title: Validity of adolescent and young adult self-report of Papanicolaou smear results.
abstract: OBJECTIVE
  To assess the validity of adolescent and young adult report of Papanicolaou smear results and to determine sociodemographic, cognitive, and behavioral factors associated with incorrect reporting.
  
  
  METHODS
  We conducted a cross-sectional study of 477 female subjects aged 12 to 24 years who attended an adolescent clinic and had a previous Papanicolaou smear. Subjects completed a self-administered survey assessing self-report of Papanicolaou smear results, knowledge about Papanicolaou smears and human papillomavirus (HPV), attitudes about Papanicolaou screening and follow-up, and risk behaviors. The sensitivity, specificity, positive predictive value, and negative predictive value of self-reported results were calculated using the cytology report as the standard. Variables significantly associated with incorrect reporting were entered into logistic regression models controlling for age and race to determine independent predictors for incorrect reporting.
  
  
  RESULTS
  Of the 477 participants, 128 (27%) had abnormal cytology reports and 66 (14%) had incorrect self-reports. Sensitivity of self-report was 0.79, specificity 0.89, positive predictive value 0.72, negative predictive value 0.92, and kappa (kappa) 0.66. The adjusted odds ratios (OR) and 95% confidence intervals (CI) of the variables comprising a logistic regression model predicting incorrect reporting were an HPV knowledge source of zero (OR 2.4, CI 1.0, 5.8), low perceived communication with the provider (OR 2.1, CI 1.1, 4.0), and no contraception at last intercourse (OR 5.5, CI 2.7, 11.0).
  
  
  CONCLUSIONS
  The validity of adolescent and young adult self-reported Papanicolaou smear result is high, except among those who lack knowledge of HPV, perceive poor communication with the provider, and use contraception inconsistently.
authors.affiliation: Division of Adolescent Medicine, Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Kahn
authors.forename: E
authors.initials: E
authors.lastname: Goodman
authors.forename: R A
authors.initials: RA
authors.lastname: Kaplowitz
authors.forename: G B
authors.initials: GB
authors.lastname: Slap
authors.forename: S J
authors.initials: SJ
authors.lastname: Emans
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D065006:Papanicolaou Test; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000523:psychology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D014412:Tumor Virus Infections / Q000523:psychology; D014626:Vaginal Smears / Q000523:psychology*