Adjusted Analyses of Psychosocial Consequences of Breast Cancer Screening: Estimated Mean Differences Between Each Pair of 3 Diagnosis Groups.
| Follow-up Time | Follow-up Time | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| 0 Months | 1 Month | 6 Months | 18 Months | 36 Months | |||||||
| Scale (Range) | Differencea | Mean Δ (95% CI) | P Value | Mean Δ (95% CI) | P Value | Mean Δ (95% CI) | P Value | Mean Δ (95% CI) | P Value | Mean Δ (95% CI) | P Value |
| 1. Sense of dejection (0–18) | Normal →→ breast cancer | 6.34 (5.52 to 7.17) | <.001 | 4.09 (2.88 to 5.30) | <.001 | 2.54 (1.86 to 3.22) | <.001 | 2.18 (1.47 to 2.88) | <.001 | 5.91 (5.08 to 6.75) | <.001 |
| Normal → false p ositive | 5.91 (5.27 to 6.55) | <.001 | 0.83 (0.23 to 1.43) | .007 | 0.88 (0.39 to 1.36) | <.001 | 0.69 (0.16 to 1.21) | .011 | 2.45 (1.89 to 3.02) | <.001 | |
| False positive → breast cancer | 0.43 (−0.58 to 1.44) | .401 | 3.26 (2.05 to 4.47) | <.001 | 1.66 (0.86 to 2.47) | <.001 | 1.49 (0.63 to 2.35) | .001 | 3.46 (2.49 to 4.43) | <.001 | |
| No. responding | 1, 270 | 942 | 993 | 1,042 | 1,034 | ||||||
| 2. Anxiety (0–18) | Normal → breast cancer | 6.17 (5.35 to 7.00) | <.001 | 3.68 (2.59 to 4.77) | <.001 | 2.38 (1.67 to 3.09) | <.001 | 2.19 (1.51 to 2.88) | <.001 | 5.35 (4.57 to 6.13) | <.001 |
| Normal → false positive | 5.83 (5.17 to 6.49) | <.001 | 1.08 (0.50 to 1.66) | <.001 | 0.95 (0.47 to 1.43) | <.001 | 0.87 (0.17 to 1.56) | .014 | 2.39 (1.84 to 2.94) | <.001 | |
| False positive → breast cancer | 0.34 (−0.68 to 1.37) | .510 | 2.60 (1.47 to 3.72) | <.001 | 1.43 (0.60 to 2.26) | .001 | 1.33 (0.37 to 2.28) | .007 | 2.96 (2.03 to 3.89) | <.001 | |
| No. responding | 1, 244 | 930 | 987 | 1,032 | 1,029 | ||||||
| 3. Negative impact on behavior (0–21) | Normal → breast cancer | 3.99 (3.26 to 4.73) | <.001 | 3.76 (2.73 to 4.79) | <.001 | 2.31 (1.59 to 3.03) | <.001 | 1.79 (1.13 to 2.46) | <.001 | 4.87 (4.10 to 5.63) | <.001 |
| Normal → false positive | 3.70 (3.12 to 4.28) | <.001 | 0.89 (0.30 to 1.49) | .003 | 0.85 (0.35 to 1.36) | .001 | 0.60 (−0.01 to 1.20) | .054 | 1.75 (1.24 to 2.25) | <.001 | |
| False positive → breast cancer | 0.29 (−0.61 to 1.20) | .527 | 2.87 (1.73 to 4.01) | <.001 | 1.46 (0.58 to 2.34) | .001 | 1.20 (0.31 to 2.08) | .008 | 3.12 (2.24 to 4.00) | <.001 | |
| No. responding | 1,235 | 934 | 985 | 1,038 | 1,025 | ||||||
| 4. Negative impact on sleep (0–12) | Normal → breast cancer | 2.89 (2.26 to 3.52) | <.001 | 2.77 (1.86 to 3.69) | <.001 | 1.99 (1.34 to 2.65) | <.001 | 1.53 (0.99 to 2.06) | <.001 | 3.20 (2.53 to 3.87) | <.001 |
