title: Agreement between self-reported and registered colorectal cancer screening: a meta-analysis.
abstract: This random-effects meta-analysis investigates the accuracy of self-reported colorectal cancer screening history as a function of screening mode (colonoscopy, flexible sigmoidoscopy, faecal occult blood testing - FOBT, double-contrast barium enema - DCBE) and survey mode (written, telephone, face-to-face). Summary estimates of sensitivity, specificity, positive predictive value (PPV) and area under the receiver operating characteristic curve (AUC) were calculated. Medical record data were used as reference. We included 23 studies comprising 11,592 subjects. Colonoscopy yielded higher AUC [0.948, 95% confidence interval (CI) = 0.918, 0.968] than flexible sigmoidoscopy (0.883, 95% CI = 0.849, 0.911) and FOBT (0.869, 95% CI = 0.833, 0.898). Colonoscopy showed the highest sensitivity (0.888, 95% CI = 0.835, 0.931), whereas specificity was comparable between screening modes (ranging from 0.802 for FOBT to 0.904 for DCBE). AUC was not significantly different between survey modes. Prevalence of screening history correlated positively with sensitivity and negatively with specificity, possibly because of errors in the medical records. In conclusion, the accuracy of self-reported cancer screening is generally moderate, and higher for colonoscopy than for sigmoidoscopy and FOBT.
authors.affiliation: Department of BioMechanical Engineering, Delft University of Technology, Delft, the Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Dodou
authors.forename: J C F
authors.initials: JC
authors.lastname: de Winter
mesh_terms: D019540:Area Under Curve; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D057566:Self Report; D012680:Sensitivity and Specificity; D012812:Sigmoidoscopy / Q000706:statistics & numerical data*
keywords: cancer; colonoscopy; mass screening; medical audit; self-report