Abstract
Purpose The aim of this study was to assess the accuracy of a National Cancer Institute (NCI)-developed colorectal cancer screening questionnaire. Methods We conducted 36 cognitive interviews and made iterative changes to the questionnaire to improve comprehension. The revised questionnaire was administered face-to-face to 201 participants. The primary outcome was agreement between questionnaire responses and medical records for whether or not a participant was up-to-date for any colorectal cancer screening test. Results Comprehension of descriptions and questions was generally good; however, the barium enema description required several revisions. The sensitivity of the questionnaire for up-to-date screening status was 94%, specificity 63%, and concordance 88%. Conclusions The modified questionnaire was highly sensitive for determining if a person was up-to-date for any colorectal cancer screening test, although the specificity was low. Given the difficulty of obtaining all relevant records, self-report using this questionnaire is a reasonable option for identifying people who have undergone testing.
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References
Vernon SW, Briss PA, Tiro JA, Warnecke RB. Some methodologic lessons learned from cancer screening research. Cancer. 2004;101:1131–1145. doi:10.1002/cncr.20513.
Vernon SW, Meissner H, Klabunde C, et al. Measures for ascertaining use of colorectal cancer screening in behavioral, health services, and epidemiologic research. Cancer Epidemiol Biomarkers Prev. 2004;13:898–905.
Baier M, Calonge N, Cutter G, et al. Validity of self-reported colorectal cancer screening behavior. Cancer Epidemiol Biomarkers Prev. 2000;9:229–232.
Gordon NP, Hiatt RA, Lampert DI. Concordance of self-reported data and medical record audit for six cancer screening procedures. J Natl Cancer Inst. 1993;85:566–570. doi:10.1093/jnci/85.7.566.
Montano DE, Phillips WR. Cancer screening by primary care physicians: a comparison of rates obtained from physician self-report, patient survey, and chart audit. Am J Public Health. 1995;85:795–800.
Willis GBRP, Bercini D. The use of verbal report methods in the development and testing of survey questionnaires. Appl Cogn Psychol. 1991;5:251–267. doi:10.1002/acp.2350050307.
Winawer S, Fletcher R, Rex D, et al. Colorectal cancer screening and surveillance: clinical guidelines and rationale-Update based on new evidence. Gastroenterology. 2003;124:544–560. doi:10.1053/gast.2003.50044.
Agresti ACB. Approximate is better than ‘exact’ for interval estimation of binomial proportions. Am Stat. 1998;52:119–126. doi:10.2307/2685469.
Tisnado DM, Adams JL, Liu H, et al. What is the concordance between the medical record and patient self-report as data sources for ambulatory care? Med Care. 2006;44:132–140. doi:10.1097/01.mlr.0000196952.15921.bf.
Rosner B. Fundamentals of biostatistics. 4th ed. Belmont: Duxbury Press; 1995.
Meissner HI, Breen N, Klabunde CN, Vernon SW. Patterns of colorectal cancer screening uptake among men and women in the United States. Cancer Epidemiol Biomarkers Prev. 2006;15:389–394. doi:10.1158/1055-9965.EPI-05-0678.
Partin MR, Slater JS, Caplan L. Randomized controlled trial of a repeat mammography intervention: effect of adherence definitions on results. Prev Med. 2005;41:734–740. doi:10.1016/j.ypmed.2005.05.001.
Blair EBS. Cognitive processes used by survey respondents to answer behavioral frequency questions. J Consum Res. 1987;14:280–288. doi:10.1086/209112.
Jobe JBMD. Cognition and survey measurement: History and overview. Appl Cogn Physchol. 1991;5:175–192. doi:10.1002/acp.2350050303.
Garbers S, Chiasson MA. Inadequate functional health literacy in Spanish as a barrier to cervical cancer screening among immigrant Latinas in New York City. Prev Chronic Dis 2004;1:A07.
Schwartz LM, Woloshin S, Fowler FJ Jr, Welch HG. Enthusiasm for cancer screening in the United States. JAMA. 2004;291:71–78. doi:10.1001/jama.291.1.71.
Wolf MS, Rademaker A, Bennett CL, et al. Development of a brief survey on colon cancer screening knowledge and attitudes among veterans. Prev Chronic Dis. 2005;2:A11.
Wilson JF. The crucial link between literacy and health. Ann Intern Med. 2003;139:875–878.
Acknowledgments
We thank Ms. Deann Cheek (Minneapolis), Mr. Christopher Newlin (Durham), and Ms. Cindy Rose (Durham) for their contributions to recruitment, questionnaire administration, and medical-record abstraction. This study was funded by the National Cancer Institute (R21 CA102379). Additional support was from a VA Health Services Research and Development Research Career Award (Fisher), R01 CA76330 (Vernon), R01 CA97263 (Vernon), and K24 DK002926 (Provenzale). The study sponsors had no role in the study design, collection, analysis, data interpretation, or the writing of this report.
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Appendix: Final Modified Colorectal Cancer Screening Questionnaire
Appendix: Final Modified Colorectal Cancer Screening Questionnaire
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Fisher, D.A., Voils, C.I., Coffman, C.J. et al. Validation of a Questionnaire to Assess Self-Reported Colorectal Cancer Screening Status Using Face-to-Face Administration. Dig Dis Sci 54, 1297–1306 (2009). https://doi.org/10.1007/s10620-008-0471-z
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DOI: https://doi.org/10.1007/s10620-008-0471-z