Validity and reliability of self-reported health indicators among women attending organized mammographic screening.

Abstract

Risk factors for breast cancer are often used for adjustment in epidemiological studies, including in the evaluation of early performance measures in mammographic screening. Information about risk factors among participants in the Norwegian Breast Cancer Screening Program has been collected since 2006. We aimed to examine the validity of self-reported history of breast cancer and mammographic screening, as well as the reliability of weight and height amongt women attending the program. Information from a questionnaire handed in by participants in the program, 2006-2015, was linked to outcomes from the Cancer Registry of Norway. Sensitivity, specificity, and positive predictive values (PPV) were calculated for self-reported histories of breast cancer and screening. Results were stratified by five-year age groups and evaluated using the χ2 statistic. The reliability of self-reported weight and height were assessed using descriptive statistics, histograms, and mean differences. A total of 538,907 of 611,711 (88%) women attending the program during the study period returned at least one part of the questionnaire. The overall sensitivity, specificity, and PPV for breast cancer and mammography were 96.5%, 99.8%, and 81.3%; and 99.9%, 84.4%, and 97.6% respectively. The mean difference in self-reported weight was 0.35 kg and for height was -0.14 cm, over a period of up to 10 years. Norwegian women attending the screening program are reasonably accurate in self-reporting their breast cancer and mammography histories. On average, women consistently reported weight and height within one kg/cm.