Original article
A comparison of physician and patient reports of pap smear histories

https://doi.org/10.1016/0895-4356(88)90148-5Get rights and content

Abstract

We describe the level of agreement between patients and their physicians with respect to their use of the Pap smear, the symptoms present, and the smear results. The data derived from a case-control interview study of 181 newly diagnosed invasive squamous cell cervical cancer cases and 905 age-matched controls, a second case-control interview study of 250 cases of cervical dysplasia and 500 age-matched controls, and the medical records of attending physicians for all patients.

Cases and controls in both studies reported more smears over the previous 5 years than their medical records indicated; also patients reported their last smear as more recent than noted in physician files. Cancer cases were somewhat more accurate on frequency and timing of smears than the other patient groups. Patients tend to report more symptoms at interview than recorded in their files. Disagreements on smear results were probably because of differences in terminology, especially in distinguishing invasive from pre-cancerous conditions; cancer cases tended to report some dysplasias as cancer, but the controls in both studies under-reported dysplasia.

If high physician response rates can be obtained, we would prefer to use physician records as the basis of evaluation of screening programs, especially when accurate dating of screening events is required. However it is less clear whether physician records are to be preferred, if the evaluation is to take symptoms into account.

References (30)

  • J.C. Kuehnle et al.

    First drinking experience in addictive and nonaddictive drinkers

    Arch Gen Psychiat

    (1974)
  • J. Mendlewicz et al.

    Accuracy of the family history method in affective illness

    Arch Gen Psychist

    (1975)
  • R. Glass et al.

    Accuracy of recall of histories of oral contraceptive use

    Br J Prev Soc Med

    (1974)
  • A. Paganini-Hill et al.

    Reliability of recall of drug usage and other health-related information

    Am J Epidemiol

    (1982)
  • A. Paganini-Hill et al.

    Age at natural menopause and breast cancer risk: The effect of errors in recall

    Am J Epidemiol

    (1984)
  • Cited by (86)

    • Colorectal and Breast Cancer Screening Status for People in Ontario Provincial Correctional Facilities

      2019, American Journal of Preventive Medicine
      Citation Excerpt :

      Similarly, the proportion of people up to date for colorectal cancer screening status was lower than the proportion found in the California study, at 22.9% compared with 31%.7 These differences may be due in part to the use of administrative data in this study rather than self-reported data, which could overestimate cancer screening.16,17 Because differences in screening rates between this study and these U.S. studies were large, the authors propose that at least part of the difference in screening rates is likely real.

    • Analysis of 13 million individual patient records pertaining to Pap smears, colposcopies, biopsies and surgery on the uterine cervix (Belgium, 1996-2000)

      2009, Preventive Medicine
      Citation Excerpt :

      For instance at national level, for the year 2000, this difference was 11% (Demarest et al., 2002; Arbyn and Van Oyen, 2004). This discrepancy is probably due to reporting biases, which appear to be inherent to interview surveys (Walter et al., 1988; McKenna et al., 1992; Fruchter et al., 1992; Kottke et al., 1995; Montano and Phillips, 1995). Therefore, estimations of the screening coverage, derived from interview surveys should be interpreted with caution.

    • Self-report was a viable method for obtaining health care utilization data in community-dwelling seniors

      2005, Journal of Clinical Epidemiology
      Citation Excerpt :

      Such systematic reporting errors could introduce bias when comparing groups that differ on these characteristics. However, no investigator has observed a specific relationship [1–3, 5–6,8]. Research by Glandon et al. [8] focused on self-report of health care utilization by older individuals compared with medical records.

    • Mammographic screening: Case-control studies

      2003, Annals of Oncology
      Citation Excerpt :

      In the evaluation of cervical Pap smear screening, for instance, the application of different rules defining which tests are counted as screens can affect the estimated benefit. Additionally, there may be differences in how tests are classified according to the source of information (clinical records or personal interviews) on symptoms [18, 19]. This issue appears not to have been explored for breast cancer.

    View all citing articles on Scopus
    View full text