False-negative results in screening programs. Medical, psychological, and other implications

Area of Science:

• Public Health
• Medical Screening
• Health Services Research

Background:

• Screening programs aim to detect diseases early but carry inherent risks.
• The consequences of false-negative results in screening programs are not well understood.
• This study systematically reviews the medical, psychological, economic, and legal impacts of false negatives.

Purpose of the Study:

• To assess the medical, psychological, economic, and legal consequences of false-negative results in national screening programs.
• To synthesize existing evidence on the harms associated with screening inaccuracies.
• To inform the evaluation of screening program appropriateness.

Main Methods:

• Systematic literature review incorporating a comprehensive search and expert consultation.
• Analysis of thirteen studies with quantitative medical data, eight with psychological data, and two with economic data.
• Evaluation of the strength of evidence from primary studies.

Main Results:

• Evidence for medical, psychological, and economic consequences of false negatives is generally limited or anecdotal.
• False-negative results can have significant legal implications.
• There is a consensus that false negatives negatively impact public confidence in screening, though evidence is limited.

Conclusions:

• False negatives occur even in high-quality screening programs, potentially delaying cancer detection.
• Psychological consequences of false negatives are poorly documented.
• False negatives can lead to legal challenges and erode public trust; improved participant information and education are recommended.