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The accuracy of self-reported Pap smear utilisation
J A Bowman1, R Sanson-Fisher, S Redman
1Discipline of Behavioural Science in Relation to Medicine, Faculty of Medicine and Health Sciences, University of Newcastle, NSW, Australia.
Social Science & Medicine (1982)
|April 1, 1997
Summary
Self-reported Pap smear (cervical screening) use is often inaccurate, with women frequently over-reporting screening history. This highlights the need for improved data collection methods for cervical cancer screening prevalence.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- Accurate measurement of cervical screening (Pap smear) utilization is crucial for public health surveillance and program evaluation.
- Self-report is a common method for collecting data on screening behaviors, but its accuracy can be a concern.
Purpose of the Study:
- To assess the accuracy of self-reported Pap smear utilization across different time frames.
- To examine the magnitude of self-reporting errors and identify sociodemographic predictors of accuracy.
Main Methods:
- A random household survey in the Hunter Region, NSW, Australia, collected self-reported Pap smear data via interview.
- Pathology laboratory records were used to verify self-reported screening histories.
- Error magnitude was assessed by comparing self-report against laboratory data over various intervals.
- Chi-square analyses explored sociodemographic predictors of reporting accuracy.
Main Results:
- Low specificity and positive predictive values indicated significant inaccuracy in self-reported Pap smear use, particularly when screening did not occur.
- Only 61.2% of women reporting a Pap smear within three years were verified in laboratory records.
- Allowing reporting "leeway" did not substantially improve accuracy, confirming clinically significant inaccuracies.
- Demographic variables did not predict accuracy, though respondent certainty showed a minor predictive impact.
Conclusions:
- Self-report consistently over-estimates Pap smear screening prevalence.
- Alternative methods for assessing screening prevalence may be preferable to self-report.
- When using self-report, employing techniques to enhance accuracy is essential, and caution is advised when comparing rates from different data sources.