title: Misclassification of survey responses and black-white disparity in mammography use, Behavioral Risk Factor Surveillance System, 1995-2006.
abstract: BACKGROUND
  The validity of self-reported data for mammography differ by race. We assessed the effect of racial differences in the validity of age-adjusted, self-reported mammography use estimates from the Behavioral Risk Factor Surveillance System (BRFSS) from 1995 through 2006 to determine whether misclassification (inaccurate survey question response) may have obscured actual racial disparities.
  
  
  METHODS
  We adjusted BRFSS mammography use data for age by using 2000 census estimates and for misclassification by using the following formula: (estimated prevalence - 1 + specificity) / (sensitivity + specificity - 1). We used values reported in the literature for the formula (sensitivity = 0.97 for both black and white women, specificity = 0.49 and 0.62, respectively, for black and white women).
  
  
  RESULTS
  After adjustment for misclassification, the percentage of women aged 40 years or older in 1995 who reported receiving a mammogram during the previous 2 years was 54% among white women and 41% among black women, compared with 70% among both white and black women after adjustment for age only. In 2006, the percentage after adjustment for misclassification was 65% among white women and 59% among black women compared with 77% among white women and 78% among black women after adjustment for age only.
  
  
  CONCLUSIONS
  Self-reported data overestimate mammography use - more so for black women than for white women. After adjustment for respondent misclassification, neither white women nor black women had attained the Healthy People 2010 objective (≥ 70%) by 2006, and a disparity between white and black women emerged.
authors.affiliation: Community Health and Program Services Branch, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS K-30, Atlanta, GA 30341, USA.
authors.forename: Rashid
authors.initials: R
authors.lastname: Njai
authors.forename: Paul Z
authors.initials: PZ
authors.lastname: Siegel
authors.forename: Jacqueline W
authors.initials: JW
authors.lastname: Miller
authors.forename: Youlian
authors.initials: Y
authors.lastname: Liao
mesh_terms: D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D044383:Black People; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D015203:Reproducibility of Results; D012107:Research Design; D057566:Self Report; D044465:White People