Do negative screening test results cause false reassurance? A systematic review

Area of Science:

• Public Health
• Preventive Medicine
• Behavioral Science

Background:

• Screening tests aim to detect diseases early, but negative results may lead to a 'false reassurance' or 'certificate of health effect'.
• This false reassurance could lead individuals to underestimate their disease risk and reduce engagement in beneficial health behaviors.

Purpose of the Study:

• To systematically review existing evidence on the false reassurance effects of negative screening test results in adults.
• To assess the impact of negative results on perceived disease risk, anxiety, health behaviors, and self-rated health.

Main Methods:

• A systematic review of MEDLINE and PsycINFO databases was conducted.
• Included trials compared adults receiving negative screening results against unscreened control groups.
• Outcomes assessed included perceived risk, anxiety, health behaviors (smoking, diet, physical activity, alcohol), and self-rated health.

Main Results:

• Nine studies with 55 measures were analyzed, with outcomes assessed up to 11 years post-screening.
• Effect sizes were generally small, with few statistically significant differences between groups.
• Significant concerns were noted regarding high risk of bias and the validity of behavioral measures in the included studies.

Conclusions:

• The current limited evidence suggests negative screening test results are unlikely to cause significant false reassurance or negatively impact lifestyle behaviors.
• False reassurance should not be considered a major harm associated with screening.
• Further high-quality research is warranted to confirm these findings, particularly in cost-effective ways.