For the TOMBOLA Group, see Appendix.
Management of low-grade cervical abnormalities detected at screening: which method do women prefer?
Article first published online: 3 JUN 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd
Volume 19, Issue 6, pages 355–362, December 2008
How to Cite
Whynes, D. K., Woolley, C., Philips, Z. and for the TOMBOLA Group (2008), Management of low-grade cervical abnormalities detected at screening: which method do women prefer?. Cytopathology, 19: 355–362. doi: 10.1111/j.1365-2303.2008.00565.x
- Issue published online: 19 NOV 2008
- Article first published online: 3 JUN 2008
- Accepted for Publication 7 December 2007
- cervical cytology;
- contingent valuation;
- self-reported health;
- visual analogue scale
Objective: To establish whether women with low-grade abnormalities detected during screening for cervical cancer prefer to be managed by cytological surveillance or by immediate colposcopy.
Methods: TOMBOLA (Trial of Management of Borderline and Other Low-grade Abnormal smears) is a randomized controlled trial comparing alternative management strategies following the screen-detection of low-grade cytological abnormalities. At exit, a sample of TOMBOLA women completed a questionnaire eliciting opinions on their management, contingent valuations (CV) of the management methods and preferences. Within-trial quality of life (EQ-5D) data collected for a sample of TOMBOLA women throughout their follow-up enabled the comparison of self-reported health at various time points, by management method.
Results: Once management had been initiated, self-reported health in the colposcopy arm rose relative to that in the surveillance arm, although the effect was short-term only. For the majority of women, the satisfaction ratings and the CV indicated approval of the management method to which they had been randomized. Of the minority manifesting a preference for the method which they had not experienced, relatively more would have preferred colposcopy than would have preferred surveillance.
Conclusions: The findings must be interpreted in the light of sample bias with respect to preferences, whereby enthusiasm for colposcopy was probably over-represented amongst trial participants. The study suggests that neither of the management methods is preferred unequivocally; rather, individual women have individual preferences, although many would be indifferent between methods.