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Women's preferences for cervical cancer screening: A study using a discrete choice experiment

Published online by Cambridge University Press:  09 August 2006

Sarah Wordsworth ,
Mandy Ryan ,
Diane Skåtun  and
Norman Waugh
Sarah Wordsworth
Affiliation:
University of Oxford
Mandy Ryan
Affiliation:
University of Aberdeen
Diane Skåtun
Affiliation:
University of Aberdeen
Norman Waugh
Affiliation:
University of Aberdeen
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Abstract

Objectives: Recent policy recommendations for cervical screening include liquid-based cytology. This new approach could improve laboratory throughput, reducing the waiting time for test results. New guidelines also standardize the interval for screening, with women aged 25–50 offered screening every 3 years and women aged 50–64 every 5 years. Quantitative evidence on the preferences of women for alternative screening programs is limited; this study, therefore, elicits such preferences.

Methods: A postal questionnaire using a discrete choice experiment was mailed to 2,000 women in the Tayside Health Board region of Scotland.

Results: A response rate of 44 percent from those women who had previously had a smear was achieved. Women had a significant positive preference for reductions in recall rates and waiting time for results. Women preferred more frequent screening, particularly those aged 50+. Expected reductions in the chance of recall from the conventional Pap smear to the new liquid-based cytology were associated with a willingness to pay of £41. Women aged 50+ would be willing to pay £42 to increase the frequency of screening from every 5 to every 3 years. Service characteristics did not influence screening participation.

Conclusions: Guidance to move to liquid-based cytology will meet women's preferences for fewer repeat cervical smears and should reduce waiting time for results. However, proposals to increase screening intervals for those aged 50+ are inconsistent with the preferences for this age group. From a policy perspective, our study results suggest that the changes in attributes of the service such as unsatisfactory smear rates and frequency of screening, will improve service efficiency without affecting participation rates.

Keywords

Cervical screeningPreferencesChoice
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 22 , Issue 3 , July 2006 , pp. 344 - 350
Copyright
© 2006 Cambridge University Press

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References

Bradley M. 1991. User's manual for SPEED version 2.1 stated preference experiment editor and designer. The Hague: Hague Consulting Group;
Franco E. Are we ready for a paradigm change in cervical cancer screening? Lancet. 2003: 362: 1866– 1867.Google Scholar
General Register Office for Scotland 2005. Available at: http://www.gro-scotland.gov.uk/.
Guidance on the use of liquid-based cytology for cervical screening. 2003 Technology Appraisal 69. UK: National Institute for Clinical Excellence; October.
Karnon J, Peters J, Platt J, Chilcott J, McGoogan E. 2004 Liquid-based cytology in cervical screening: An updated rapid and systematic review. Health Technol Assess. 20: 1– 78.Google Scholar
Moss SM, Gray A, Legood R, Henstock E. 2004 Evaluation of HPV/LBC Cervical Screening Pilot Studies. First report to the Department of Health on evaluation of LBC; October.
Pearmain D, Swanson J, Kroes E, Bradley M. 1991. Stated preference techniques: A guide to practice. 2nd ed. Cambridge: Steer Davis Gleave, Hague Consulting Group;
Ryan M, Gerard K. 2003 Using discrete choice experiments to value health care: Current practice and future prospects. Appl Health Econ Health Policy. 2: 55– 64.Google Scholar
Ryan M; Skåtun D. 2004 Modelling non-demanders in choice experiments. Health Econ. 13: 397– 402.Google Scholar
Sasieni P, Adams J, Cuzick J. 2003 Benefit of cervical screening at different ages: Evidence from the UK audit of screening histories. Br J Cancer. 89: 88– 93.Google Scholar
2002 Steering group report on the feasibility of introducing liquid based cytology. Scottish Cervical Screening Programme; January
The OCCURS Group. 1988 Computerisation of screening for cervical cancer. Health Bull (Edinb). 46: 146– 152.Google Scholar
Wordsworth S, Scott A. 2002 Ultrasound scanning by general practitioners: Is it worthwhile? J Public Health Med. 24: 88– 94.Google Scholar
Wordsworth S, Skatun D, Scott A, French F. 2004 Preferences for general practice jobs: A survey of principals and sessional GPs. Br J Gen Pract. 54: 740– 746.Google Scholar
Zwerina K, Huber J, Kuhfeld W. 1996. A general method for constructing efficient choice designs. Durham, NC: Fuqua School of Business, Duke University;