INFORMED CHOICE ON PAP SMEAR STILL LIMITED BY LACK OF KNOWLEDGE ON THE MEANING OF FALSE POSITIVE OR FALSE NEGATIVE TEST RESULTS

Sunday, October 24, 2010
Sheraton Hall E/F (Sheraton Centre Toronto Hotel)
Ida J. Korfage, PhD1, Marjolein van Ballegooijen, MD, PhD1, Brendy Wauben, MSc2, Dik Habbema, PhD3 and Marie-Louise Essink-bot, MD, PhD4, (1)Erasmus MC - University Medical Center Rotterdam, Rotterdam, Netherlands, (2)Comprehensive Cancer Centre Limburg, Maastricht, Netherlands, (3)Erasmus MC, University Medical Center, Rotterdam, Netherlands, (4)Social Medicine, Amsterdam, Netherlands

Purpose: Cervical cancer screening may have both favourable and unfavourable effects at the individual woman’s level. We assessed if invitees in the Netherlands made informed choices about their participation.

Method: In a questionnaire study among screen invitees we addressed informed decision making about screen participation. An informed decision was defined as based on decision-relevant knowledge, while there was consistency between the decision maker’s attitude and her actual screening behaviour. Data on screen participation was obtained from the screening organisation conditional on permission of the women involved.

Result: 60% of cervical screen participants responded to the questionnaire (924/1551). The attitude towards cervical screening was predominantly positive (98%). Decision-relevant knowledge was sufficient in 595 women. Especially knowledge about false positive and false negative test results was limited. Requirements for informed decision making were met in 571 (68%). Most frequently reported reasons to attend were ‘being in time’ in case of an abnormal smear result (84%) and reassurance in case of a normal smear (60%).

Conclusion: Insufficient knowledge was the main cause of uninformed attendance. Although cervical screening is a well-established program, adequate strategies to provide invitees with sufficient decision-relevant information remain needed, particularly regarding knowledge about false positive and false negative test results.