Validity of adolescent and young adult self-report of Papanicolaou smear results

Objective: To assess the validity of adolescent and young adult report of P apanicolaou smear results and to determine sociodemographic, cognitive, and behavioral factors associated with incorrect reporting. Methods: We conducted a cross-sectional study of 477 female subjects aged 1 2 to 24 years who attended an adolescent clinic and had a previous Papanico laou smear. Subjects completed a self-administered survey assessing self-re port of Papanicolaou smear results, knowledge about Papanicolaou smears and human papillomavirus (HPV), attitudes about Papanicolaou screening and fol low-up, and risk behaviors. The sensitivity, specificity, positive predicti ve value, and negative predictive value of self-reported results were calcu lated using the cytology report as the standard. Variables significantly as sociated with incorrect reporting were entered into logistic regression mod els controlling for age and race to determine independent predictors for in correct reporting. Results: Of the 477 participants, 128 (27%) had abnormal cytology reports a nd 66 (14%) had incorrect self-reports. Sensitivity of self-report was 0.79 , specificity 0.89, positive predictive value 0.72, negative predictive val ue 0.92, and kappa (kappa) 0.66. The adjusted odds ratios (OR) and 95% conf idence intervals (CI) of the variables comprising a logistic regression mod el predicting incorrect reporting were an HPV knowledge source of zero (OR 2.4, CI 1.0, 5.8), low perceived communication with the provider (OR 2.1, C I 1.1, 4.0), and no contraception at last intercourse (OR 5.5, CI 2.7, 11.0 ). Conclusion: The validity of adolescent and young adult self-reported Papani colaou smear result is high, except among those who lack knowledge of HPV, perceive poor communication with the provider, and use contraception incons istently. (Obstet Gynecol 2000;96:625-31. (C) 2000 by The American College of Obstetricians and Gynecologists.).