Validity of self-reported diagnoses of gynaecological and breast cancers in a prospective cohort study: the Japan Nurses’ Health Study

Objectives To validate the self-reported diagnoses of gynaecological and breast cancers in a nationwide prospective cohort study of nursing professionals: the Japan Nurses’ Health Study (JNHS).Design and setting Retrospective analysis of the JNHS.Participants and measures Data were reviewed for 15 7...

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Main Authors: Kunihiko Hayashi, Yuki Ideno, Kazue Nagai, Toshiyuki Yasui, Kiyoshi Takamatsu, Mami Kikuchi, Naho Maruoka
Format: Article
Language:English
Published: BMJ Publishing Group 2021-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/6/e045491.full
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author Kunihiko Hayashi
Yuki Ideno
Kazue Nagai
Toshiyuki Yasui
Kiyoshi Takamatsu
Mami Kikuchi
Naho Maruoka
author_facet Kunihiko Hayashi
Yuki Ideno
Kazue Nagai
Toshiyuki Yasui
Kiyoshi Takamatsu
Mami Kikuchi
Naho Maruoka
author_sort Kunihiko Hayashi
collection DOAJ
description Objectives To validate the self-reported diagnoses of gynaecological and breast cancers in a nationwide prospective cohort study of nursing professionals: the Japan Nurses’ Health Study (JNHS).Design and setting Retrospective analysis of the JNHS.Participants and measures Data were reviewed for 15 717 subjects. The mean age at baseline was 41.6±8.3 years (median: 41), and the mean follow-up period was 10.5±3.8 years (median: 12). Participants are regularly mailed a follow-up questionnaire once every 2 years. Respondents who self-reported a positive cancer diagnosis were sent an additional confirmation questionnaire and contacted the diagnosing facility to confirm the diagnosis based on medical records. A review panel of experts verified the disease status. Regular follow-up, confirmation questionnaires and expert review were validated for their positive predictive value (PPV) and negative predictive value (NPV).Results New incidences were verified in 37, 47, 26 and 300 cervical, endometrial, ovarian and breast cancer cases, respectively. The estimated incidence rates were 22.0, 25.4, 13.8 and 160.4 per 100 000 person-years. These were comparable with those of national data from regional cancer registries in Japan. For regular follow-up, the corresponding PPVs for cervical, endometrial, ovarian and breast cancer were 16.9%, 54.2%, 45.1% and 81.4%, and the NPVs were 100%, 99.9%, 99.9% and 99.9%, respectively. Adding the confirmation questionnaire improved the PPVs to 31.5%, 88.9%, 76.7% and 99.9%; the NPVs were uniformly 99.9%. Expert review yielded PPVs and NPVs that were all ~100%.Conclusions Gynaecological cancer cannot be accurately assessed by self-reporting alone. Additionally, the external validity of cancer incidence in this cohort was confirmed.
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spelling doaj-art-ef35791f8e664609b9130ea4ccbccb122024-11-20T08:00:07ZengBMJ Publishing GroupBMJ Open2044-60552021-06-0111610.1136/bmjopen-2020-045491Validity of self-reported diagnoses of gynaecological and breast cancers in a prospective cohort study: the Japan Nurses’ Health StudyKunihiko Hayashi0Yuki Ideno1Kazue Nagai2Toshiyuki Yasui3Kiyoshi Takamatsu4Mami Kikuchi5Naho Maruoka6Department of International/Community Health Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma University, Maebashi, JapanCenter for Mathematics and Data Science, Gunma University, Maebashi, JapanDepartment of International/Community Health Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma University, Maebashi, JapanDepartment of Reproductive and Menopausal Medicine, University of Tokushima Graduate School of Biomedical Sciences, Tokushima, JapanDepartment of Obstetrics and Gynecology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, JapanCenter of Regional Medical Research and Education, Gunma University Hospital, Meabashi, JapanDepartment of International/Community Health Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma University, Maebashi, JapanObjectives To validate the self-reported diagnoses of gynaecological and breast cancers in a nationwide prospective cohort study of nursing professionals: the Japan Nurses’ Health Study (JNHS).Design and setting Retrospective analysis of the JNHS.Participants and measures Data were reviewed for 15 717 subjects. The mean age at baseline was 41.6±8.3 years (median: 41), and the mean follow-up period was 10.5±3.8 years (median: 12). Participants are regularly mailed a follow-up questionnaire once every 2 years. Respondents who self-reported a positive cancer diagnosis were sent an additional confirmation questionnaire and contacted the diagnosing facility to confirm the diagnosis based on medical records. A review panel of experts verified the disease status. Regular follow-up, confirmation questionnaires and expert review were validated for their positive predictive value (PPV) and negative predictive value (NPV).Results New incidences were verified in 37, 47, 26 and 300 cervical, endometrial, ovarian and breast cancer cases, respectively. The estimated incidence rates were 22.0, 25.4, 13.8 and 160.4 per 100 000 person-years. These were comparable with those of national data from regional cancer registries in Japan. For regular follow-up, the corresponding PPVs for cervical, endometrial, ovarian and breast cancer were 16.9%, 54.2%, 45.1% and 81.4%, and the NPVs were 100%, 99.9%, 99.9% and 99.9%, respectively. Adding the confirmation questionnaire improved the PPVs to 31.5%, 88.9%, 76.7% and 99.9%; the NPVs were uniformly 99.9%. Expert review yielded PPVs and NPVs that were all ~100%.Conclusions Gynaecological cancer cannot be accurately assessed by self-reporting alone. Additionally, the external validity of cancer incidence in this cohort was confirmed.https://bmjopen.bmj.com/content/11/6/e045491.full
spellingShingle Kunihiko Hayashi
Yuki Ideno
Kazue Nagai
Toshiyuki Yasui
Kiyoshi Takamatsu
Mami Kikuchi
Naho Maruoka
Validity of self-reported diagnoses of gynaecological and breast cancers in a prospective cohort study: the Japan Nurses’ Health Study
BMJ Open
title Validity of self-reported diagnoses of gynaecological and breast cancers in a prospective cohort study: the Japan Nurses’ Health Study
title_full Validity of self-reported diagnoses of gynaecological and breast cancers in a prospective cohort study: the Japan Nurses’ Health Study
title_fullStr Validity of self-reported diagnoses of gynaecological and breast cancers in a prospective cohort study: the Japan Nurses’ Health Study
title_full_unstemmed Validity of self-reported diagnoses of gynaecological and breast cancers in a prospective cohort study: the Japan Nurses’ Health Study
title_short Validity of self-reported diagnoses of gynaecological and breast cancers in a prospective cohort study: the Japan Nurses’ Health Study
title_sort validity of self reported diagnoses of gynaecological and breast cancers in a prospective cohort study the japan nurses health study
url https://bmjopen.bmj.com/content/11/6/e045491.full
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