| Normal → false positive | 2.81 (2.33 to 3.30) | <.001 | 0.65 (0.14 to 1.16) | .013 | 0.71 (0.25 to 1.17) | .003 | 0.71 (0.17 to 1.25) | .010 | 1.31 (0.87 to 1.75) | <.001 | |
| False positive → breast cancer | 0.08 (−0.69 to 0.85) | .845 | 2.12 (1.17 to 3.08) | <.001 | 1.29 (0.50 to 2.08) | .001 | 0.82 (0.08 to 1.55) | .029 | 1.89 (1.12 to 2.66) | <.001 | |
| No. responding | 1,257 | 941 | 984 | 1,043 | 1,043 | ||||||
| 5. Breast examination (0–6) | Normal → breast cancer | 1.73 (1.40 to 2.06) | <.001 | 1.13 (0.69 to 1.57) | <.001 | 0.99 (0.69 to 1.30) | <.001 | 0.67 (0.38 to 0.95) | <.001 | 1.37 (1.08 to 1.66) | <.001 |
| Normal → false positive | 1.64 (1.40 to 1.88) | <.001 | 0.46 (0.22 to 0.69) | <.001 | 0.38 (0.17 to 0.60) | .001 | 0.38 (0.14 to 0.62) | .002 | 0.69 (0.47 to 0.90) | <.001 | |
| False positive → breast cancer | 0.10 (−0.29 to 0.48) | .629 | 0.67 (0.21 to 1.14) | .005 | 0.61 (0.27 to 0.95) | <.001 | 0.28 (−0.06 to 0.63) | .106 | 0.68 (0.35 to 1.02) | <.001 | |
| No. responding | 1,28 0 | 942 | 998 | 1,053 | 1,04 4 | ||||||
| 6. Negative impact on sexuality (0–6) | Normal → breast cancer | 1.04 (0.58 to 1.50) | <.001 | 1.55 (1.00 to 2.11) | <.001 | 1.26 (0.80 to 1.72) | <.001 | 1.01 (0.63 to 1.39) | <.001 | 1.97 (1.54 to 2.40) | <.001 |
| Normal → false positive | 0.76 (0.45 to 1.07) | <.001 | 0.26 (−0.09 to 0.61) | .151 | 0.13 (−0.09 to 0.35) | .234 | 0.31 (−0.04 to 0.66) | .086 | 0.50 (0.26 to 0.74) | <.001 | |
| False positive → breast cancer | 0.29 (−0.27 to 0.84) | .316 | 1.29 (0.66 to 1.92) | <.001 | 1.13 (0.65 to 1.61) | <.001 | 0.70 (0.20 to 1.21) | .006 | 1.47 (0.99 to 1.95) | <.001 | |
| No. responding | 992 | 842 | 889 | 939 | 900 | ||||||
| Single item: felt less attractive (0–3) | Normal → breast cancer | 0.20 (0.10 to 0.30) | <.001 | 0.48 (0.32 to 0.65) | <.001 | 0.45 (0.26 to 0.65) | <.001 | 0.29 (0.17 to 0.41) | <.001 | 0.36 (0.24 to 0.48) | <.001 |
| Normal → false positive | 0.17 (0.10 to 0.25) | <.001 | 0.08 (−0.00 to 0.16) | .060 | 0.13 (0.03 to 0.22) | .008 | 0.07 (0.01 to 0.14) | .023 | 0.09 (0.03 to 0.15) | .003 | |
| False positive → breast cancer | 0.03 (−0.10 to 0.15) | .668 | 0.40 (0.22 to 0.58) | <.001 | 0.33 (0.11 to 0.54) | .003 | 0.22 (0.09 to 0.35) | .001 | 0.27 (0.14 to 0.40) | <.001 | |
| No. responding | 1,261 | 941 | 993 | 1,050 | 1,0 42 | ||||||
| Single item: Keeping my mind off things (0–3) | Normal → breast cancer | 1.14 (0.96 to 1.31) | <.001 | 0.84 (0.57 to 1.11) | <.001 | 0.44 (0.28 to 0.60) | <.001 | 0.51 (0.34 to 0.67) | <.001 | 1.07 (0.89 to 1.25) | <.001 |
| Normal → false positive | 1.10 (0.96 to 1.25) | <.001 | 0.21 (0.05 to 0.37) | .010 | 0.23 (0.11 to 0.35) | <.001 | 0.16 (0.04 to 0.27) | .007 | 0.44 (0.32 to 0.57) | <.001 | |
