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验证研究表明,BRCA1/2 基因突变携带者自我报告的乳房 X 光检查史不存在差异分类错误。

Validation study suggested no differential misclassification of self-reported mammography history in BRCA1/2 mutation carriers.

机构信息

Department of Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.

出版信息

J Clin Epidemiol. 2011 Dec;64(12):1434-43. doi: 10.1016/j.jclinepi.2011.04.005. Epub 2011 Jul 20.

DOI:10.1016/j.jclinepi.2011.04.005
PMID:21764559
Abstract

OBJECTIVES

We assessed accuracy of self-reported lifetime mammography history by BRCA1/2 mutation carriers with and without breast cancer.

STUDY DESIGN AND SETTING

Within the framework of the HEBON study (The Netherlands Collaborative Group on Hereditary Breast Cancer), 218 Dutch BRCA1/2 mutation carriers had completed a risk factor questionnaire between 2006 and 2007. Accuracy of self-reported lifetime mammography history was assessed by medical record review and calculated by proportion agreement and Cohen's kappa coefficient (κ).

RESULTS

For 177 (81%) carriers, validation could be completed. Accuracy of reporting of ever/never exposure was excellent (i.e., agreement ≥ 93%, κ ≥ 0.81) for all time frames (lifetime, before age 30, and at ages 30-39). Accuracy of age at first mammogram was poor to moderate (i.e., 39%, κ=0.37) for exact agreement and improved to almost excellent (i.e., 70%, κ=0.69) for agreement within 1 year, indicating that differences were small. Although cases more often tended to underestimate their exact age at first mammogram, whereas unaffected carriers tended to overestimate, this difference in the direction of inaccuracy was not statistically significant (P=0.237). Accuracy of age at last mammogram was moderate and improved to excellent for agreement within 1 year. Carriers tended to underreport the time since last mammogram ("telescoping") and overreported the number of mammograms.

CONCLUSION

Accuracy of self-reported lifetime mammography history in carriers highly varied, depending on the measure under investigation. However, the extent of the observed misclassification was small and mostly nondifferential.

摘要

目的

我们评估了携带 BRCA1/2 突变且患有或未患有乳腺癌的个体自我报告的终生乳房 X 线照相术史的准确性。

研究设计和设置

在 HEBON 研究(荷兰遗传性乳腺癌协作组)的框架内,218 名荷兰 BRCA1/2 突变携带者在 2006 年至 2007 年间完成了一份危险因素调查问卷。通过病历回顾评估自我报告的终生乳房 X 线照相术史的准确性,并通过比例一致性和 Cohen's kappa 系数(κ)进行计算。

结果

对于 177 名(81%)携带者,完成了验证。所有时间框架(终生、30 岁之前和 30-39 岁)的暴露史(即曾经/从未接触)的报告准确性均为优秀(即,一致性≥93%,κ≥0.81)。首次乳房 X 线照相术的年龄的准确性为差至中等(即,39%,κ=0.37),精确一致;一致性提高到接近优秀(即,70%,κ=0.69),1 年内一致,表明差异较小。尽管病例更倾向于低估其首次乳房 X 线照相术的确切年龄,而未受影响的携带者更倾向于高估,但这种准确性差异在方向上无统计学意义(P=0.237)。最近一次乳房 X 线照相术的年龄的准确性为中等,1 年内一致则提高到优秀。携带者往往会缩短(“缩时”)报告上次乳房 X 线照相术的时间,并会高估进行乳房 X 线照相术的次数。

结论

携带者自我报告的终生乳房 X 线照相术史的准确性差异很大,具体取决于所研究的指标。然而,观察到的错误分类程度很小,且主要是非差异性的。

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