Race and the validity of self-reported cancer screening behaviors: Development of a conceptual model

Background: Many estimates of cancer screening are based on self-reported screening behavior. There is growing concern that self-reported screening measures may be less accurate among members of racial and ethnic minority groups. This would have considerable implications for research on racial and ethnic disparities in cancer screening. Objectives: To review the literature on the relationship between race/ethnicity and the accuracy of self-reported cancer screening behavior and develop a conceptual framework that would provide a deeper understanding of factors underlying this relationship. Methods: We developed a conceptual framework drawing from diverse literatures including validation studies examining the accuracy of self-reported cancer screening behaviors and articles on survey response bias. Results and conclusions: Evidence suggests that racial and ethnic minorities may be less likely to provide accurate reports of their cancer screening behavior and that overreporting may be particularly problematic. Research conducted in other areas suggests that these sources of measurement error may stem from cognitive and motivational processes and that they can be moderated by question wording and data collection characteristics. At this point, however, the quality of the evidence is not strong and more research is needed before definitive conclusions can be drawn.