Validity of Four Self-reported Colorectal Cancer Screening Modalities in a General Population: Differences over Time and by Intervention Assignment

Little is known about the validity of self-reported colorectal cancer screening. To date, few published studies have validated all four screening modalities per recommended guidelines or included a general population-based sample, and none has assessed validity over time and by intervention conditio...

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Bibliographic Details
Published in:Cancer epidemiology, biomarkers & prevention biomarkers & prevention, 2008-04, Vol.17 (4), p.777-784
Main Authors: Jones, Resa M, Mongin, Steven J, Lazovich, DeAnn, Church, Timothy R, Yeazel, Mark W
Format: Article
Language:English
Subjects:
Aged
Barium Sulfate
Colonoscopy - statistics & numerical data
Colorectal Cancer
Colorectal Neoplasms - diagnosis
Enema - statistics & numerical data
Female
Guideline Adherence
Humans
Male
Mass Screening - methods
Mass Screening - statistics & numerical data
Medical Records
Methodologic Studies
Middle Aged
Minnesota
Occult Blood
Patient Compliance
Reproducibility of Results
Screening
Self-report
Sigmoidoscopy - statistics & numerical data
Validity
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Summary:Little is known about the validity of self-reported colorectal cancer screening. To date, few published studies have validated all four screening modalities per recommended guidelines or included a general population-based sample, and none has assessed validity over time and by intervention condition. To estimate the validity of self-reported screening, a random sample of 200 adults, ages ≥50 years, was selected from those completing annual surveys on screening behavior as part of an intervention study. Approximately 60% of the validation sample authorized medical record review. Sensitivity, specificity, and positive and negative predictive values were calculated for baseline and year 1 follow-up reports for each test and for overall screening adherence. Sensitivity at baseline ranged from 86.9% (flexible sigmoidoscopy) to 100% (colonoscopy). Sensitivity at follow-up was slightly lower. Adjusting for validity measures, the sample overreported screening prevalence at baseline for each of the four modalities. At follow-up, overreporting was greatest for fecal occult blood test (13.0%). Overreporting across intervention conditions was highest for fecal occult blood test (10.8% for control; 24.8% for the most intense intervention) and overall screening adherence (10.9% for control; 14.3% for the most intense intervention). Sensitivity and specificity of self-reported colorectal cancer screening compared with medical records were high; however, adjusting self-reported screening rates based on relative error rates reduced screening prevalence estimates. Those exposed to more intense interventions to modify screening behavior seemed more likely to overestimate their screening rates compared with those who were not exposed. (Cancer Epidemiol Biomarkers Prev 2008;17(4):777–84)
ISSN:1055-9965
1538-7755
DOI:10.1158/1055-9965.EPI-07-0441