Correlates of self-reported colorectal cancer screening accuracy in a multi-specialty medical group practice

Purpose: We assessed whether accuracy of self-reported screening for colorectal cancer (CRC) varied by respondent characteristics or healthcare utilization. Methods: From 2005 to 2007, 857 respondents aged 51 - 74 were recruited from a multi-specialty medical group practice to answer a questionnaire about their CRC screening (CRCS) behaviors. Self-reports were compared with administrative and medical records to assess concordance, sensitivity, specificity, and report-to-records ratios for overall CRCS (fecal occult blood test, sigmoidoscopy, and/or colonoscopy). Results: Concordance was good (30.8 to <0.9) or fair (30.7 to <0.8) for most subgroups; respondents with >5 visits outside the clinic had poor (<0.7) concordance. Sensitivity estimates were mostly excellent (30.9) or good but poor for respondents whose healthcare provider did not advise a specific CRCS test. Specificity was poor for the following respondents: 65+ years, males, college graduates, family history of CRC, >5 visits outside of the clinic, or whose healthcare provider advised a specific CRCS test. Respondents 65+ years and with >5 outside visits over-reported CRCS. Conclusions: With few exceptions, self-reports of CRCS in an insured population is reasonably accurate across subgroups. More work is needed to replicate these findings in diverse settings and populations to better understand subgroup differences and improve measures of CRCS.