JAMA & ARCHIVES
Arch Fam Med
SEARCH
GO TO ADVANCED SEARCH
HOME  PAST ISSUES  TOPIC COLLECTIONS  CME  PHYSICIAN JOBS  CONTACT US  HELP
Institution: STANFORD Univ Med Center  | My Account | E-mail Alerts | Access Rights | Sign In
  Vol. 6 No. 4, July 1997 TABLE OF CONTENTS
  Archives
  •  Online Features
  ORIGINAL CONTRIBUTIONS
 This Article
 •References
 •Full text PDF
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Contact me when this article is cited
 Related Content
 •Similar articles in this journal

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

Daron G. Ferris, MD; David Kriegel; Lise Cote, MD; Mark Litaker, MS; Lisa Woodward

Arch Fam Med. 1997;6(4):348-353.


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, {varkappa}2). Alternatively, 51% of women wanted colposcopy to evaluate an LSIL report compared with the other 3 options (P<.001, {varkappa}2). Test accuracy was the most important factor that influenced women's decisions for each test, compared with cost, discomfort, and other reasons (P<.001, {varkappa}2). 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, {varkappa}2), 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, {varkappa}2), and history of cervical dysplasia (P=.02, {varkappa}2).

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 Affiliations

From the Medical Effectiveness Education and Research Program (Dr Ferris), Office of Biostatistics (Mr Litaker) and Department of Family Medicine (Ms Woodward), Medical College of Georgia, and the Department of Family and Community Medicine, Eisenhower Army Medical Center, Fort Gordon (Dr Cote), Augusta, Ga.



THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Cytological surveillance compared with immediate referral for colposcopy in management of women with low grade cervical abnormalities: multicentre randomised controlled trial
TOMBOLA Group
BMJ 2009;339:b2546-b2546.
ABSTRACT | FULL TEXT  

A 21-Year-Old Woman With Atypical Squamous Cells of Undetermined Significance
Sawaya
JAMA 2005;294:2210-2218.
FULL TEXT  




HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | PHYSICIAN JOBS | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 1997 American Medical Association. All Rights Reserved.