Objective: Studies have found that women are less likely than men to undergo colorectal cancer (CRC) screening. While one source of these disparities may be gender differences in barriers and facilitators to screening, another may be differences in reporting bias. Method: In this study of 345 male and female veterans, conducted in 2006 in Minneapolis, MN, we examined CRC screening adherence rates by gender using medical records and self-report and assessed whether any differences were due to reporting bias. Results: We found a significantly higher rate of colonoscopy use among men when using self-report data, but no significant differences in either overall or test-specific screening adherence when using medical record data. Analyses examining the prevalence and determinants of concordance between self-report and medical records screening revealed that compared to women, men were less accurate in reporting sigmoidoscopy and colonoscopy and over-reported screening by colonoscopy. Men were also more likely to have missing self-report data and how missing data were handled affected differences in screening behavior. Accuracy in screening behavior was not explained by demographic variables, good physical or mental health, or physician recommendation for screening. Conclusions: Reported gender disparities in CRC screening adherence may be a result of reporting bias.
Bibliographical noteFunding Information:
This research was supported by a grant from VA Health Services Research and Development Service ( No. HFP 98-001 ), awarded to the Center for Chronic Disease Outcomes Research (CCDOR). The views expressed in this article are those of the author(s) and do not necessarily represent the views of the Department of Veterans Affairs. Part of this work was presented at AcademyHealth, Orlando, FL, June 2007. The authors wish to thank all the veteran participants for the time they provided for this project.
Copyright 2010 Elsevier B.V., All rights reserved.
- Colorectal cancer
- Medical record