Informed choice on Pap smear still limited by lack of knowledge on the meaning of false-positive or false-negative test results.
OBJECTIVE
Screening for cervical cancer may have favourable or unfavourable effects at the individual level. This study assesses whether invitees in The Netherlands made an informed choice about screen uptake.


METHODS
Attached to the invitation letter and the information leaflet, screen invitees were sent a questionnaire. An informed decision was defined as based on decision-relevant knowledge, while the woman's attitude was consistent with her actual screening behaviour.


RESULTS
Of all cervical screen participants, 60% (924/1551) responded to the questionnaire. Decision-relevant knowledge was sufficient in 595 women. Especially knowledge about false-positive and false-negative test results was limited. The attitude towards cervical screening was mainly positive (99%). Requirements for informed decision making were met in 571 (68%) women and in 91% when an alternative cut-off point of sufficient decision-relevant knowledge was applied. Most frequently reported main reasons to attend were early detection of abnormalities (67%) and reassurance in case of a normal smear (22%).


CONCLUSIONS
Insufficient decision-relevant knowledge was the main cause of uninformed attendance.


CONCLUSIONS
Adequate strategies to provide invitees with sufficient decision-relevant information are still needed, especially regarding false-positive and false-negative test results.
Dept. of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. i.korfage@erasmusmc.nl
Ida J
IJ
Korfage
Marjolein
M
van Ballegooijen
Brendy
B
Wauben
J Dik F
JD
Habbema
Marie-Louise
ML
Essink-Bot
D000328:Adult; D003657:Decision Making; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009426:Netherlands; D065006:Papanicolaou Test; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears; D014930:Women / Q000523:psychology*