifesaving medical advances, according to the CDC, NLM and NIH.
Common causes of death in the 1900s
The first official national mortality statistics were published by the U.S. Census Bureau in 1900.
The data points to the following leading causes of death in the 1900s.
- Influenza & pneumonia: Viral flu and bacterial/viral lung infections were responsible for about 40,000 to 65,000 deaths per year during the period between 1900 and 1910, according to the CDC’s National Center for Health Statistics (NCHS).
- Tuberculosis: The bacteria lung infection claimed about 35,000 to 40,000 lives per year during that same time frame, per the above source.
- Diarrhea/enteritis: Intestinal infections causing severe dehydration led to approximately 25,000 to 35,000 annual deaths between 1900 and 1910.
- Heart disease: Diseases affecting the heart and circulatory system killed between 27,000 and 40,000 Americans per year in this time frame, according to NCHS.
- Stroke: Strokes, which interrupt the flow of blood to the brain, took between 20,000 and 30,000 lives annually.
- Kidney disease: Diseases that impair kidney function (also called nephritis), killed between 17,000 and 25,000 people in the U.S. each year, data shows.
- Accidents: Between 15,000 and 22,000 Americans died each year from unintentional injuries at work, home and in transportation, per NCHS.
- Cancer: Various types of cancer, in which malignant tumors invade surrounding tissues, contributed to between 13,000 and 20,000 deaths annually in this time frame.
- Senility: This was a historical diagnosis for deaths attributed to old age in the early 1900s. It was listed as the cause of death for about 12,000 to 18,000 people per year.
- Diphtheria: The bacterial throat infection, which can block the airway, led to 8,000 to 12,000 deaths per year, mortality data highlights.
Nearly one-third of all deaths were caused by pneumonia, tuberculosis and diarrheal diseases, and about 30% of all deaths occurred in children younger than age 5, records show.
A diphtheria vaccination is administered in the 1900s in this illustration. (Getty Images)
Medical breakthroughs that transformed survival
The introduction of vaccines dramatically reduced certain diseases, including smallpox, polio, diphtheria, measles and whooping cough.
In 1980, smallpox became the first human disease ever eradicated worldwide.
The introduction of vaccines dramatically reduced certain diseases, including smallpox, polio, diphtheria, measles and whooping cough. (iStock)
Improvements in clean water and sanitation also contributed to greater longevity, as cities built sewage systems, water treatment plants and indoor plumbing, according to the CDC. As a result, deaths from cholera, dysentery and typhoid fever fell dramatically.
Germ theory also emerged in the late 1800s, in which scientists discovered that germs caused disease. This led to vast transformations in surgery, childbirth, handwashing, sterilization and infection control, per NIH and the Science History Institute.
In the 1940s, the widespread use of penicillin allowed for the treatment of diseases that were once fatal.
Routine screening has enabled earlier detection of breast, cervical and colorectal cancers, while improvements in surgery, radiation therapy, chemotherapy, targeted therapies and immunotherapy have helped many patients live longer.
A recent analysis by the National Cancer Institute found that prevention and screening accounted for about 80% of the cancer deaths averted over the past 45 years for five major cancer types.
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In the 1940s, the widespread use of penicillin allowed for the treatment of diseases that were once fatal, including pneumonia, strep infections, wound infections and sepsis.
Advances in childbirth — including prenatal care, Cesarean sections, blood transfusions, antibiotics and neonatal intensive care — also dramatically improved maternal and infant survival compared with colonial America.
The use of CPR, defibrillators, coronary care units, bypass surgery, stents, statins and blood pressure medications helped to reduce cardiovascular deaths. (iStock)
The mid-20th century also ushered in improvements in heart disease treatments. The use of CPR, defibrillators, coronary care units, bypass surgery, stents, statins and blood pressure medications helped to reduce cardiovascular deaths, according to the American Heart Association.
What’s killing Americans today?
In a vast contrast to 1776, chronic diseases now account for most American deaths, because people generally live long enough to develop them.
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Current U.S. health data indicates that the following conditions are now the leading causes of death.
- Heart disease: Disorders affecting the heart and blood vessels, including coronary artery disease and heart attacks, killed more than 638,000 Americans in 2024, according to NCHS data.
- Cancer: Approximately 619,876 people died of cancer in the U.S. in 2024.
- Unintentional injuries: Accidental deaths, including drug overdoses, motor vehicle crashes and falls, were the causes of more than 197,440 deaths that same year, records show.
- Stroke: Interruption of blood flow to the brain, which causes brain damage, claimed 166,852 American lives in 2024, per NCHS.
- Chronic lower respiratory disease: Long-term lung diseases — such as COPD, emphysema and chronic bronchitis — killed 145,643 people in the U.S. that year.
- Alzheimer’s disease: The most common type of dementia, which destroys memory and cognitive function, was responsible for 116,022 deaths in 2024, NCHS data shows.
- Diabetes: The chronic disease, which impairs the body’s ability to properly regulate blood sugar, contributed to 94,445 deaths that year.
- Kidney disease: Diseases that damage the kidneys and impair their ability to filter blood were blamed for 55,081 deaths in 2024.
- Chronic liver disease/cirrhosis: Progressive liver damage caused by conditions such as hepatitis, alcohol misuse or fatty liver disease were responsible for 52,274 deaths that year, per NCHS.
- Suicide: Death caused by intentional self-harm claimed 48,824 lives in 2024. (If you or someone you know is having thoughts of suicide, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).)
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“The transformation of deaths in the last 250 years, largely from infectious diseases to currently chronic debilitating diseases, represents both success and new challenges Americans will have to face,” Dr. Omer Awan, a physician and professor at the University of Maryland School of Medicine, told Fox News Digital.
“The chronic disease epidemic has been fueled by a lack of exercise, as well as by diets rich in fats, salts and ultraprocessed foods,” a doctor told Fox News Digital. (iStock)
The uptick in chronic diseases is driven not only by an increasingly aging population, but by people’s lifestyle behaviors, according to the doctor.
“The chronic disease epidemic has been fueled by lack of exercise, as well as diets rich in fats, salts and ultraprocessed foods,” he told Fox News Digital. “This has also led to the rise of obesity, which contributes to many of the chronic medical conditions that are among the top killers for Americans in the modern era.”
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Public health advances can change the course of health for millions of Americans, Awan said.
“Just as vaccines and antibiotics prolonged life centuries ago, so can lifestyle changes, exercise and new therapies that target obesity — like GLP-1 drugs and medications that promote better metabolic health.”
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