Jensen Heidi Amalie Rosendahl, Horsbøl Trine Allerslev, Thygesen Lau Caspar, Davidsen Michael, Christensen Anne Illemann, Ekholm Ola
National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark.
Int J Cancer. 2024 Jan 15;154(2):217-225. doi: 10.1002/ijc.34692. Epub 2023 Aug 18.
Previous studies show that the agreement between self-reported and registry-documented diseases varies across diseases. Few studies have addressed these challenges across site-specific cancer diagnoses. The present study aimed to examine the sensitivity and negative predictive value (NPV) of self-reported cancer in a Danish nationwide survey among adults aged ≥16 years, using registry data as the criterion standard. Moreover, the influence of sociodemographic variables and time since diagnosis on sensitivity was explored using multiple logistic regression models. Self-reported data on cancer history of any site were derived from the Danish National Health Survey 2017 (n = 183 372). Individual-level survey data were linked to data from the Danish Cancer Registry on 10 site-specific cancer diagnoses. NPV was consistently high ≥99.5% across the included cancer diagnoses. In contrast, sensitivity varied greatly and was lowest for cancer in brain/central nervous system (CNS) among both men (25.6%) and women (23.9%) and highest for rectal cancer among men (96.9%) and for breast cancer among women (98.9%). Sensitivity was also relatively low for nonmelanoma skin cancer (41.4% among men; 44.6% among women) and urinary tract cancer (60.0% among men; 60.4% among women). When restricting diagnostic definitions for cancer in brain/CNS and urinary tract cancer to include only malignant neoplasms, sensitivity increased. For several cancer diagnoses, sensitivity decreased with increasing age and lower educational level, whereas conflicting results were observed for time from diagnosis to self-report. Future studies are encouraged to use self-reported cancer history data with caution and for example, include questions on only site-specific cancer diagnoses with high sensitivity.
先前的研究表明，自我报告的疾病与登记记录的疾病之间的一致性因疾病而异。很少有研究针对特定部位癌症诊断面临的这些挑战进行探讨。本研究旨在以登记数据作为标准参照，在丹麦一项针对16岁及以上成年人的全国性调查中，检验自我报告癌症的敏感性和阴性预测值（NPV）。此外，使用多元逻辑回归模型探讨了社会人口统计学变量以及自诊断以来的时间对敏感性的影响。关于任何部位癌症病史的自我报告数据源自2017年丹麦国民健康调查（n = 183372）。个体层面的调查数据与丹麦癌症登记处关于10种特定部位癌症诊断的数据相链接。在所纳入的癌症诊断中，NPV始终很高，≥99.5%。相比之下，敏感性差异很大，男性和女性中脑/中枢神经系统（CNS）癌症的敏感性最低（男性为25.6%，女性为23.9%），男性直肠癌的敏感性最高（96.9%），女性乳腺癌的敏感性最高（98.9%）。非黑色素瘤皮肤癌（男性为41.4%；女性为44.6%）和泌尿系统癌症（男性为60.0%；女性为60.4%）的敏感性也相对较低。当将脑/CNS癌症和泌尿系统癌症的诊断定义限制为仅包括恶性肿瘤时，敏感性有所提高。对于几种癌症诊断，敏感性随着年龄增长和教育水平降低而下降，而从诊断到自我报告的时间则观察到相互矛盾的结果。鼓励未来的研究谨慎使用自我报告的癌症病史数据，例如，仅纳入敏感性高的特定部位癌症诊断相关问题。
