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Validity of self-reported hysterectomy: a prospective cohort study within the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)
  1. Aleksandra Gentry-Maharaj1,
  2. Henry Taylor1,
  3. Jatinderpal Kalsi1,
  4. Andy Ryan1,
  5. Matthew Burnell1,
  6. Aarti Sharma1,
  7. Sophia Apostolidou1,
  8. Stuart Campbell2,
  9. Ian Jacobs1,3,
  10. Usha Menon1
  1. 1Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK
  2. 2Create Health Clinic, London, UK
  3. 3Faculty of Medical and Human Sciences, University of Manchester, Manchester
  1. Correspondence to Dr Aleksandra Gentry-Maharaj; a.gentry-maharaj{at}ucl.ac.uk

Abstract

Objective To evaluate the validity of self-reported hysterectomy against the gold standard of uterine visualisation using pelvic ultrasound.

Design Prospective cohort study.

Setting UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) based in 13 National Health Service (NHS) Trusts in England, Wales and Northern Ireland.

Participants Between April 2001 and October 2005, 48 215 postmenopausal women aged 50–74 randomised to the ultrasound screening arm of UKCTOCS underwent the first (initial) scan on the trial.

Interventions At recruitment, the women completed a recruitment questionnaire (RQ) which included previous hysterectomy. The sonographer asked each woman regarding previous hysterectomy (interview format, IF) prior to the scan. At the scan, in addition to ovarian morphology, endometrial thickness (ET)/endometrial abnormality were captured if the uterus was visualised at the scan.

Outcome measures Self-reported hysterectomy at RQ or IF was compared to ultrasound data on ET/endometrial abnormality (as surrogate uterine visualisation markers) on the first (initial) scan.

Results Of 48 215 women, 3 had congenital uterine agenesis and 218 inconclusive results. The uterus was visualised in 39 121 women. 8871 self-reported hysterectomy at RQ, 8641 at IF and 8487 at both. The uterus was visualised in 39 123, 39 353 and 38 969 women not self-reporting hysterectomy at RQ, IF or both. Validity, sensitivity, specificity, positive predictive value and negative predictive value of using RQ alone, IF or both RQ/IF were 99.6%, 98.9%, 99.7%, 98.9% and 99.7%; 98.9%, 98.4%, 99.1%, 95.9% and 99.7%; 99.8%, 99.6%, 99.9%, 99.4% and 99.9%, respectively.

Conclusions Self-reported hysterectomy is a highly accurate and valid source for studying long-term associations of hysterectomy with disease onset.

Trial registration International Standard Randomised Controlled Trial Number (ISRCTN)—22488978

  • Gynaecology
  • Epidemiology
  • Oncology

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/3.0/

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