Is the Accuracy of Self-Reported Colorectal Cancer Screening Associated with Social Desirability?

University of Texas-Houston School of Public Health, Division of Health Promotion and Behavioral Sciences, 7000 Fannin Street, Suite 2560, Houston, TX 77030, USA.
Cancer Epidemiology Biomarkers & Prevention (Impact Factor: 4.13). 12/2011; 21(1):61-5. DOI: 10.1158/1055-9965.EPI-11-0552
Source: PubMed


Self-reported cancer screening behaviors are often overreported and may lead to biased estimates of prevalence and of subgroup differences in screening. We examined whether the tendency to give socially desirable responses was associated with concordance between self-reported colorectal cancer (CRC) screening behaviors and medical records.
Primary care patients (n = 857) age 50 to 74 years completed a mail, face-to-face, or telephone survey that assessed CRC screening and social desirability measured by a short version of the Marlowe-Crowne scale. We used medical records to verify self-reports of fecal occult blood testing (FOBT), sigmoidoscopy, colonoscopy, and barium enema.
Social desirability scores were lower for whites versus African Americans, college graduates, and patients reporting no prior screening tests; they were higher for telephone versus mail or face-to-face survey respondents. In univariable logistic regression analysis, social desirability scores were not associated with concordance for FOBT (OR = 1.03, 95% CI = 0.94-1.13), sigmoidoscopy (OR = 0.95, 95% CI = 0.86-1.04), or colonoscopy (OR = 0.99, 95% CI = 0.88-1.11); however, lower social desirability scores were associated with increased concordance for barium enema (OR = 0.87, 95% CI = 0.77-0.99). In multivariable analyses, no associations were statistically significant.
Social desirability as measured by the Marlowe-Crowne scale was not associated with accuracy of self-reported CRC tests in our sample, suggesting that other explanations for overreporting need to be explored.
By understanding sources of response bias, we can improve the accuracy of self-report measures.

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    • "The impact of the intention item is premised on the notion that by asking people if they intend to engage in a socially desirable behavior such as CRC screening before the actual past behavior, they will feel less pressure to misrepresent their past practice of that behavior in a positive light. However, recent studies have found that the accuracy of self-reported CRC screening is unrelated to social desirability [14,15], so one could posit that the accuracy of CRC screening would be little impacted by the inclusion of the intention item. "
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