Women's Triage and Management Preferences for Cervical Cytologic Reports Demonstrating Atypical Squamous Cells of Undetermined Significance and Low-grade Squamous Intraepithelial Lesions

Daron Gale Ferris, David Lynn Kriegel, Lise Cote, Mark Litaker, Lisa Woodward

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18 Citations (Scopus)

Abstract

Objective: To determine women's triage test preferences for the evaluation and management of atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) Papanicolaou smear reports. Design: A 35-item questionnaire. Setting: Primary care clinic waiting rooms. Participants: A convenience sample of 968 women. Intervention: Women received standardized descriptions of the meaning of ASCUS and LSIL Papanicolaou smear classifications and uniform descriptions of the 4 triage tests: Papanicolaou smear, human papillomavirus DNA test, cervicography, and colposcopy. Main Outcome Measures: Subjects' responses to questionnaire. Results: More women (58.4%) preferred a repeat Papanicolaou smear for an ASCUS report than would choose human papillomavirus DNA testing (7.3%), cervicography (20.6%), or colposcopy (13.8%) (P<.001, x2). Alternatively, 51% of women wanted colposcopy to evaluate an LSIL report compared with the other 3 options (P<.001, x2). Test accuracy was the most important factor that influenced women's decisions for each test, compared with cost, discomfort, and other reasons (P<.001, x2). Positive predictors for women's selection of colposcopy to evaluate a Papanicolaou smear showing LSIL included older age (P<.01, logistic regression analysis), higher level of income (P<.001, x2), greater level of education (P<.001, logistic regression analysis), greater level of knowledge of colposcopy and Papanicolaou smears (P<.001, logistic regression analysis), family history of cervical cancer (P<.01, x2), and history of cervical dysplasia (P=.02, x2). Conclusions: Most women preferred a repeat Papanicolaou smear to further evaluate an initial Papanicolaou smear demonstrating ASCUS and colposcopy to evaluate a report of LSIL. Women identified test accuracy as the most important reason for triage test selection. Multiple factors, primarily involving patient and family history of cervical neoplasia, level of education, income, age, and knowledge of tests, influence women's desire for specific triage tests. Because no optimal management of women with ASCUS and LSIL Papanicolaou smear reports has been determined, consideration of women's triage test preferences should complement overall patient care.

Original languageEnglish (US)
Pages (from-to)348-353
Number of pages6
JournalArchives of Family Medicine
Volume6
Issue number4
DOIs
StatePublished - Jan 1 1997

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Triage
Papanicolaou Test
Colposcopy
Logistic Models
Regression Analysis
Squamous Intraepithelial Lesions of the Cervix
Atypical Squamous Cells of the Cervix
Human Papillomavirus DNA Tests
Uterine Cervical Dysplasia
Education
Uterine Cervical Neoplasms
Primary Health Care
Patient Care
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{c137ef065ece43b382ee2f742a88aef6,
title = "Women's Triage and Management Preferences for Cervical Cytologic Reports Demonstrating Atypical Squamous Cells of Undetermined Significance and Low-grade Squamous Intraepithelial Lesions",
abstract = "Objective: To determine women's triage test preferences for the evaluation and management of atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) Papanicolaou smear reports. Design: A 35-item questionnaire. Setting: Primary care clinic waiting rooms. Participants: A convenience sample of 968 women. Intervention: Women received standardized descriptions of the meaning of ASCUS and LSIL Papanicolaou smear classifications and uniform descriptions of the 4 triage tests: Papanicolaou smear, human papillomavirus DNA test, cervicography, and colposcopy. Main Outcome Measures: Subjects' responses to questionnaire. Results: More women (58.4{\%}) preferred a repeat Papanicolaou smear for an ASCUS report than would choose human papillomavirus DNA testing (7.3{\%}), cervicography (20.6{\%}), or colposcopy (13.8{\%}) (P<.001, x2). Alternatively, 51{\%} of women wanted colposcopy to evaluate an LSIL report compared with the other 3 options (P<.001, x2). Test accuracy was the most important factor that influenced women's decisions for each test, compared with cost, discomfort, and other reasons (P<.001, x2). Positive predictors for women's selection of colposcopy to evaluate a Papanicolaou smear showing LSIL included older age (P<.01, logistic regression analysis), higher level of income (P<.001, x2), greater level of education (P<.001, logistic regression analysis), greater level of knowledge of colposcopy and Papanicolaou smears (P<.001, logistic regression analysis), family history of cervical cancer (P<.01, x2), and history of cervical dysplasia (P=.02, x2). Conclusions: Most women preferred a repeat Papanicolaou smear to further evaluate an initial Papanicolaou smear demonstrating ASCUS and colposcopy to evaluate a report of LSIL. Women identified test accuracy as the most important reason for triage test selection. Multiple factors, primarily involving patient and family history of cervical neoplasia, level of education, income, age, and knowledge of tests, influence women's desire for specific triage tests. Because no optimal management of women with ASCUS and LSIL Papanicolaou smear reports has been determined, consideration of women's triage test preferences should complement overall patient care.",
author = "Ferris, {Daron Gale} and Kriegel, {David Lynn} and Lise Cote and Mark Litaker and Lisa Woodward",
year = "1997",
month = "1",
day = "1",
doi = "10.1001/archfami.6.4.348",
language = "English (US)",
volume = "6",
pages = "348--353",
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issn = "1063-3987",
publisher = "American Medical Association",
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TY - JOUR

