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Accuracy of Self-reported Abnormal Pap Smears Among Reproductive-age African-American Women

Moore, Kristen R.; Baird, Donna D.

doi: 10.1097/EDE.0000000000000947
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Background: Self-reported history of abnormal Pap smear is used in large public health surveys. However, literature on the accuracy of this reporting is limited. We sought to assess the validity of self-reported abnormal Pap history in a community-based sample of African-American women 24–37 years of age in the Detroit, MI, recruited from 2010 to 2012.

Methods: We compared self-reported data on 2-year history of abnormal Pap smear to medical Pap record data (the gold standard) obtained from eligible participants. Sensitivity and specificity were evaluated to summarize the accuracy of the self-reported data. We also explored the sensitivity by severity of abnormality.

Results: We identified 345 participants with 480 eligible Pap records. Thirty-five percent of abnormal Pap results were not identified by self-report (sensitivity/specificity: 65%/91%; kappa = 0.54). The sensitivity of reporting an abnormal Pap tended to be higher for those with a more severe abnormality.

Conclusions: A large proportion of abnormal Pap smears were not identified by self-report in this sample of African-American women. Public health studies utilizing self-reported abnormal Pap information should be interpreted with caution.

From the Epidemiology Branch A3-05, National Institute of Environmental Health Sciences, Research Triangle Park, NC.

Submitted April 26, 2018; accepted November 14, 2018.

The research was supported by the Intramural Research Program of the National Institute of Health (NIH), National Institute of Environmental Health Sciences (10-E-N044). Funding also came from the American Recovery and Reinvestment Act funds designated for NIH research.

The authors report no conflicts of interest.

The data and computer code are not available for replication because the data are not publicly available. Data may be requested by contacting the principal investigator, Dr. Donna Baird (baird@niehs.nih.gov).

Correspondence: Kristen R. Moore, Epidemiology Branch A3-05, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709. E-mail: kristen.moore@nih.gov.

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