Validity of four self-reported colorectal cancer screening modalities in a general population: Differences over time and by intervention assignment
Validity of four self-reported colorectal cancer screening modalities in a general population: Differences over time and by intervention assignment
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DOI：
10.1158/1055-9965.epi-07-0441
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发表时间：
2008-04-01
影响因子：
3.8
通讯作者：
Yaezel, Mark W.
中科院分区：
文献类型：
--
作者：
Jones, Resa M.;Mongin, Steven J.;Yaezel, Mark W.
关于自我报告的结直肠癌筛查的有效性知之甚少。到目前为止，很少有已发表的研究根据推荐的指南验证了所有四种筛查方式或包括基于一般人群的样本，并且没有一项研究评估了随时间推移和干预条件的有效性。为了评估自我报告筛查的有效性，随机抽取了200名年龄≥ 50岁的成年人，他们是从完成年度筛查行为调查的人中选出的，作为干预研究的一部分。大约60%的验证样本授权进行病历审查。根据基线和第1年随访报告计算每项检测的敏感性、特异性、阳性和阴性预测值以及总体筛选依从性。基线灵敏度范围为86.9%（乙状结肠镜检查）至100%（结肠镜检查）。随访时的敏感性略低。调整的有效性措施，样本高估了筛查患病率在基线的四种方式。随访时，粪便潜血试验的过度报告率最高（13.0%）。在干预条件下，粪便潜血试验（对照组为10.8%;最强烈干预组为24.8%）和总体筛查依从性（对照组为10.9%;最强烈干预组为14.3%）的过度报告率最高。与病历相比，自我报告的结直肠癌筛查的敏感性和特异性较高;然而，根据相对误差率调整自我报告的筛查率降低了筛查患病率估计值。那些暴露于更强烈的干预措施，以修改筛选行为似乎更有可能高估他们的筛选率相比，那些没有暴露。
Little is known about the validity of self-reported colorectal cancer screening. To date, few published studies have validated all four screening modalities per recommended guidelines or included a general population-based sample, and none has assessed validity over time and by intervention condition. To estimate the validity of self-reported screening, a random sample of 200 adults, ages >= 50 years, was selected from those completing annual surveys on screening behavior as part of an intervention study. Approximately 60% of the validation sample authorized medical record review. Sensitivity, specificity, and positive and negative predictive values were calculated for baseline and year 1 follow-up reports for each test and for overall screening adherence. Sensitivity at baseline ranged from 86.9% (flexible sigmoidoscopy) to 100% (colonoscopy). Sensitivity at follow-up was slightly lower. Adjusting for validity measures, the sample overreported screening prevalence at baseline for each of the four modalities. At follow-up, overreporting was greatest for fecal occult blood test (13.0%). Overreporting across intervention conditions was highest for fecal occult blood test (10.8% for control; 24.8% for the most intense intervention) and overall screening adherence (10.9% for control; 14.3% for the most intense intervention). Sensitivity and specificity of self-reported colorectal cancer screening compared with medical records were high; however, adjusting self-reported screening rates based on relative error rates reduced screening prevalence estimates. Those exposed to more intense interventions to modify screening behavior seemed more likely to overestimate their screening rates compared with those who were not exposed.