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Accuracy of patients' recall of pap and cholesterol screening.

Am J Public Health 2000 90:1431–5 
 
 
 
A cross-sectional, door-to-door community survey was used to gather self-report data on Pap smear and cholesterol screening from 195 rural Australian individuals randomly selected from population statistics. Trained interviewers used a standard reporting form to collect information on screening results, knowledge of recommended screening frequency, and demographics. The two regional pathology laboratories were queried about consenting patients. Adequate screening was defined as any smear within 2 years. Of 146 women eligible for validation of Pap smears, the sensitivity of a self-report of inadequate screening was 45%, the specificity was 98%, the negative predictive value was 72%, and the positive predictive value was 93%. For example, 93% of women who said they had not had a Pap smear in at least 2 years in fact had not, while only 72% of those who claimed to have had a smear within 2 years actually had. Among 91 women reporting Pap results, more than half of those with abnormalities were missed by self-report. The accuracy of recall was not associated with knowledge or demographic factors. 
 
 
 
Comment: Although its use of a rural, Australian population limits the ability to generalize the conclusions of the report for the population in the United States, the results of this study are consistent with those of previous ones: women tend to overestimate the frequency of their Pap smears and to minimize their recall of abnormalities. Self-report should not be used in studies of the adequacy of Pap smear screening, and it should not be relied on to determine who is eligible for screening at 3-year intervals by virtue of three prior normal smears. (LSM)