Validity of self-reported mammography in low-income African-American women

Background: Mammography screening reduces mortality by 25% to 30% in women aged 50 to 69. Because mammography screening is often used less frequently than the recommended guidelines, many descriptive and intervention studies are underway to increase use of this important screening tool. Assessment of intervention effect is dependent on valid measurement of mammography use. Although several studies have shown a close correspondence between self-report and medical records, most had few minority participants. Methods: The purpose of this report was to compare self-reported mammography and medical records of mammography status in a low-income African-American sample. A total of 229 low-income (at 150% of poverty or below) African-American women were interviewed regarding breast cancer screening. Response categories that assessed last mammogram were "within the last 12 months," "13-24 months," and "over 24 months," as well as date and location of last mammogram. Self-reported mammography was compared with medical records at the facility named by respondents. Results: Comparison with self-report showed that only 49% to 60% of reported mammography use could be verified within categories. Conclusion: Self-report alone may not provide accurate rates of mammography compliance. Further research is necessary with ethnic and low-income women.