Patient assessment of tests to detect cervical cancer.
OBJECTIVE
This study was undertaken to understand how women view characteristics of tests for cervical dysplasia, because these characteristics can affect patient decision-making about screening and follow-up.


METHODS
We recruited women who participated in a clinical trial of optical spectroscopy for the diagnosis of cervical dysplasia and used conjoint analysis to assess the women's preferences concerning test attributes. One group of women had a history of an abnormal Papanicolaou smear (diagnostic sample), while the other group did not (screening sample). Participants rated pairs of test scenarios that varied on characteristics such as test sensitivity and painfulness. Based on their responses, the relative importance of test sensitivity, specificity, timing of results feedback and treatment, and pain were calculated, and a cluster analysis was done to identify subgroups of participants with different preference patterns.


RESULTS
In the overall sample, sensitivity was the most important attribute, followed by timing, specificity, and pain. Cluster analysis revealed four distinct groups who placed varying importance on each characteristic. The participants in the cluster for which pain was the most important attribute were more likely to be diagnostic patients, non-white, and have low education levels. They also reported more anxiety and pain during the examination than participants in other clusters.


CONCLUSIONS
To continue to reduce morbidity and mortality from cervical cancer, developers of new testing procedures should take into account test attributes such as these, which may affect adherence to screening and diagnostic follow-up to further minimize morbidity and mortality from cervical cancer.
Basen-Engquist
Karen
K
Department of Behavioral Science, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA. kbasenen@mdanderson.org
Fouladi
Rachel T
RT
Cantor
Scott B
SB
Shinn
Eileen
E
Sui
Dawen
D
Sharman
Mathilde
M
Follen
Michele
M
D000328:Adult; D003127:Colposcopy; D003657:Decision Making; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D017060:Patient Satisfaction; D014481:United States; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*; D014626:Vaginal Smears