Patient preference for the management of mildly abnormal Papanicolaou smears

Our objective was to investigate patient knowledge, desire for participatio n in medical decision making, and preference for the management of mildly a bnormal Papanicolaou (Pap) smears (low-grade squamous intraepithelial lesio ns [LGSIL]) in the context of the continuing controversy between active (im mediate colposcopy and biopsy) and surveillance (repeat Pap smears) managem ent strategies. One hundred thirty-six women referred for a diagnostic colp oscopy with a first-time mildly abnormal Pap smear result completed questio nnaires before contact with either the nurse or physician. They were given the State-Trait Anxiety Inventory, the CESD Depression scale, and a knowled ge about dysplasia quiz. They were then presented with the two management o ptions and asked to state a preference, if any. They then completed the Pro blem Solving-Decision Making Scale, a measure of desire for involvement in medical decision making. The majority of women in this sample opted for the active management strategy. Management preference was related to anxiety, with the most anxious women more likely to choose the active management str ategy. Management preference was not related to knowledge or to desire for an active role in decision making, although the more knowledgeable women al so reported a desire for an active role in the decision-making process. Giv en the current controversy over the management of mildly abnormal Pap smear s (LGSIL), as well as the fact that there is no conclusive evidence to supp ort one strategy over another, the informed management preference of women affected by these decisions should be factored into the equation.