| False positive → breast cancer | 0.04 (−0.18 to 0.26) | .741 | 0.63 (0.34 to 0.92) | <.001 | 0.21 (0.01 to 0.41) | .037 | 0.35 (0.16 to 0.55) | <.001 | 0.63 (0.41 to 0.84) | <.001 | |
| No. responding | 1,292 | 946 | 999 | 1,053 | 1,048 | ||||||
| 7. Worried about breast cancer (0–4) | Normal → breast cancer | NA | NA | NA | NA | NA | |||||
| Normal → false positive | NA | 0.61 (0.30 to 0.92) | <.001 | 0.23 (0.02 to 0.43) | .030 | 0.16 (−0.03 to 0.35) | .099 | 0.69 (0.49 to 0.90) | <.001 | ||
| False positive → breast cancer | NA | NA | NA | NA | NA | ||||||
| No. responding | 0 | 826 | 863 | 912 | 930 | ||||||
| 8. Inner calm (0–4) | Normal → breast cancer | NA | 0.56 (0.28 to 0.84) | <.001 | 0.43 (0.18 to 0.67) | .001 | 0.39 (0.14 to 0.63) | .002 | 0.76 (0.55 to 0.98) | <.001 | |
| Normal → false positive | NA | 0.42 (0.13 to 0.72) | .005 | 0.16 (−0.04 to 0.36) | .115 | 0.03 (−0.16 to 0.21) | .786 | 0.65 (0.46 to 0.84) | <.001 | ||
| False positive → breast cancer | NA | 0.13 (−0.19 to 0.46) | .423 | 0.26 (−0.01 to 0.54) | .063 | 0.36 (0.08 to 0.64) | .012 | 0.11 (−0.14 to 0.37) | .396 | ||
| No. responding | 0 | 974 | 1,014 | 1,056 | 1,085 | ||||||
| 9. Social network (0–6) | Normal → breast cancer | NA | 0.81 (0.50 to 1.12) | <.001 | 0.91 (0.65 to 1.18) | <.001 | 0.58 (0.33 to 0.82) | <.001 | 1.29 (1.02 to 1.56) | <.001 | |
| Normal → false positive | NA | 0.34 (0.04 to 0.64) | .026 | 0.27 (0.09 to 0.46) | .004 | 0.20 (0.04 to 0.40) | .016 | 0.39 (0.22 to 0.57) | <.001 | ||
| False positive → breast cancer | NA | 0.47 (0.14 to 0.81) | .006 | 64 (0.34 to 0.94) | <.001 | 0.38 (0.10 to 0.65) | .007 | 0.90 (0.60 to 1.19) | <.001 | ||
| No. responding | 0 | 967 | 1,00 4 | 1,055 | 1,082 | ||||||
| 10. Existential values (0–12) | Normal → breast cancer | NA | 2.90 (2.04 to 3.75) | <.001 | 2.59 (1.94 to 3.24) | <.001 | 2.27 (1.61 to 2.93) | <.001 | 3.02 (2.41 to 3.63) | <.001 | |
| Normal → false positive | NA | 1.74 (1.04 to 2.44) | <.001 | 1.46 (0.95 to 1.97) | <.001 | 0.83 (0.36 to 1.30) | .001 | 2.51 (2.02 to 3.00) | <.001 | ||
| False positive → breast cancer | NA | 1.15 (0.23 to 2.07) | .015 | 1.12 (0.36 to 1.89) | .004 | 1.43 (0.69 to 2.19) | <.001 | 0.51 (−0.20 to 1.23) | .158 | ||
| No. responding | 0 | 959 | 996 | 1,043 | 1,075 | ||||||
Note: The correlation between repeated measures on the same woman is controlled for by generalized estimating equations (GEE) methods.
NA = not applicable.
↵a The mean difference Ä should be interpreted as the mean score in the group after the arrow minus the mean score in the group before the arrow shown in column marked Difference.