What women want. Women's preferences for the management of low-grade abnormal cervical screening tests: a systematic review

TY - JOUR

T1 - What women want. Women's preferences for the management of low-grade abnormal cervical screening tests

T2 - a systematic review

AU - Frederiksen, M E

AU - Lynge, E

AU - Rebolj, M

N1 - © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

PY - 2012/1

Y1 - 2012/1

N2 - BACKGROUND: If human papillomavirus (HPV) testing will replace cytology in primary cervical screening, the frequency of low-grade abnormal screening tests will double. Several available alternatives for the follow-up of low-grade abnormal screening tests have similar outcomes. In this situation, women's preferences have been proposed as a guide for management decisions.OBJECTIVES: To determine women's preferences for the follow-up of low-grade cervical screening abnormalities.SEARCH STRATEGY: Using Medical Subject Headings (MeSH) terms, PubMed was searched for articles published up to December 2010. The reference lists of the retrieved studies were consulted.SELECTION CRITERIA: Studies asking women to state a preference between active follow-up and observation for the management of low-grade abnormalities on screening cytology or HPV tests.DATA COLLECTION AND ANALYSIS: Information on study design, participants and outcomes was retrieved using a prespecified form. Studies were sorted by design.MAIN RESULTS: Thirteen studies were included in the review. In all five studies that surveyed women with abnormal tests before any management had started, two-thirds preferred active follow-up, predominantly as immediate colposcopy, to observation, predominantly as repeated Pap smears. In all but two studies testing other situations, women more often expressed a preference for active follow-up than for observation; however, women appeared to be somewhat more willing to accept observation if reassured of the low risk of cervical cancer.CONCLUSIONS: Even for low-grade abnormal cervical tests, women tend to prefer active management strategies. It may be a challenge to meet their expectations of optimal follow-up when HPV testing is used in primary screening.

AB - BACKGROUND: If human papillomavirus (HPV) testing will replace cytology in primary cervical screening, the frequency of low-grade abnormal screening tests will double. Several available alternatives for the follow-up of low-grade abnormal screening tests have similar outcomes. In this situation, women's preferences have been proposed as a guide for management decisions.OBJECTIVES: To determine women's preferences for the follow-up of low-grade cervical screening abnormalities.SEARCH STRATEGY: Using Medical Subject Headings (MeSH) terms, PubMed was searched for articles published up to December 2010. The reference lists of the retrieved studies were consulted.SELECTION CRITERIA: Studies asking women to state a preference between active follow-up and observation for the management of low-grade abnormalities on screening cytology or HPV tests.DATA COLLECTION AND ANALYSIS: Information on study design, participants and outcomes was retrieved using a prespecified form. Studies were sorted by design.MAIN RESULTS: Thirteen studies were included in the review. In all five studies that surveyed women with abnormal tests before any management had started, two-thirds preferred active follow-up, predominantly as immediate colposcopy, to observation, predominantly as repeated Pap smears. In all but two studies testing other situations, women more often expressed a preference for active follow-up than for observation; however, women appeared to be somewhat more willing to accept observation if reassured of the low risk of cervical cancer.CONCLUSIONS: Even for low-grade abnormal cervical tests, women tend to prefer active management strategies. It may be a challenge to meet their expectations of optimal follow-up when HPV testing is used in primary screening.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Choice Behavior

KW - Disease Management

KW - Female

KW - Humans

KW - Mass Screening/psychology

KW - Middle Aged

KW - Papillomavirus Infections/prevention & control

KW - Patient Preference/psychology

KW - Research Design

KW - Uterine Cervical Neoplasms/prevention & control

KW - Young Adult

U2 - 10.1111/j.1471-0528.2011.03130.x

DO - 10.1111/j.1471-0528.2011.03130.x

M3 - Review article

C2 - 21895959

SN - 1470-0328

VL - 119

SP - 7

EP - 19

JO - BJOG

JF - BJOG

IS - 1

ER -