Accuracy of self-reported cancer-screening histories: a meta-analysis.
BACKGROUND
Survey data used to study trends in cancer screening may overestimate screening utilization while potentially underestimating existing disparities in use.


METHODS
We did a literature review and meta-analysis of validation studies examining the accuracy of self-reported cancer-screening histories. We calculated summary random-effects estimates for sensitivity and specificity, separately for mammography, clinical breast exam (CBE), Pap smear, prostate-specific antigen testing (PSA), digital rectal exam, fecal occult blood testing, and colorectal endoscopy.


RESULTS
Sensitivity was highest for mammogram, CBE, and Pap smear (0.95, 0.94, and 0.93, respectively) and lowest for PSA and digital rectal exam histories (0.71 and 0.75). Specificity was highest for endoscopy, fecal occult blood testing, and PSA (0.90, 0.78, and 0.73, respectively) and lowest for CBE, Pap smear, and mammogram histories (0.26, 0.48, and 0.61, respectively). Sensitivity and specificity summary estimates tended to be lower in predominantly Black and Hispanic samples compared with predominantly White samples. When estimates of self-report accuracy from this meta-analysis were applied to cancer-screening prevalence estimates from the National Health Interview Survey, results suggested that prevalence estimates are artificially increased and disparities in prevalence are artificially decreased by inaccurate self-reports.


CONCLUSIONS
National survey data are overestimating cancer-screening utilization for several common procedures and may be masking disparities in screening due to racial/ethnic differences in reporting accuracy.
Rauscher
Garth H
GH
School of Public Health, Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL 60612, USA. garthr@uic.edu
Johnson
Timothy P
TP
Cho
Young Ik
YI
Walk
Jennifer A
JA
D001943:Breast Neoplasms / Q000175:diagnosis*; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D009780:Occult Blood; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D015203:Reproducibility of Results; D012650:Self Disclosure; D012680:Sensitivity and Specificity; D012923:Social Class
D017430:Prostate-Specific Antigen