Inconsistent self-reported mammography history: findings from the National Population Health Survey longitudinal cohort.
BACKGROUND
Self-reported information has commonly been used to monitor mammography utilization across populations and time periods. However, longitudinal investigations regarding the prevalence and determinants of inconsistent responses over time and the impact of such responses on population screening estimates are lacking.


METHODS
Based on longitudinal panel data for a representative cohort of Canadian women aged 40+ years (n = 3,537) assessed in the 1994-95 (baseline) and 1996-97 (follow-up) National Population Health Survey (NPHS), we examined the prevalence of inconsistent self-reports of mammography utilization. Logistic regression models were used to estimate the associations between women's baseline sociodemographic and health characteristics and 2 types of inconsistent responses: (i) baseline reports of ever use which were subsequently contradicted by follow-up reports of never use; and (ii) baseline reports of never use which were contradicted by follow-up reports of use prior to 1994-95.


RESULTS
Among women who reported having a mammogram at baseline, 5.9% (95% confidence interval (CI): 4.6-7.3%) reported at follow-up that they had never had one. Multivariate logistic regression analyses showed that women with such inconsistent responses were more often outside target age groups, from low income households and less likely to report hormone replacement therapy and Pap smear use. Among women reporting never use at baseline and ever use at follow-up, 17.4% (95%CI: 11.7-23.1%) reported their most recent mammogram as occurring prior to 1994-95 (baseline) and such responses were more common among women aged 70+ years and those in poorer health.


CONCLUSIONS
Women with inconsistent responses of type (i), i.e., ever users at baseline but never users at follow-up, appeared to exhibit characteristics typical of never users of mammography screening. Although limited by sample size, our preliminary analyses suggest that type (ii) responses are more likely to be the result of recall bias due to competing morbidity and age. Inconsistent responses, if removed from the analyses, may be a greater source of loss to follow-up than deaths/institutionalization or item non-response.
Bancej
Christina M
CM
Centre for Chronic Disease Prevention & Control, Population and Public Health Branch, Health Canada, Ottawa ON, Canada. Christina_Bancej@hc-sc.gc.ca <Christina_Bancej@hc-sc.gc.ca>
Maxwell
Colleen J
CJ
Snider
Judy
J
D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000523:psychology; D002170:Canada; D016001:Confidence Intervals; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D008137:Longitudinal Studies; D008327:Mammography / Q000706:statistics & numerical data*; D011939:Mental Recall; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012650:Self Disclosure; D012923:Social Class; D016387:Women's Health