Validation of Self-reported Screening Mammography Histories among Women with and without Breast Cancer

• Published in: American journal of epidemiology Vol. 158; no. 3; pp. 264 - 271
• Main Authors: Norman, Sandra A., Localio, A. Russell, Zhou, Lan, Bernstein, Leslie, Coates, Ralph J., Flagg, Elaine W., Marchbanks, Polly A., Malone, Kathleen E., Weiss, Linda K., Lee, Nancy C., Nadel, Marion R.
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 01.08.2003; Oxford Publishing Limited (England)
• Subjects: Adult; Bias; Biological and medical sciences; breast neoplasms; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - epidemiology; CARE; Case-Control Studies; confidence interval; Contraceptive and Reproductive Experiences; Female; Genital system. Mammary gland; Humans; Investigative techniques, diagnostic techniques (general aspects); mammography; Mammography - statistics & numerical data; Mass Screening; Medical History Taking; Medical sciences; Mental Recall; Middle Aged; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Sensitivity and Specificity; Truth Disclosure; Human; Radiodiagnosis; breast neoplasms; Mammography; mass screening; Malignant tumor; Medical screening; sensitivity and specificity; Mammary gland diseases; Validity; Sensitivity; Specificity; Female; Mammary gland; case-control studies
• ISSN: 0002-9262; 1476-6256; 0002-9262
• DOI: 10.1093/aje/kwg136

As part of a case-control study of the efficacy of screening mammography, the authors validated the mammography histories of 2,495 women aged 40–64 years with incident breast cancer diagnosed in 1994–1998 and a 25% random sample of 615 controls never diagnosed with breast cancer, all reporting a mammogram in the past 5 years. Subjects from five metropolitan areas of the United States were cross-classified by facility records (“gold standard”) and self-report according to history of a recent screening mammogram (within 1 year or within 2 years). Sensitivity and specificity of self-reported screening at 1 year were 0.93 and 0.82, respectively, for cases and 0.92 and 0.80 for controls. At 2 years, sensitivity and specificity were 0.97 and 0.78 for both cases and controls. Confidence intervals for the differences in sensitivity and specificity were narrow and included zero. Scant evidence was found of telescoping (recollection of events as more recent than actual). Findings suggest that, in an interview-based case-control study of the efficacy of screening mammography, 1) estimated true prevalences of recent screening mammography adjusted for sensitivity and specificity will be slightly lower than self-reported prevalences, and 2) differential misclassification of exposure status is slight. Therefore, odds ratios will likely be biased toward the null, underestimating screening efficacy.