Baier M, Calonge N, Cutter G, McClatchey M, Schoentgen S, Hines S, Marcus A, Ahnen D
American Medical Center Cancer Research Center, Lakewood, Colorado 80214, USA.
Cancer Epidemiol Biomarkers Prev. 2000 Feb;9(2):229-32.
End points for trials promoting cancer screening are often based on self-reported screening behavior. This study was designed to evaluate and optimize the reliability of a computer-assisted telephone interview for collecting self-reported colorectal cancer screening behavior. Cases who had received a fecal occult blood test (FOBT), flexible sigmoidoscopy, and/or colonoscopy, and controls who had no record of colorectal screening were identified among 40-75-year-old members of the Denver Kaiser Permanente Health Care Program and were contacted by telephone. Sensitivities and specificities of self-reported screening were calculated by comparison of subjects' recall with Kaiser Permanente records. The questionnaire was revised based upon results of the pilot phase of the study. Using the revised questionnaire, the sensitivity of self-reported screening was 96.2% for the FOBT, 94.9% for flexible sigmoidoscopy, 88.7% for colonoscopy, and 96.2% for either endoscopic screening test. The specificity of self-reported screening was 85.9% for the FOBT, 92.2% for flexible sigmoidoscopy, 96.8% for colonoscopy, and 92.0% for either endoscopic screening test. No marked differences in the accuracy of the self-reports were detected as a function of gender, age, ethnicity, or family history of colorectal cancer of the participants. Self-reports of colon cancer screening behavior can be reliably used as end points for intervention trials when carefully phrased questions are used.
促进癌症筛查的试验终点通常基于自我报告的筛查行为。本研究旨在评估和优化用于收集自我报告的结直肠癌筛查行为的计算机辅助电话访谈的可靠性。在丹佛凯撒永久医疗保健计划40至75岁的成员中，识别出接受过粪便潜血试验（FOBT）、乙状结肠镜检查和/或结肠镜检查的病例，以及没有结直肠癌筛查记录的对照者，并通过电话联系他们。通过将受试者的回忆与凯撒永久医疗保健记录进行比较，计算自我报告筛查的敏感性和特异性。根据研究试点阶段的结果对问卷进行了修订。使用修订后的问卷，自我报告筛查的敏感性对于FOBT为96.2%，对于乙状结肠镜检查为94.9%，对于结肠镜检查为88.7%，对于任何一种内镜筛查试验为96.2%。自我报告筛查的特异性对于FOBT为85.9%，对于乙状结肠镜检查为92.2%，对于结肠镜检查为96.8%，对于任何一种内镜筛查试验为92.0%。未发现自我报告的准确性因参与者的性别、年龄、种族或结直肠癌家族史而有明显差异。当使用精心措辞的问题时，结直肠癌筛查行为的自我报告可以可靠地用作干预试验的终点。
