Objective: Screening for cervical cancer may have favourable or unfavourable effects at the individual level. This study assesses whether invitees in the Netherlands made an informed choice about screen uptake. Methods: Attached to the invitation letter and the information leaflet, screen invitees were sent a questionnaire. An informed decision was defined as based on decision-relevant knowledge, while the woman's attitude was consistent with her actual screening behaviour. Results: Of all cervical screen participants, 60% (924/1551) responded to the questionnaire. Decision-relevant knowledge was sufficient in 595 women. Especially knowledge about false-positive and false-negative test results was limited. The attitude towards cervical screening was mainly positive (99%). Requirements for informed decision making were met in 571 (68%) women and in 91% when an alternative cut-off point of sufficient decision-relevant knowledge was applied. Most frequently reported main reasons to attend were early detection of abnormalities (67%) and reassurance in case of a normal smear (22%). Conclusion: Insufficient decision-relevant knowledge was the main cause of uninformed attendance. Practice implication: Adequate strategies to provide invitees with sufficient decision-relevant information are still needed, especially regarding false-positive and false-negative test results.

Attitude to health, Cervix cancer, Informed decision making, Questionnaires, Screening
dx.doi.org/10.1016/j.pec.2010.12.014, hdl.handle.net/1765/30842
Patient Education and Counseling
Erasmus MC: University Medical Center Rotterdam

Korfage, I.J, van Ballegooijen, M, Wauben, B, Habbema, J.D.F, & Essink-Bot, M.L.E. (2011). Informed choice on Pap smear still limited by lack of knowledge on the meaning of false-positive or false-negative test results. Patient Education and Counseling, 85(2), 214–218. doi:10.1016/j.pec.2010.12.014