Desai M M, Bruce M L, Desai R A, Druss B G
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, USA.
Am J Epidemiol. 2001 Feb 1;153(3):299-306. doi: 10.1093/aje/153.3.299.
Few studies have addressed the accuracy of self-reported cancer history, although epidemiologic studies routinely use self-reported information as the sole source of exposure or outcome data or as a criterion for exclusion from study participation. In this paper, false-negative reporting of cancer history is examined in a community-based sample by comparing interview data with tumor registry records. Subjects were participants in the 1980 New Haven Epidemiologic Catchment Area study; in 1995, cancer records (from 1935 onward) were obtained by linking the sample to the Connecticut Tumor Registry. Analyses focused on 263 individuals who had at least one tumor reported to the Connecticut Tumor Registry prior to participation in the Epidemiologic Catchment Area study. The overall rate of false-negative reporting was 39.2%. Logistic regression analysis revealed that false-negative reporting was significantly associated with non-White race, older age, increased time since cancer diagnosis, number of previous tumors, and type of cancer treatment received. In addition, false-negative reporting varied widely by cancer site, ranging from 0% for melanoma skin cancer to 83.3% for central nervous system cancers. The false-negative rate for breast cancer was 20.8%, that for colon and prostate cancers was 42.1%, and that for bladder cancer was 61.5%. Implications of these findings for prevalence estimation and future epidemiologic studies are discussed.
虽然流行病学研究通常将自我报告的信息作为暴露或结果数据的唯一来源,或作为排除参与研究的标准,但很少有研究探讨自我报告的癌症病史的准确性。在本文中,通过将访谈数据与肿瘤登记记录进行比较,对基于社区的样本中癌症病史的假阴性报告进行了研究。研究对象是1980年纽黑文流行病学集水区研究的参与者;1995年,通过将样本与康涅狄格肿瘤登记处相链接,获取了(从1935年起的)癌症记录。分析聚焦于263名在参与流行病学集水区研究之前至少有一个肿瘤报告给康涅狄格肿瘤登记处的个体。假阴性报告的总体发生率为39.2%。逻辑回归分析显示,假阴性报告与非白人种族、年龄较大、癌症诊断后的时间增加、既往肿瘤数量以及接受的癌症治疗类型显著相关。此外,假阴性报告因癌症部位而异,范围从皮肤黑色素瘤的0%到中枢神经系统癌症的83.3%。乳腺癌的假阴性率为20.8%,结肠癌和前列腺癌为42.1%,膀胱癌为61.5%。本文讨论了这些发现对患病率估计和未来流行病学研究的意义。