Patient preference for the management of mildly abnormal Papanicolau smears

The article provides information on a study that investigated management preference and desire for decision-making involvement in women who have received a first mildly abnormal Papanicolaou smear. The majority of women in this highly educated sample preferred active management of their mildly abnormal Pap smears, although a substantial minority either opted for the surveillance strategy or reported no strong preference. Furthermore, management preference in this sample was not related to knowledge but rather to level of state anxiety. This indicates that these decisions may be guided more by emotions than by facts. Research has shown repeatedly that abnormal Pap smears are associated with a significant amount of anxiety. It could be that fear of invasive carcinoma weighs in heavily on the side of the active management strategy, despite knowledge of its being a low probability event. As gynecologists continue to evaluate the comparative medical efficacy of different strategies in the management of low-grade cervical abnormalities. It seems important that patient preference and psychosocial factors affecting preference be integrated into the evaluation process and incorporated into clinical practice