Validation of Colorectal Cancer Screening Behaviors

Abstract

The importance of identifying efficacious and effective strategies to improve the use of evidence-based cancer screening tests and reduce disparities is well documented (1). Among many methodologic challenges to rigorous study design (2) are several related to obtaining reliable and valid measures of screening behaviors. Meissner and colleagues (3) have made several major recommendations for future research studies that promote the use of cancer screening. Included in these recommendations are the importance of developing and testing standardized behavioral outcome measures, and the need for additional studies of reliability and validity in different population subgroups.Vernon and colleagues (2) have emphasized that selection and measurement of primary outcome measures is critical to the credibility of studies of systems and behavioral change interventions. The authors identified seven important ''lessons learned'' for cancer screening research. Among these lessons were (a) the need for agreement regarding conceptual and operational definitions of behavioral outcomes; and (b) that studies, using self-reported cancer-screening participation, should assess reliability and validity and quantify measurement error and bias in a broad range of respondents.With regard to the first point, the need for agreement on operational definitions, progress has been made with respect to colorectal cancer (CRC) screening behaviors.

Self‐Reported Cancer Screening Among Elderly Medicare Beneficiaries: A Rural‐Urban Comparison

“…First, the outcome measures are self‐reported use of mammogram and CRC screenings. Self‐reported screening use rates have been shown to be higher than claim data or medical records for mammogram, FOBT, and colonoscopy 35 , 40–44 . However, given the nature of 1‐year cross‐sectional data, we do not have information on colonoscopy claim information.…”

“…Self-reported screening use rates have been shown to be higher than claim data or medical records for mammogram, FOBT, and colonoscopy. 35,[40][41][42][43][44] However, given the nature of 1-year cross-sectional data, we do not have information on colonoscopy claim information. We also have concerns with Medicare claim data for FOBT because the reimburse rate for FOBT is low, and many physicians may not submit.…”

Exploring Disparities and Variability in Perceptions and Self-Reported Colorectal Cancer Screening Among Three Ethnic Subgroups of U. S. Blacks

“…Since the current study was completed, the authors have received additional funding to begin the translation and transcreation of measures into Haitian Creole. Recent published reports suggest that the validity of self-reported CRC screening generally is respectable (Zapka, 2008) but may vary by test (Partin et al, 2008; Vernon et al, 2008) and by other factors such as age, education, family history (Partin et al, 2008), and race (Rauscher, Johnson, Cho, & Walk, 2008). …”

Decision Aid to Technologically Enhance Shared decision making (DATES): study protocol for a randomized controlled trial

“…The only acceptable outcome endpoint will be a medically documented CRCS procedure. Self-report of completing CRCS with no documentation, and self-report of not completing CRCS, will be coded as no CRCS done [72-79]. Documented incomplete CRCS test (for example, unsuccessful colonoscopy, incomplete number of stool blood cards submitted) will be coded as incomplete CRCS.…”