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Patient assessment of tests to detect cervical cancer

Published online by Cambridge University Press:  01 April 2007

Karen Basen-Engquist ,
Rachel T. Fouladi ,
Scott B. Cantor ,
Eileen Shinn ,
Dawen Sui ,
Mathilde Sharman  and
Michele Follen
Karen Basen-Engquist
Affiliation:
The University of Texas M.D. Anderson Cancer Center
Rachel T. Fouladi
Affiliation:
Simon Fraser University
Scott B. Cantor
Affiliation:
The University of Texas M.D. Anderson Cancer Center
Eileen Shinn
Affiliation:
The University of Texas M.D. Anderson Cancer Center
Dawen Sui
Affiliation:
The University of Texas M.D. Anderson Cancer Center
Mathilde Sharman
Affiliation:
The University of Texas M.D. Anderson Cancer Center
Michele Follen
Affiliation:
The University of Texas M.D. Anderson Cancer Center
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Abstract

Objectives: 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.

Keywords

Cervical cancer screeningColposcopyConjoint analysisDecision makingTechnology assessment
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 23 , Issue 2 , April 2007 , pp. 240 - 247
Copyright
Copyright © Cambridge University Press 2007

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