» Back to list of all Management eBriefs
|Issue 152||April 2019|
The report is a product of the VA/HSR&D Evidence Synthesis Program.
Evidence Brief: Accuracy of Self-Report for Cervical and Breast Cancer Screening
Guideline-based breast and cervical cancer screening are considered essential health benefits and are fundamental components of high-quality primary care services in the United States. The aim of cancer screening is to identify cancers in an early stage when treatment is more likely to be effective. Accurate measurement of cancer screening rates is vital to understanding if women are adequately screened and to determining if disparities exist in receipt of screening. There are trade-offs to consider when utilizing self-report versus medical record documentation. Although self-report data may reduce administrative burden compared to medical record documentation, its accuracy is often questioned.
Concerns about the accuracy of self-report data for cervical and breast cancer screening and the potential for adverse outcomes, including missed screenings, missed diagnoses, or duplicative screening, have led to policy variations in requirements for reporting documentation of these screenings. Prior to considering changing documentation requirements, it is important to understand the benefits and harms of accepting self-report. Thus, the purpose of this evidence review is to provide an updated synthesis of the evidence on the accuracy of self-reported measures of cervical and breast cancer screening compared to medical records – and the benefits and potential harms of relying on patient self-report instead of medical record documentation.
Investigators with VA's Evidence Synthesis Coordinating Center in Portland, OR reviewed the literature including: MEDLINE®, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and other sources up to November 2018. Investigators identified 1,213 unique, potentially relevant articles and included 39 diagnostic accuracy studies (22 in cervical cancer screening, 29 in breast cancer screening, and 1 systematic review) in their analysis. A total of 61,383 patients were included in studies of cervical cancer screening, and 444,055 patients were included in studies of breast cancer screening. No studies assessed clinical or system-level outcomes and no studies included Veterans.
Summary of Findings
Implications for VHA Policy/Practice
Please feel free to forward this information to others!
ESP is currently soliciting review topics from the broader VA community. Nominations will be accepted electronically using the online Topic Submission Form. If your topic is selected for a synthesis, you will be contacted by an ESP Center to refine the questions and determine a timeline for the report.
This Management e-Brief is provided to inform you about recent HSR&D findings that may be of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. If you have any questions or comments about this Brief, please email CIDER. The Center for Information Dissemination and Education Resources (CIDER) is a VA HSR&D Resource Center charged with disseminating important HSR&D findings and information to policy makers, managers, clinicians, and researchers working to improve the health and care of Veterans.
This report is a product of VA/HSR&D's Evidence Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers –; and to disseminate these reports throughout VA.
See all reports online.