Examining the effects of false positive lung cancer screening results on subsequent lung cancer screening adherence.

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.