title: What women want. Women's preferences for the management of low-grade abnormal cervical screening tests: a systematic review.
abstract: 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.
  
  
  OBJECTIVE
  To determine women's preferences for the follow-up of low-grade cervical screening abnormalities.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  Information on study design, participants and outcomes was retrieved using a prespecified form. Studies were sorted by design.
  
  
  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.
authors: Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors: M E
authors: ME
authors: Frederiksen
authors: E
authors: E
authors: Lynge
authors: M
authors: M
authors: Rebolj
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002755:Choice Behavior; D019468:Disease Management; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000517:prevention & control* / Q000523:psychology; D057240:Patient Preference / Q000523:psychology*; D012107:Research Design; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000523:psychology* / Q000821:virology; D055815:Young Adult