title: Agreement Between Self-Reported and Confirmed Cancer Diagnoses in New York City Firefighters and EMS Workers, 2001-2011.
abstract: OBJECTIVE
  Because of the delay in availability of cancer diagnoses from state cancer registries, self-reported diagnoses may be valuable in assessing the current cancer burden in many populations. We evaluated agreement between self-reported cancer diagnoses and state cancer registry-confirmed diagnoses among 21,437 firefighters and emergency medical service workers from the Fire Department of the City of New York. We also investigated the association between World Trade Center (WTC) exposure and other characteristics in relation to accurate reporting of cancer diagnoses.
  
  
  METHODS
  Participants self-reported cancer status in questionnaires from October 2, 2001, to December 31, 2011. We obtained data on confirmed cancer diagnoses from nine state cancer registries, which we used as our gold standard. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), comparing self-reported cancer diagnoses with confirmed cancer diagnoses. We used multivariable logistic regression models to assess the association between WTC exposure and correct self-report of cancer status, false-positive cancer reports, and false-negative cancer reports.
  
  
  RESULTS
  Sensitivity and specificity for all cancers combined were 90.3% and 98.7%, respectively. Specificities and NPVs remained high in different cancer types, while sensitivities and PPVs varied considerably. WTC exposure was not associated with accurate reporting.
  
  
  CONCLUSIONS
  We found high specificities, NPVs, and general concordance between self-reported cancer diagnoses and registry-confirmed diagnoses. Given the low population prevalence of cancer, self-reported cancer diagnoses may be useful for determining non-cancer cases. Because of the low sensitivities and PPVs for some individual cancers, however, case confirmation with state cancer registries or medical records remains critically important.
authors: Montefiore Medical Center, Department of Medicine, Bronx, NY; Fire Department of the City of New York, Bureau of Health Services, Brooklyn, NY.
authors: Rachel
authors: R
authors: Zeig-Owens
authors: Fire Department of the City of New York, Bureau of Health Services, Brooklyn, NY.
authors: Andrea
authors: A
authors: Kablanian
authors: Fire Department of the City of New York, Bureau of Health Services, Brooklyn, NY; Montefiore Medical Center and Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Division of Epidemiology, Bronx, NY.
authors: Mayris P
authors: MP
authors: Webber
authors: Fire Department of the City of New York, Bureau of Health Services, Brooklyn, NY; Montefiore Medical Center and Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Division of Epidemiology, Bronx, NY.
authors: Yang
authors: Y
authors: Liu
authors: Fire Department of the City of New York, Bureau of Health Services, Brooklyn, NY.
authors: Edward
authors: E
authors: Mayerson
authors: Fire Department of the City of New York, Bureau of Health Services, Brooklyn, NY; Montefiore Medical Center and Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Division of Epidemiology, Bronx, NY.
authors: Theresa
authors: T
authors: Schwartz
authors: Fire Department of the City of New York, Bureau of Health Services, Brooklyn, NY.
authors: Nadia
authors: N
authors: Jaber
authors: Fire Department of the City of New York, Bureau of Health Services, Brooklyn, NY.
authors: Kerry J
authors: KJ
authors: Kelly
authors: Fire Department of the City of New York, Bureau of Health Services, Brooklyn, NY; Montefiore Medical Center and Albert Einstein College of Medicine, Department of Pulmonary Medicine, Bronx, NY.
authors: David J
authors: DJ
authors: Prezant
mesh_terms: D000328:Adult; D000068598:Data Accuracy; D004634:Emergency Medical Technicians / Q000706:statistics & numerical data*; D005260:Female; D061388:Firefighters / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D009519:New York City / Q000453:epidemiology; D057566:Self Report; D047851:September 11 Terrorist Attacks / Q000706:statistics & numerical data