title: The agreement between self-reported cervical smear abnormalities and screening programme records.
abstract: METHODS
  The Million Women Study is a cohort study of women aged 50-64 years in England and Scotland. As a component of the follow-up questionnaire, participants were asked to indicate if they had an abnormal cervical smear in the previous five years. This study compared self-reported cervical abnormalities with screening records obtained from the National Health Service Cervical Screening Programme.
  
  
  METHODS
  For 1944 randomly selected Million Women Study participants in Oxfordshire, screening records were assessed over a six-year period prior to the date of self-reporting. The six-year period was chosen to allow for errors in the recall of timing of abnormal smears.
  
  
  RESULTS
  A total of 68 women (3.5%) had a record of at least one equivocal or abnormal smear within the last six years, whereas 49 women (2.5%) self-reported an abnormality. There was a strong trend for an increased probability of self-reporting a history of an abnormal smear as the severity of the recorded abnormality increased (P <0.001). For women with an NHS record of borderline dyskaryosis, mild dyskaryosis, or moderate dyskaryosis/severe dyskaryosis/invasive cancer, the proportions reporting an abnormality were 40%, 58% and 77%, respectively. For women with negative and inadequate smears, the proportion self-reporting an abnormality were 0.6% and 0.7%, respectively.
  
  
  CONCLUSIONS
  These results indicate that among women whose screening programme records show an abnormal smear, the proportion self-reporting an abnormality increases with the severity of the recorded lesion. Almost all women with a record of negative or inadequate smear(s) correctly interpret the result and do not self-report an abnormality.
authors.affiliation: Cancer Epidemiology Research Unit, Cancer Research and Registers Division, The Cancer Council NSW, Sydney, Australia. karenc@nswcc.org.au
authors.forename: Karen
authors.initials: K
authors.lastname: Canfell
authors.forename: Valerie
authors.initials: V
authors.lastname: Beral
authors.forename: Jane
authors.initials: J
authors.lastname: Green
authors.forename: Rebecca
authors.initials: R
authors.lastname: Cameron
authors.forename: Krys
authors.initials: K
authors.lastname: Baker
authors.forename: Anna
authors.initials: A
authors.lastname: Brown
mesh_terms: D015331:Cohort Studies; D003625:Data Collection; D004739:England; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008499:Medical Records; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D011230:Precancerous Conditions; D012042:Registries; D015203:Reproducibility of Results; D012606:Scotland; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears