Background: Survey data used to study trends in cancer screening may overestimate screening utilization while potentially underestimating existing disparities in use. Methods: We did a literature review and meta-analysis of validation studies examining the accuracy of selfreported cancer-screening histories. We calculated summary random-effects estimates for sensitivity and specificity, separately for mammography, clinical breast exam (CBE), Pap smear, prostate-specific antigen testing (PSA), digital rectal exam, fecal occult blood testing, and colorectal endoscopy.

What do chronic obstructive pulmonary disease patients die from? A multiple cause coding analysis. A.L. Hansell, J.A. Walk, J.B. Soriano. #ERS Journals Ltd 2003. ABSTRACT: Information on obstructive lung disease (OLD) deaths is generally derived from the underlying cause of death on the death certificate. This neglects information on other conditions mentioned and may underestimate the burden of disease.Descriptive analyses of all conditions mentioned on the death certificate for all decedents where OLD (chronic obstructive pulmonary disease or asthma) was mentioned as a contributing cause of death were conducted for England and Wales for 1993-1999. OLD was mentioned in 312,664 or 8.0% of all deaths. OLD comprised the underlying cause of death in 59.8% of deaths with any mention of OLD. Where OLD was not the underlying cause of death, the leading causes by the International Classification of Disease version 9 chapter were diseases of the circulatory system, neoplasms, and non-OLD diseases of the respiratory system. The top single causes were acute myocardial infarction, other ischaemic heart disease, and lung cancer.The current analysis confirms that using the underlying cause of death underestimates the contribution of obstructive lung disease to mortality in England and Wales, in contrast to myocardial infarction where underlying cause of death captures most (94% Chronic obstructive pulmonary disease (COPD) is a condition with significant morbidity and mortality and was estimated as the third leading cause of mortality worldwide in 1990 [1] and fourth leading cause of death in the USA in 1996 [2]. Work in the USA [3] has suggested that using underlying cause of death as an indicator of the health burden from severe COPD may dramatically underestimate the impact of the disease, with nonrespiratory causes accounting for w50% of the underlying causes of death in COPD patients in the USA [3]. Most studies on the mechanisms and causes of death in COPD have been conducted on small groups of patients [4]. One of the largest such studies involved 215 decedents with COPD and on long-term oxygen therapy. This found that the major causes of death were acute-on-chronic respiratory failure, heart failure, pulmonary infection, pulmonary embolism, cardiac arrhythmia and lung cancer [5]. Much less is known of the circumstances of death and the specific causes of death of COPD patients in the community [4].Data on all conditions mentioned on the death certificate in England and Wales became available electronically from 1993 [6]. This study aimed to quantify the extent to which obstructive lung disease (OLD) made a significant contribution to the death in the opinion of the certifying physician by examining the extent to which OLD was mentioned anywhere on the death certificate. The study also aimed to better characterise the specific causes of death in OLD patients in England and Wales, where OLD was mentioned on the death certificate but not the underlying cause. MethodsMortality and population statistics for England and W...

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