Understanding recall rates in screening mammography: A conceptual framework review of the literature

• Recall rates vary across countries and readers and for initial and subsequent screens.
• Falsely recalling women has important clinical, cost and psycho-social implications.
• Imaging technology, readers' expertise and patient presentation affect recall rates.
• Higher recall rates do not translate into improved sensitivity at higher thresholds.
• Multidisciplinary approaches to reduce recall rates may improve women experiences.

Recall rates are one of the performance measures used to evaluate the effectiveness of mammography screening programs. There is conflicting evidence regarding the link between recall rates and cancer detection rates and a variety of differing recall rates exist between countries and readers. This variability in recall rates may have important clinical and economic implications such as unnecessary follow-up procedures, additional costs to the health care system and psychological effects for the women themselves associated with false-positive mammograms results. In order to reduce the impact of false positive recall rates in screening mammography, it is essential for all multidisciplinary health care providers, especially those in medical imaging, to fully understand the factors that may contribute and affect recall rates. The multifactorial nature of recall rates is explored in this paper through the construction of a conceptual map based on a review of the current literature.