Accuracy and certainty of self-report for colorectal cancer screening among ambulatory patients

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Abstract
Inaccurate reports of screening for disease lead to over- and underestimates of use that may delay early detection of disease or waste finite resources. Accuracy and certainty of self-report for colorectal cancer (CRC) screening was assessed among a diverse sample (N = 52) of ambulatory patients age 50 and older. Face-to-face interviews were conducted to assess accuracy of self-reported CRC screening compared to medical data. Accuracy was evaluated by seven summary indices. Accuracy of recall of prior CRC screening was high for both ever (89%) and current screening (87%). Agreement between self-report and medical records was substantial for endoscopic screening (Kappa = 0.89; CI, 0.76 - 1.01); moderate for fecal occult blood test (FOBT, Kappa = 0.60; CI, 0.25 - 0.95). Accuracy increased as a function of certainty. Multiple sources accounted for discordance, including participant certainty of time interval since last screening and unverifiable data. Although whether is less difficult to accurately recall than when, results provide support for the accuracy of self-reported endoscopic screening among a patient sample. Reliance on self-report for FOBT may lead to overestimates of screening participation and should be viewed with caution unless objectively verified. Future investigations focusing on identifying methods to verify and enhance the accuracy of self-reported health information are warranted.

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