T1 - Women's Triage and Management Preferences for Cervical Cytologic Reports Demonstrating Atypical Squamous Cells of Undetermined Significance and Low-grade Squamous Intraepithelial Lesions

AU - Ferris, Daron Gale

AU - Kriegel, David Lynn

AU - Cote, Lise

AU - Litaker, Mark

AU - Woodward, Lisa

PY - 1997/1/1

Y1 - 1997/1/1

N2 - Objective: To determine women's triage test preferences for the evaluation and management of atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) Papanicolaou smear reports. Design: A 35-item questionnaire. Setting: Primary care clinic waiting rooms. Participants: A convenience sample of 968 women. Intervention: Women received standardized descriptions of the meaning of ASCUS and LSIL Papanicolaou smear classifications and uniform descriptions of the 4 triage tests: Papanicolaou smear, human papillomavirus DNA test, cervicography, and colposcopy. Main Outcome Measures: Subjects' responses to questionnaire. Results: More women (58.4%) preferred a repeat Papanicolaou smear for an ASCUS report than would choose human papillomavirus DNA testing (7.3%), cervicography (20.6%), or colposcopy (13.8%) (P<.001, x2). Alternatively, 51% of women wanted colposcopy to evaluate an LSIL report compared with the other 3 options (P<.001, x2). Test accuracy was the most important factor that influenced women's decisions for each test, compared with cost, discomfort, and other reasons (P<.001, x2). Positive predictors for women's selection of colposcopy to evaluate a Papanicolaou smear showing LSIL included older age (P<.01, logistic regression analysis), higher level of income (P<.001, x2), greater level of education (P<.001, logistic regression analysis), greater level of knowledge of colposcopy and Papanicolaou smears (P<.001, logistic regression analysis), family history of cervical cancer (P<.01, x2), and history of cervical dysplasia (P=.02, x2). Conclusions: Most women preferred a repeat Papanicolaou smear to further evaluate an initial Papanicolaou smear demonstrating ASCUS and colposcopy to evaluate a report of LSIL. Women identified test accuracy as the most important reason for triage test selection. Multiple factors, primarily involving patient and family history of cervical neoplasia, level of education, income, age, and knowledge of tests, influence women's desire for specific triage tests. Because no optimal management of women with ASCUS and LSIL Papanicolaou smear reports has been determined, consideration of women's triage test preferences should complement overall patient care.

AB - Objective: To determine women's triage test preferences for the evaluation and management of atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) Papanicolaou smear reports. Design: A 35-item questionnaire. Setting: Primary care clinic waiting rooms. Participants: A convenience sample of 968 women. Intervention: Women received standardized descriptions of the meaning of ASCUS and LSIL Papanicolaou smear classifications and uniform descriptions of the 4 triage tests: Papanicolaou smear, human papillomavirus DNA test, cervicography, and colposcopy. Main Outcome Measures: Subjects' responses to questionnaire. Results: More women (58.4%) preferred a repeat Papanicolaou smear for an ASCUS report than would choose human papillomavirus DNA testing (7.3%), cervicography (20.6%), or colposcopy (13.8%) (P<.001, x2). Alternatively, 51% of women wanted colposcopy to evaluate an LSIL report compared with the other 3 options (P<.001, x2). Test accuracy was the most important factor that influenced women's decisions for each test, compared with cost, discomfort, and other reasons (P<.001, x2). Positive predictors for women's selection of colposcopy to evaluate a Papanicolaou smear showing LSIL included older age (P<.01, logistic regression analysis), higher level of income (P<.001, x2), greater level of education (P<.001, logistic regression analysis), greater level of knowledge of colposcopy and Papanicolaou smears (P<.001, logistic regression analysis), family history of cervical cancer (P<.01, x2), and history of cervical dysplasia (P=.02, x2). Conclusions: Most women preferred a repeat Papanicolaou smear to further evaluate an initial Papanicolaou smear demonstrating ASCUS and colposcopy to evaluate a report of LSIL. Women identified test accuracy as the most important reason for triage test selection. Multiple factors, primarily involving patient and family history of cervical neoplasia, level of education, income, age, and knowledge of tests, influence women's desire for specific triage tests. Because no optimal management of women with ASCUS and LSIL Papanicolaou smear reports has been determined, consideration of women's triage test preferences should complement overall patient care.

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