Accuracy of Smoking Status Reporting: Proxy Information in a Rapidly Fatal Cancer Setting

Mayo Clin Proc Innov Qual Outcomes. 2020 Dec 10;4(6):801-809. doi: 10.1016/j.mayocpiqo.2020.07.010. eCollection 2020 Dec.

Abstract

Objective: To assess whether patients and relatives can serve as reliable proxy reporters of other family members' cigarette-smoking history.

Patients and methods: Two samples (325 patients, 707 relatives) were identified from the Mayo Clinic Biospecimen Resource for Pancreas Research, enrolled from November, 6, 2000, to March 15, 2018. Smoking-history data, including categorical (ever/never) and quantitative (packs per day and years smoked) smoking measures, were obtained from self-completed questionnaires by patients and relatives. Relative reports were compared with patient reports on self; patient reports were compared with relative reports on self.

Results: Overall, spouses and first-degree relatives (FDRs) were accurate (94.5%) when reporting patient ever smoking; spouse reports were 98.6% sensitive and 97.7% accurate. Accuracy of patient reports was 97.8% for spouse smoking and 85.5% for FDR smoking; accuracy varied by relationship of FDR. When not concordant, patients generally over-reported daily packs smoked by relatives and under-reported years smoked. Within a 25% agreement range, spouse reports about patients' daily packs smoked was 46.7%, and years smoked was 69.6%, whereas FDRs were 50% and 64.6%, respectively. When not concordant, relatives generally over-reported daily packs smoked by patients, but no consistent pattern was observed of over- or under-reporting years smoked by patients.

Conclusions: Patients and relatives can be reliable proxies for smoking history (ever/never) in their family members, especially spouses. An accurate reporting of smoking status will help physicians to better gauge performance status and family smoking exposures to inform disease management.

Keywords: CI, confidence interval; FDR, first-degree relative; PC, pancreatic cancer; RFQ, Risk-Factor Questionnaire; SD, standard deviation; SPORE, Specialized Program of Research Excellence.