Abstract
Background:The Japan Nurses’ Health Study (JNHS) is a large-scale, nationwide prospective cohort study of female nurses. This study aimed to examine the validity of self-reported diagnosis of cancer among the JNHS cohort members (N=15,019). Methods:For women who reported any diagnosis of five cancers (stomach, colorectal, liver, lung and thyroid) in the biennial follow-up surveys, an additional outcome survey, medical facility survey, and confirmation of death certificate (DC) were conducted. The JNHS Validation Study Committee (referred to as “the committee”) made a final decision on the reported outcomes. To examine the validity of self-reported diagnosis of cancer, the positive predictive value (PPV) was calculated using the committee’s decision as the gold standard. To examine the validity of the committee’s decision based on self-reports and DCs, PPV was calculated using physician-reported information as the gold standard. Results:The PPV of self-reported diagnosis in the biennial follow-up surveys was 77.8% for stomach, 66.2% for colorectal, 41.7% for liver, 60.2% for lung, and 64.6% for thyroid cancer. The corresponding PPVs in the additional outcome survey were 96.2%, 80.7%, 62.5%, 82.5%, and 96.9%, respectively. The PPV of the committee’s decision was 100% for stomach, 87.5% for colorectal, 94.7% for lung, and 100% for thyroid cancer (data not available for liver cancer). The proportion of DC-only cases among committee-defined cases was below 10% for all cancers except liver cancer (28.6%). Conclusions:The validity of identifying cancer diagnosis based on self-reported information in the JNHS was favorable for stomach, colorectal, lung and thyroid cancer.
Highlights
This study aimed to examine the validity of self-reported diagnosis of cancer among the Japan Nurses’ Health Study (JNHS) cohort members (N=15,019)
The validity of identifying cancer diagnosis based on self-reported information in the JNHS was favorable for stomach, colorectal, lung and thyroid cancer
The present study examined the validity of selfreported diagnosis of cancer among female nurses in the JNHS by combining information from the participants medical facilities, and death certificates
Summary
Identifying and validating disease outcomes are some of the biggest challenges in epidemiological research. One strategy is to use information provided in physician records and to conduct periodic examinations, which is typically adopted in hospital-based studies or communitybased studies with good access to healthcare data (Boring III et al, 1996). Another way is through linkage with population-based disease registries, a strategy that is widely used for large-scale cohort studies on cancer and requires high-quality population-based cancer registry systems in the study area (Calle et al, 2002; Inoue et al, 2011; Sado et al, 2017). Conclusions: The validity of identifying cancer diagnosis based on self-reported information in the JNHS was favorable for stomach, colorectal, lung and thyroid cancer
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