Impact of Age at Menarche on Breast Cancer: The Assessment of Recall Bias

Background: Our aim was to determine the association between age at menarche (AAM) and breast cancer adjusted for recall bias (misclassification) in AAM. Methods: We have used data provided from a case-control study conducted in Iran from 2005 to 2009. The cases and controls were frequency matched based on 5-year age groups and region of residence. First, logistic regression was conducted to estimate the odds ratio (OR) and second, Bayesian analysis was applied to estimate the ORs adjusted for misclassification. Results: The study was conducted on 880 cases and 998 controls. In the assumption of no correction for recall bias on self-reported AAM, the o‎r was 1.36 (95% Credible Interval (0.98, 1.90). Based on a sensitivity value = 71% and a specificity value = 81% (the indices about the ratio of true recall of AAM) for the case and control groups (as the first scenario), the AAM ≤ 12 years of age was associated with a lower o‎r for breast cancer by 1.23 (95% Credible Interval: 0.50, 3.13). In the other scenario, with consideration of 100% sensitivity and specificity of self- reported AAM in the case group, and 71% and 81% sensitivity and specificity of the item in the control group, the related o‎r between breast cancer and AAM was found increased to 2.96 (95% Credible Interval: 0.75, 7.66). Conclusion: After adjustment for misclassification related to recall bias, this study provides evidence that the self-reported mode of AAM has a moderate impact on calculation of the OR.