title: Accuracy of self-reported cancer-screening histories: a meta-analysis.
abstract: 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.
authors.affiliation: School of Public Health, Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL 60612, USA. garthr@uic.edu
authors.forename: Garth H
authors.initials: GH
authors.lastname: Rauscher
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Johnson
authors.forename: Young Ik
authors.initials: YI
authors.lastname: Cho
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Walk
mesh_terms: 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
chemical_list: D017430:Prostate-Specific Antigen