AGREEMENT BETWEEN SELF-REPORTED EARLY CANCER-DETECTION PRACTICES AND MEDICAL AUDITS AMONG HISPANIC AND NON-HISPANIC WHITE HEALTH PLAN MEMBERS IN NORTHERN CALIFORNIA

Background. Using the medical records of a large, prepaid health plan, our purpose was to assess the accuracy of self-reported data on cance r detection practices and to evaluate any differences in accuracy betw een Hispanics and non-Hispanic whites. Methods. Data were collected on six procedures: mammography, clinical breast examination, Pap smear, sigmoidoscopy, fecal occult blood tests, and digital rectal examinatio n. We audited the medical records of 815 randomly selected Hispanic an d 483 non-Hispanic white members of the Kaiser Permanente Medical Care Program in Northern California. All responded to a telephone survey. Using a standardized form, we recorded any of the six target examinati ons that had been performed within 5 years of the telephone interview. We then compared the times of the most recent screening tests as repo rted in the telephone survey with those in the medical record. Results . For the 2 years before the telephone interview, self-reports for scr eening tests overestimated the actual rates at which these tests were performed as documented in the medical records. Lack of agreement betw een self-report and medical record audits was substantial for all scre ening procedures except sigmoidoscopy. Hispanic members had fewer proc edures done for most tests, but the differences were not statistically significant. Overestimates in self-reported screening rates did not d iffer substantially between Hispanics and non-Hispanic whites. Conclus ions. Self-reported data on early cancer detection procedures can subs tantially overestimate their occurrence among both non-Hispanic white and Hispanic populations. These findings confirm earlier findings for Pap smear and affect decisions on cancer prevention procedures that re ly on the accuracy of self-reported data. (C) 1995 Academic Press, Inc .