Accuracy of self-reported exam indications for breast cancer screening.

We validated updated National Health Interview Survey questions on mammography indications compared to electronic health records (EHR). We asked 244 Kaiser Permanente Washington members ages 40-74 years and eligible for breast cancer screening to self-report their most recent mammogram reason using a series of new hierarchical yes/no questions. We first asked if they had the mammogram because of a health problem, then as a follow-up test, and last for screening. We compared self-reported reasons to two EHR datasets: procedure/diagnostic codes, and radiologist-defined indications. Self-reported exams for a health problem had 89.2% agreement with codes and 92.2% agreement with radiologist-defined indications. Self-reported exams for follow-up had 87.5% agreement with codes, and 89.3% agreement with radiologist-defined indications. Self-reported exams for screening had 91.4% agreement with codes, and 95.7% agreement with radiologist-defined indications. Self-reported mammogram indications have good agreement with procedure/diagnostic codes and radiologist-reported indications, when asked using this novel hierarchical approach.