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

M E Frederiksen, E Lynge, M Rebolj

    Research output: Contribution to journalReview articlepeer-review

    19 Citations (Scopus)


    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.

    Original languageEnglish
    Pages (from-to)7-19
    Number of pages13
    Issue number1
    Publication statusPublished - Jan 2012


    • Adolescent
    • Adult
    • Aged
    • Aged, 80 and over
    • Choice Behavior
    • Disease Management
    • Female
    • Humans
    • Mass Screening/psychology
    • Middle Aged
    • Papillomavirus Infections/prevention & control
    • Patient Preference/psychology
    • Research Design
    • Uterine Cervical Neoplasms/prevention & control
    • Young Adult


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