Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
BJOG. 2012 Jan;119(1):7-19. doi: 10.1111/j.1471-0528.2011.03130.x. Epub 2011 Sep 6.
If human papillomavirus (HPV) testing will replace cytology in primary cervical screening, the frequency of low-grade abnormal screening tests will double. Several available alternatives for the follow-up of low-grade abnormal screening tests have similar outcomes. In this situation, women's preferences have been proposed as a guide for management decisions.
To determine women's preferences for the follow-up of low-grade cervical screening abnormalities.
Using Medical Subject Headings (MeSH) terms, PubMed was searched for articles published up to December 2010. The reference lists of the retrieved studies were consulted.
Studies asking women to state a preference between active follow-up and observation for the management of low-grade abnormalities on screening cytology or HPV tests.
Information on study design, participants and outcomes was retrieved using a prespecified form. Studies were sorted by design.
Thirteen studies were included in the review. In all five studies that surveyed women with abnormal tests before any management had started, two-thirds preferred active follow-up, predominantly as immediate colposcopy, to observation, predominantly as repeated Pap smears. In all but two studies testing other situations, women more often expressed a preference for active follow-up than for observation; however, women appeared to be somewhat more willing to accept observation if reassured of the low risk of cervical cancer.
Even for low-grade abnormal cervical tests, women tend to prefer active management strategies. It may be a challenge to meet their expectations of optimal follow-up when HPV testing is used in primary screening.
如果人乳头瘤病毒（HPV）检测将取代细胞学检查用于宫颈癌的初级筛查，那么低级别异常筛查试验的频率将增加一倍。目前有几种可供选择的方法用于低级别异常筛查试验的随访，这些方法的结局相似。在这种情况下，女性的偏好可以作为管理决策的指南。
确定女性对低级别宫颈筛查异常的随访偏好。
使用医学主题词(MeSH)术语，对截至 2010 年 12 月发表的文章进行了 PubMed 检索。查阅了检索到的研究的参考文献列表。
要求女性对低级别细胞学或 HPV 检测筛查异常的管理选择积极随访或观察的研究。
使用预定义的表格提取研究设计、参与者和结局的信息。研究按设计分类。
综述共纳入了 13 项研究。在所有五项研究中，调查了在开始任何管理之前有异常检查的女性，三分之二的人更喜欢积极的随访，主要是立即行阴道镜检查，而不是观察，主要是重复巴氏涂片检查。在除了两项测试其他情况的研究中，女性更倾向于选择积极的随访，而不是观察；然而，如果告知其宫颈癌风险较低，女性似乎更愿意接受观察。
即使是低级别异常的宫颈检查，女性也倾向于选择积极的管理策略。当 HPV 检测用于初级筛查时，可能难以满足女性对最佳随访的期望。
