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Reliability of self-reported family history of cancer in a large case-control study of lymphoma.
J Natl Cancer Inst. 2006 Jan 04; 98(1):61-8.JNCI

Abstract

BACKGROUND

Case-control studies of familial cancer risk traditionally rely on self-reported family history of cancer, which may bias results due to differential recall between case patients and control subjects. To evaluate the reliability of self-reported data, we analyzed questionnaire and registry-based data on familial cancer from a population-based case-control study of malignant lymphoma.

METHODS

All 1508 lymphoma case patients and 1229 control subjects completed a telephone interview assessing cancer in family members. Participants were linked to the Swedish Multi-Generation Register and Cancer Register to identify confirmed cancer diagnoses in first-degree relatives. The sensitivity and specificity of self-reported familial cancer were calculated among case patients and control subjects and were compared using logistic regression. All statistical tests were two-sided.

RESULTS

Lymphoma case patients reported a family history of any cancer with statistically significantly higher sensitivity than control subjects (0.85, 95% confidence interval [CI] = 0.83 to 0.87 and 0.80, 95% CI = 0.77 to 0.82, respectively) but with marginally lower specificity (0.89, 95% CI = 0.87 to 0.91 and 0.92, 95% CI = 0.90 to 0.94, respectively). The sensitivity of self-reporting familial cancers by site ranged from less than 0.20 for rare malignancies to nearly 0.75 for more common types, whereas specificity was generally 0.98 or greater. For most sites, the reliability of self-report was similar in patients and control subjects. However, patients reported familial hematopoietic cancer with statistically significantly higher sensitivity (0.60, 95% CI = 0.57 to 0.62) than control subjects (0.38, 95% CI = 0.35 to 0.40). Odds ratios for the association between familial cancer and risk of non-Hodgkin lymphoma were consistently higher when based on self-reported, compared with registry data-based, family history of any cancer or of hematopoietic cancer.

CONCLUSIONS

Reliability of self-reported family history of cancer varies between case patients and control subjects. Recall bias may thus produce biased results in case-control studies of familial cancer risk.

Authors+Show Affiliations

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. ellen@nccc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16391372

Citation

Chang, Ellen T., et al. "Reliability of Self-reported Family History of Cancer in a Large Case-control Study of Lymphoma." Journal of the National Cancer Institute, vol. 98, no. 1, 2006, pp. 61-8.
Chang ET, Smedby KE, Hjalgrim H, et al. Reliability of self-reported family history of cancer in a large case-control study of lymphoma. J Natl Cancer Inst. 2006;98(1):61-8.
Chang, E. T., Smedby, K. E., Hjalgrim, H., Glimelius, B., & Adami, H. O. (2006). Reliability of self-reported family history of cancer in a large case-control study of lymphoma. Journal of the National Cancer Institute, 98(1), 61-8.
Chang ET, et al. Reliability of Self-reported Family History of Cancer in a Large Case-control Study of Lymphoma. J Natl Cancer Inst. 2006 Jan 4;98(1):61-8. PubMed PMID: 16391372.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reliability of self-reported family history of cancer in a large case-control study of lymphoma. AU - Chang,Ellen T, AU - Smedby,Karin Ekström, AU - Hjalgrim,Henrik, AU - Glimelius,Bengt, AU - Adami,Hans-Olov, PY - 2006/1/5/pubmed PY - 2006/1/13/medline PY - 2006/1/5/entrez SP - 61 EP - 8 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 98 IS - 1 N2 - BACKGROUND: Case-control studies of familial cancer risk traditionally rely on self-reported family history of cancer, which may bias results due to differential recall between case patients and control subjects. To evaluate the reliability of self-reported data, we analyzed questionnaire and registry-based data on familial cancer from a population-based case-control study of malignant lymphoma. METHODS: All 1508 lymphoma case patients and 1229 control subjects completed a telephone interview assessing cancer in family members. Participants were linked to the Swedish Multi-Generation Register and Cancer Register to identify confirmed cancer diagnoses in first-degree relatives. The sensitivity and specificity of self-reported familial cancer were calculated among case patients and control subjects and were compared using logistic regression. All statistical tests were two-sided. RESULTS: Lymphoma case patients reported a family history of any cancer with statistically significantly higher sensitivity than control subjects (0.85, 95% confidence interval [CI] = 0.83 to 0.87 and 0.80, 95% CI = 0.77 to 0.82, respectively) but with marginally lower specificity (0.89, 95% CI = 0.87 to 0.91 and 0.92, 95% CI = 0.90 to 0.94, respectively). The sensitivity of self-reporting familial cancers by site ranged from less than 0.20 for rare malignancies to nearly 0.75 for more common types, whereas specificity was generally 0.98 or greater. For most sites, the reliability of self-report was similar in patients and control subjects. However, patients reported familial hematopoietic cancer with statistically significantly higher sensitivity (0.60, 95% CI = 0.57 to 0.62) than control subjects (0.38, 95% CI = 0.35 to 0.40). Odds ratios for the association between familial cancer and risk of non-Hodgkin lymphoma were consistently higher when based on self-reported, compared with registry data-based, family history of any cancer or of hematopoietic cancer. CONCLUSIONS: Reliability of self-reported family history of cancer varies between case patients and control subjects. Recall bias may thus produce biased results in case-control studies of familial cancer risk. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/16391372/Reliability_of_self_reported_family_history_of_cancer_in_a_large_case_control_study_of_lymphoma_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djj005 DB - PRIME DP - Unbound Medicine ER -