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Preferences for surveillance strategies for women treated for high-grade precancerous cervical lesions.

Abstract：

OBJECTIVES:Data are lacking on how women view alternative approaches to surveillance for cervical cancer after treatment of high-grade cervical intraepithelial neoplasia. We measured and compared patient preferences (utilities) for scenarios with varying surveillance strategies and outcomes to inform guidelines and cost-effectiveness analyses of post-treatment surveillance options. METHODS:English- or Spanish-speaking women who had received an abnormal Pap test result within the past 2 years were recruited from general gynecology and colposcopy clinics and newspaper and online advertisements in 2007 and 2008. Participation consisted of one face-to-face interview, during which utilities for 11 different surveillance scenarios and their associated outcomes were elicited using the time tradeoff metric. A sociodemographic questionnaire also was administered. RESULTS:65 women agreed to participate and successfully completed the preference elicitation exercises. Mean utilities ranged from 0.989 (undergoing only a Pap test, receiving normal results) to 0.666 (invasive cervical cancer treated with radical hysterectomy or radiation and chemotherapy). Undergoing both Pap and HPV tests and receiving normal/negative results had a lower mean utility (0.953) then undergoing only a Pap test and receiving normal results (0.989). Having both tests and receiving normal Pap but positive HPV results was assigned an even lower mean utility (0.909). 15.9% of the respondents gave higher utility scores to the Pap plus HPV testing scenario (with normal/negative results) than to the "Pap test alone" scenario (with normal results), while 17.5% gave the Pap test alone scenario a higher utility score. CONCLUSIONS:Preferences for outcomes ending with normal results but involving alternative surveillance processes differ substantially. The observed differences in utilities have important implications for clinical guidelines and cost-effectiveness analyses.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Kuppermann M,Melnikow J,Slee C,Tancredi DJ,Kulasingam S,Birch S,Helms LJ,Bayoumi AM,Sawaya GF

doi

10.1016/j.ygyno.2010.05.002

subject

Has Abstract

pub_date

2010-08-01 00:00:00

pages

108-15

issue

eissn

0090-8258

issn

1095-6859

pii

S0090-8258(10)00355-0

journal_volume

118

pub_type

杂志文章

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Preferences for surveillance strategies for women treated for high-grade precancerous cervical lesions.