Estimating the Cumulative Risk of a False-Positive Test in a Repeated Screening Program with Multiple Modalities

• Activity Number: 607
• Type: Contributed
• Date/Time: Thursday, August 6, 2009 : 10:30 AM to 12:20 PM
• Sponsor: Biometrics Section
• Author(s): Jian-Lun Xu*+ and Richard M. Fagerstrom and Philip C. Prorok and Barnett S. Kramer
• Companies: National Cancer Institute and National Cancer Institute and National Cancer Institute and Office of Disease Prevention
• Keywords: cancer screening ; false-positive ; screening modality ; maximum likelihood estimator ; asymptotic normality

Abstract

The goal of screening tests for cancer is early detection and treatment with a consequent reduction in mortality. Screening tests, however, produce false-positive (FP) and false-negative results. With an increasing number of screening tests, the risk of a FP screen, a finding with potentially significant emotional, financial and health costs, also cumulatively increases. Elmore et al. (1998, NEJM 338, 1089-1096), Christiansen et al.(2000, JNCI 92, 1657- 1666) and Gelfand and Wang (2000, Stat. in Med.19, 1865-1879) and Xu et al. (2004, Biometrics 60, 651-660) investigated this problem with one screening modality. In this paper we introduce a new model which incorporates multiple screening modalities. The MLE of the cumulative risk of receiving a FP screen for each modality is derived and its asymptotic normality is proved. We apply our new model to the data set of a cancer screening trial.