Comparison of self-reported fecal occult blood testing with automated laboratory records among older women in a health maintenance organization.
Screening guidelines for colorectal cancer recommend annual fecal occult blood (FOB) testing for adults aged 50 years and older. Self-reported history of screening is frequently the sole source of data available to researchers and clinicians. This study validated FOB testing in a sample of 1,021 older women. Testing rates based on self-reported data exceeded rates based on computerized laboratory records by 13.9%. Agreement was moderate (kappa = 0.52; 95% confidence interval 0.47, 0.58). Sensitivity was 0.92 and specificity 0.58. Logistic regression analysis showed that older age and physician encouragement for FOB testing were associated with accurate recall (p<0.05). Self-report is the most commonly available information about the occurrence and timing of cancer detection procedures. These data suggest cautious use of self-reported screening by FOB for clinical decision making and for research and surveillance.
Mandelson
M T
MT
Center for Health Studies, Group Health Cooperative, Seattle, WA 98101, USA.
LaCroix
A Z
AZ
Anderson
L A
LA
Nadel
M R
MR
Lee
N C
NC
D000368:Aged; D001294:Attitude to Health; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D005260:Female; D006279:Health Maintenance Organizations; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000706:statistics & numerical data*; D008485:Medical Audit / Q000706:statistics & numerical data; D011939:Mental Recall; D008875:Middle Aged; D009780:Occult Blood; D011237:Predictive Value of Tests; D012648:Self Care; D012680:Sensitivity and Specificity; D014861:Washington / Q000453:epidemiology