THE ACCURACY OF SELF-REPORTED PAP SMEAR UTILIZATION

This study assessed the accuracy of self-reported Pap smear utilisatio n over four different time frames, examining the magnitude of errors i n self-report and sociodemographic predictors of accuracy. Self-report data on women's cervical screening was collected by interview in a ra ndom household survey (Hunter Region, NSW, Australia), with pathology laboratory data collected by a search of records within laboratories. The magnitude of error in self-report was assessed by comparing it aga inst longer intervals in pathology laboratory data. Sociodemographic p redictors of accuracy were explored using chi square analyses. Low val ues for specificity and positive predictive value across all four time frames indicate a considerable degree of inaccuracy in women's report ing of those instances where, in truth, screening has not occurred. Of women reporting a smear within the last three years, only 61.2% were verified within pathology laboratory records. Allowing women some ''le eway'' in their reporting, comparing self-report to longer intervals o f pathology laboratory data, did not greatly improve the accuracy of r eporting, confirming that the magnitude of inaccuracy involved is of r eal clinical significance. Demographic variables were not related to t he accuracy of self-report and, while a woman's certainty of her respo nse was predictive, this had little impact on the measures of agreemen t. Self-report of Pap smear histories consistently results in over-rep orting of screening. Other means of assessing the prevalence of screen ing may be preferable to self-report. Where self-report data is collec ted, techniques to improve accuracy should be employed, and care shoul d be taken in comparing screening rates obtained by different methods. (C) 1997 Elsevier Science Ltd.