Comparison of Self-reported Fecal Occult Blood Testing with Automated Laboratory Records among Older Women in a Health Maintenance Organization

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Abstract
Screening guidelines for colorectal cancer recommend annual fecal occult blood (FOB) testing for adults aged 50 years and older. Self-reported history of screening is frequently the sole source of data available to researchers and clinicians. This study validated FOB testing in a sample of 1, 021 older women. Testing rates based on self-reported data exceeded rates based on computerized laboratory records by 13. 9%. Agreement was moderate (kappa = 0. 52; 95% confidence interval 0. 47, 0. 58). Sensitivity was 0. 92 and specificity 0. 58. Logistic regression analysis showed that older age and physician encouragement for FOB testing were associated with accurate recall (p < 0. 05). Self-report is the most commonly available information about the occurrence and timing of cancer detection procedures. These data suggest cautious use of self-reported screening by FOB for clinical decision making and for research and surveillance. Am J Epidemiol 1999; 150: 617-21.

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