Reliability of self-reported family history of cancer in a large case-control study of lymphoma
Reliability of self-reported family history of cancer in a large case-control study of lymphoma
复制标题
DOI：
10.1093/jnci/djj005
复制
发表时间：
2006-01-04
影响因子：
10.3
通讯作者：
Adami, HO
中科院分区：
文献类型：
--
作者：
Chang, ET;Smedby, KE;Adami, HO
背景：家族性癌症风险的病例对照研究传统上依赖于癌症家族史的自我报告，由于病例患者和对照受试者之间回忆的差异，这可能会使结果产生偏差。为了评估自我报告数据的可靠性，我们分析了一项基于人群的恶性淋巴瘤病例对照研究中有关家族性癌症的问卷调查和基于登记的数据。
方法：所有1508例淋巴瘤病例患者和1229例对照受试者完成了一次电话访谈，评估家庭成员中的癌症情况。参与者与瑞典多代登记处和癌症登记处相关联，以确定一级亲属中确诊的癌症诊断。计算病例患者和对照受试者中自我报告家族性癌症的敏感性和特异性，并使用逻辑回归进行比较。所有统计检验均为双侧检验。
结果：淋巴瘤病例患者报告任何癌症家族史的敏感性在统计学上显著高于对照受试者（分别为0.85，95%置信区间[CI]=0.83 - 0.87和0.80，95%CI = 0.77 - 0.82），但特异性略低（分别为0.89，95%CI = 0.87 - 0.91和0.92，95%CI = 0.90 - 0.94）。按部位自我报告家族性癌症的敏感性从罕见恶性肿瘤的小于0.20到更常见类型的近0.75不等，而特异性通常为0.98或更高。对于大多数部位，自我报告的可靠性在患者和对照受试者中相似。然而，患者报告家族性造血系统癌症的敏感性在统计学上显著高于对照受试者（分别为0.60，95%CI = 0.57 - 0.62和0.38，95%CI = 0.35 - 0.40）。当基于自我报告的任何癌症或造血系统癌症家族史时，与基于登记数据的家族史相比，家族性癌症与非霍奇金淋巴瘤风险之间关联的比值比始终更高。
结论：癌症家族史自我报告的可靠性在病例患者和对照受试者之间存在差异。因此，回忆偏差可能会在家族性癌症风险的病例对照研究中产生有偏差的结果。
Background: Case-control studies of familial cancer risk traditionally rely on self-reported family history of cancer, which may bias results due to differential recall between case patients and control subjects. To evaluate the reliability of self-reported data, we analyzed questionnaire and registry-based data on familial cancer from a population-based case-control study of malignant lymphoma. Methods: All 1508 lymphoma case patients and 1229 control subjects completed a telephone interview assessing cancer in family members. Participants were linked to the Swedish Multi-Generation Register and Cancer Register to identify confirmed cancer diagnoses in first-degree relatives. The sensitivity and specificity of self-reported familial cancer were calculated among case patients and control subjects and were compared using logistic regression. All statistical tests were two-sided. Results: Lymphoma case patients reported a family history of any cancer with statistically significantly higher sensitivity than control subjects (0.85, 95% confidence interval [CI] = 0.83 to 0.87 and 0.80, 95% CI = 0.77 to 0.82, respectively) but with marginally lower specificity (0.89, 95% CI = 0.87 to 0.91 and 0.92, 95% CI = 0.90 to 0.94, respectively). The sensitivity of self-reporting familial cancers by site ranged from less than 0.20 for rare malignancies to nearly 0.75 for more common types, whereas specificity was generally 0.98 or greater. For most sites, the reliability of self-report was similar in patients and control subjects. However, patients reported familial hematopoietic cancer with statistically significantly higher sensitivity (0.60, 95% CI = 0.57 to 0.62) than control subjects (0.38, 95% CI = 0.35 to 0.40). Odds ratios for the association between familial cancer and risk of non-Hodgkin lymphoma were consistently higher when based on self-reported, compared with registry data-based, family history of any cancer or of hematopoietic cancer. Conclusions: Reliability of self-reported family history of cancer varies between case patients and control subjects. Recall bias may thus produce biased results in case-control studies of familial cancer risk.