McGovern P G, Lurie N, Margolis K L, Slater J S
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015, USA.
Am J Prev Med. 1998 Apr;14(3):201-8. doi: 10.1016/s0749-3797(97)00076-7.
Cancer screening history can often be obtained only by self-report, particularly for disadvantaged populations. We examined the accuracy of self-report of mammography and Pap smear for an urban, low-income population.
Women attending non-primary care clinics (mostly surgery and orthopedics) at a large public teaching hospital in Minneapolis between July 1992 and May 1993 were queried about their screening history (n = 477). The women were interviewed by a trained peer-recruiter and asked whether they had ever heard of a Pap smear or mammogram, whether they had ever had one, where it was done, and when the last one was. We verified self-report by checking medical records where the test was performed.
The positive and negative predictive value of recall of mammography in the previous year was 72.4% and 90.6%, respectively. The figures for Pap smear recall were somewhat lower, 65.5% and 85.9%, respectively. We found a record of a mammogram in 88% of women able to recall the year. Of these, slightly over two-thirds recalled their mammogram in the same year as their record indicated. Inaccurate recalls were more commonly of the "telescoping" type, i.e., tests were recalled as having occurred more recently than was the case. Recall was substantially better for recent tests. Results for Pap smear recalls were broadly similar.
The accuracy of self-report of mammography and Pap smear is relatively poor for medical practice but is acceptable in population surveys with appropriate correction for overreporting.
癌症筛查史通常只能通过自我报告获得，尤其是对于弱势群体。我们研究了城市低收入人群自我报告乳房X光检查和巴氏涂片检查的准确性。
对1992年7月至1993年5月期间在明尼阿波利斯一家大型公共教学医院的非初级保健诊所（主要是外科和骨科）就诊的女性询问其筛查史（n = 477）。这些女性由一名经过培训的同伴招募者进行访谈，询问她们是否听说过巴氏涂片检查或乳房X光检查，是否做过这些检查，在哪里做的，以及最后一次检查是什么时候。我们通过检查进行检查的医疗记录来核实自我报告。
前一年乳房X光检查回忆的阳性预测值和阴性预测值分别为72.4%和90.6%。巴氏涂片检查回忆的数字略低，分别为65.5%和85.9%。在能够回忆起年份的女性中，88%有乳房X光检查记录。其中，略超过三分之二的人回忆的乳房X光检查年份与记录显示的年份相同。不准确的回忆更常见于“时间压缩”类型，即检查被回忆为比实际发生的时间更近。对于近期检查，回忆要好得多。巴氏涂片检查回忆的结果大致相似。
乳房X光检查和巴氏涂片检查自我报告的准确性在医疗实践中相对较差，但在进行适当的过度报告校正的人群调查中是可以接受的。
