Study finds patients overestimate cancer screening history

A new American Cancer Society study finds female African American patients tend to overestimate their level of cancer screening, indicating that current estimates of screening based on self-reported data may be lower than reported.

Researchers from the Society’s Behavioral Research Center, led by Barbara D. Powe, PhD, RN, interviewed 116 African American female patients at a federally qualified health center (FQHC) and compared their recollection to the screening history documented in the patients’ medical records for four medical tests: clinical breast examination; mammography; Pap testing; and screening with a fecal occult blood test (FOBT). They found the level of incongruence between self-report and medical record documentation was more than 50 percent for some procedures.

Eighty-six percent of the women who were age 20 or older (n = 94) reported having a CBE in their lifetime, 67 percent in the past year, 20 percent in the past two to five years, and 10 percent more than five years ago. Based on medical record documentation, 35 percent of the women had a CBE in their lifetime, 26 percent in the past year, 4 percent in the past two to five years, and 2 percent more than five years ago.

Seventy-seven percent of the women over 40 (n=35) reported ever having a mammogram in their lifetime, 29 percent in the past year, 29 percent in the past two to five years, and 6 percent more than five years ago. Based on documentation in the medical record, 40 percent of the women had a mammogram in their lifetime, 9 percent in the past year, 26 percent in the past two to five years, and 6 percent more than five years ago.

Of the 43 women asked about Pap test use, 96 percent reported having had a Pap test in their lifetime, 72 percent in the past year, 26 percent in the past two to five years, and 12 percent more than five years ago. Based on documentation in the medical record, 58 percent of the women had a Pap test in their lifetime, 39 percent in the past year, 25 percent in the past two to five years, and 13 percent more than five years ago.

Fifty-six percent of the women over 50 (n=16) reported ever having a fecal occult blood test (FOBT) in their lifetime, 35 percent in the past year, 12 percent in the past two to five years, and 6 percent more than five years ago. Based on documentation in the medical record, 11 percent of the women had a FOBT in their lifetime, 12 percent in the past year, and 0 percent in the past two to five years or more than five years ago.

The researchers acknowledge that the women could have received services without documentation in the medical record or that the women could have mistakenly believed a clinical service included screening when it did not. Nevertheless, they cite previous research that also has found patients tend to over-report their level of screening.

The authors say maintaining efforts to effectively monitor and track participation in cancer screening among African Americans and other groups should be a priority, offering the electronic medical record as one way to ensure more accurate medical documentation. “Self-reported screening rates are the foundation for many policy decisions that have a significant influence on the availability of resources for this population,” said Dr. Powe. “Indeed, over- or underestimation of screening can be even more significant for African Americans, who bear a disproportionate cancer burden.”

Source: American Cancer Society

Related stories:

Pregnancy alone is not associated with increased risk for mental disorders
Pregnancy alone does not appear to be associated with an increased risk of the most prevalent mental disorders, according to a report in the July issue of Archives of General Psychiatry, one of the JAMA/Archives journals. However, post-partum women may have a higher risk of major depressive disorder.
News from Cancer: Risk factors for deadly form of lymphoma
A new study indicates that the incidence of mantle cell lymphoma, an aggressive type of non-Hodgkin's lymphoma, is on the rise, most frequently striking men, Caucasians and older individuals. The study, published in the August 15, 2008 issue of CANCER, a peer-reviewed journal of the American Cancer Society, also reveals that most patients are diagnosed with advanced stages of the disease.
Major rise in Caesarean sections linked to impaired womb function with age
Delaying childbirth has substantially contributed to recent rises in caesarean section rates, according to a paper published this week by scientists at Cambridge University.
Analysis of cancer incidence, mortality and survival combined reveals encouraging European trends
The first research to look at recent trends in European cancer incidence, mortality and survival together has shown that cancer prevention and management in Europe is moving in the right direction. However, the research reveals that variations between countries in policies for mass screening, access to health care and treatment are reflected in the different cancer rates.
Late-life remarriage: Stepfamilies make caring more complex
Late-life remarriage complicates caring for an ailing spouse, according to a University of Michigan researcher who is conducting one of the first known studies to focus on the challenges facing older remarried caregivers---a growing segment of the older U.S. population.
Symptom screening plus a simple blood test improves early detection of ovarian cancer
Women's reports of persistent, recent-onset symptoms linked to ovarian cancer – abdominal or pelvic pain, difficulty eating or feeling full quickly and abdominal bloating – when combined with the CA125 blood test may improve the early detection of ovarian cancer by 20 percent, according to new findings by researchers at Fred Hutchinson Cancer Research Center published online in CANCER.

Scientists use Iceland's genealogical database to pinpoint the heritage of a deadly disease
A collaboration of scientists from Iceland and the United States has used Iceland's genealogical database to trace the ancestors of patients suffering from hereditary cystatin C amyloid angiopathy (HCCAA). Analysis shows that the deadly mutation in the cystatin C gene, L68Q, derives from a common ancestor born roughly 18 generations ago, around 1550AD. Details are published June 20th in the open-access journal PLoS Genetics.
Psychosocial issues affect HIV/AIDS treatment outcomes
Psychosocial influences such as stress, depression and trauma have been neglected in biomedical and treatment studies involving people infected with HIV, yet they are now known to have significant health impacts on such individuals and the spread of AIDS, according to a University of North Carolina at Chapel Hill scientist.

News discussion:

Medicine & Health news