Patient Preference and Adherence (Jul 2019)
What benefits and harms are important for a decision about cervical screening? A study of the perspective of different subgroups of women
Abstract
Amber E van der Meij,1 Olga C Damman,1 Ellen Uiters,2 Danielle RM Timmermans1,31Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; 2National Institute for Public Health and the Environment (RIVM), Centre for Nutrition, Prevention and Health Services, Bilthoven, The Netherlands; 3National Institute for Public Health and the Environment (RIVM), Bilthoven, The NetherlandsBackground: In cervical screening programs, women typically receive information leaflets to support their decision about participation. However, these leaflets are often based on what experts consider important benefits and harms of screening and not what women themselves consider important to know.Objective: To identify which benefits and harms women consider important for making a decision about cervical screening.Design: Cross-sectional study.Setting and participants: Women from the Dutch target group of cervical screening (N=248; 30–60 years), recruited through an online access panel.Main variables studied: Perceived importance of different benefits and harms of cervical screening, assessed through two rating items (“How important is the information about [this harm/benefit] for your decision?” and “For me it is a [benefit/harm] that participating in the screening program leads to [the benefit/harm]”), and one ranking item (“Rank the information according to their importance for your own choice”).Results: Women overall considered the benefits of cervical screening more important than the harms or disadvantages. The most important harm according to women was the chance of false positive results (M=4.88; SD=1.75). Differences between those with lower and higher numeracy/health literacy were found regarding several aspects, e.g. for the chance of false positive results, the chance of false negative results, the chance of overtreatment.Discussion and conclusion: The results suggest that leaflets could include more explicit information about false positive results.Keywords: informed decision making, cervical screening, risk communication, lay perspective
