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Am J Prev Med. 2002 Jan;22(1):56-8.

The accuracy of primary care patients' self-reports of prostate-specific antigen testing.

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Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX 77005, USA.



The accuracy of reports made by male primary care patients of previous screening for prostate cancer with the prostate-specific antigen (PSA) assay is important for clinical practice, surveillance, and research.


As part of a clinical trial that evaluated a decision aid for prostate cancer screening, 133 male primary care patients, aged 45 to 70 years, were contacted 1 year after enrollment and asked whether they had received PSA testing. To corroborate these self-reports, each patient's clinic and hospital medical records were reviewed for evidence of PSA test results.


The raw percentage agreement between self-reported PSA testing and the medical records was 74.4% (kappa=0.48). When compared to the findings of the medical record reviews, apparent overreporting by some patients was explained by problems with recalling the test within the 1-year time frame (4.5%) and by having been tested outside of the medical center (5.3%). Uncertainty about having been tested was reported by six (4.5%) patients with PSA test results in their medical records. Misreported testing could not be explained for 11.3% of patients. Patients who had not completed high school were 2.7 times more likely to misreport PSA testing (95% confidence interval, 1.61-3.87).


The accuracy of primary care patients' self-reports of previous PSA testing is questionable. Errors in reporting are due largely to problems with recalling a test within a specific time frame or to testing outside of the primary care setting. Under-reporting is a problem for patients uncertain of previous testing.

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