Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jun;18(6):1699-705.
doi: 10.1158/1055-9965.EPI-09-0020.

Bias associated with self-report of prior screening mammography

Kathleen A Cronin  1 , Diana L Miglioretti, Martin Krapcho, Binbing Yu, Berta M Geller, Patricia A Carney, Tracy Onega, Eric J Feuer, Nancy Breen, Rachel Ballard-Barbash
Affiliations

Bias associated with self-report of prior screening mammography

Kathleen A Cronin et al. Cancer Epidemiol Biomarkers Prev. 2009 Jun.

Abstract

Background: Self-reported screening behaviors from national surveys often overestimate screening use, and the amount of overestimation may vary by demographic characteristics. We examine self-report bias in mammography screening rates overall, by age, and by race/ethnicity.

Methods: We use mammography registry data (1999-2000) from the Breast Cancer Surveillance Consortium to estimate the validity of self-reported mammography screening collected by two national surveys. First, we compare mammography use from 1999 to 2000 for a geographically defined population (Vermont) with self-reported rates in the prior two years from the 2000 Vermont Behavioral Risk Factor Surveillance System. We then use a screening dissemination simulation model to assess estimates of mammography screening from the 2000 National Health Interview Survey.

Results: Self-report estimates of mammography use in the prior 2 years from the Vermont Behavioral Risk Factor Surveillance System are 15 to 25 percentage points higher than actual screening rates across age groups. The differences in National Health Interview Survey screening estimates from models are similar for women 40 to 49 and 50 to 59 years and greater than for those 60 to 69, or 70 to 79 (27 and 26 percentage points versus 14, and 14, respectively). Overreporting is highest among African American women (24.4 percentage points) and lowest among Hispanic women (17.9) with non-Hispanic White women in between (19.3). Values of sensitivity and specificity consistent with our results are similar to previous validation studies of mammography.

Conclusion: Overestimation of self-reported mammography usage from national surveys varies by age and race/ethnicity. A more nuanced approach that accounts for demographic differences is needed when adjusting for overestimation or assessing disparities between populations.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The percent of women who live in Vermont who had a mammography examination for any reason and specifically for screening from the Breast Cancer Surveillance Consortium and the percent of women who reported have a mammogram for any reason or specifically for screening in the previous 2 years from the 2000 Vermont Behavioral Risk Factors Survey (BRFS). Single standard error bars are added to the BRFS estimates.
Figure 2
Figure 2
The percent of women predicted to have a mammogram in the years 1999 and 2000 based on the mammography dissemination and usage model and the percent of women who reported have a mammogram for any reason or specifically for screening in the previous 2 years from the 2000 National Health Information Survey (NHIS). Single standard error bars are added to the NHIS estimates. a) All Women b) Non-Hispanic White Women c) Non Hispanic African American Women d) Hispanic Women.
Figure 2
Figure 2
The percent of women predicted to have a mammogram in the years 1999 and 2000 based on the mammography dissemination and usage model and the percent of women who reported have a mammogram for any reason or specifically for screening in the previous 2 years from the 2000 National Health Information Survey (NHIS). Single standard error bars are added to the NHIS estimates. a) All Women b) Non-Hispanic White Women c) Non Hispanic African American Women d) Hispanic Women.
Figure 2
Figure 2
The percent of women predicted to have a mammogram in the years 1999 and 2000 based on the mammography dissemination and usage model and the percent of women who reported have a mammogram for any reason or specifically for screening in the previous 2 years from the 2000 National Health Information Survey (NHIS). Single standard error bars are added to the NHIS estimates. a) All Women b) Non-Hispanic White Women c) Non Hispanic African American Women d) Hispanic Women.
Figure 2
Figure 2
The percent of women predicted to have a mammogram in the years 1999 and 2000 based on the mammography dissemination and usage model and the percent of women who reported have a mammogram for any reason or specifically for screening in the previous 2 years from the 2000 National Health Information Survey (NHIS). Single standard error bars are added to the NHIS estimates. a) All Women b) Non-Hispanic White Women c) Non Hispanic African American Women d) Hispanic Women.
Figure 3
Figure 3
Values of reporting sensitivity and specificity that are consistent with the differences between modeled screening rates in 1999 and 2000 and self reported mammography screening rates in the previous 2 years from the 2000 National Health Information Survey and previously reported estimates for sensitivity and specificity from the literature.
See this image and copyright information in PMC

References

    1. Newell SA, Girgis A, Sanson-Fisher RW, Savolainen NJ. The accuracy of self-reported health behaviors and risk factors relating to cancer and cardiovascular disease in the general population: A critical review. Am J Prev Med. 1999;17:211–29. - PubMed
    1. Rauscher GH, Johnson TP, Cho YI, Walk JA. Accuracy of Self-Reported Cancer-Screening Histories: A Meta-analysis. Cancer Epidemiol Biomarkers Prev. 2008;17:748–57. - PubMed
    1. Caplan LS, Mandelson MT, Anderson LA. Validity of Self-reported Mammography: Examining Recall and Covariates among Older Women in a Health Maintenance Organization. Am J Epidemiol. 2003;157:267–72. - PubMed
    1. Caplan LS, McQueen DV, Qualters JR, Leff M, Garrett C, Calonge N. Validity of Women’s Self-Reports of Cancer Screening Test Utilization in a Managed Care Population. Cancer Epidemiol Biomarkers Prev. 2003;12:1182–7. - PubMed
    1. Gordon NP, Hiatt RA, Lampert DI. Concordance of self-reported data and medical record audit for six cancer screening procedures. J Natl Cancer Inst. 1993;85:566–70. - PubMed

Publication types