Iyer Anita L, Bundorf M Kate, Gyrd-Hansen Dorte, Goldhaber-Fiebert Jeremy D, Cyr Pascale-Renée, Sønbø Kristiansen Ivar
Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway.
Department of Health Research and Policy.
Eur J Cancer Prev. 2019 Mar;28(2):87-95. doi: 10.1097/CEJ.0000000000000436.
Cervical cancer (CC) is the 13th most frequent cancer among women in Norway, but the third most common among women aged 25-49 years. The national screening program sends information letters to promote screening participation. We aimed to evaluate how women's stated intention to participate in screening and pursue treatment changed with the provision of additional information on harms associated with screening, and to assess women's preferences on the timing and source of such information. We administered a web-based questionnaire to a panel of Norwegian women aged 25-69 years and randomized into three groups on the basis of when in the screening process additional information was introduced: (i) invited for routine screening, (ii) recommended an additional test following detection of cellular abnormalities, and (iii) recommended precancer treatment. A fourth (control) group did not receive any additional information. Results show that among 1060 respondents, additional information did not significantly alter women's stated intentions to screen. However, it created decision uncertainty on when treatment was recommended (8.76-9.09 vs. 9.40; 10-point Likert scale; P=0.004). Over 80% of women favored receiving information on harms and 59% preferred that information come from a qualified public health authority. Nearly 90% of women in all groups overestimated women's lifetime risk of CC. In conclusion, additional information on harms did not alter Norwegian women's stated intention to screen for CC; yet, it resulted in greater decision uncertainty to undergo precancer treatment. Incorporating information on harms into invitation letters is warranted as it would increase women's ability to make informed choices.
宫颈癌（CC）是挪威女性中第13大常见癌症，但在25至49岁女性中是第三大常见癌症。国家筛查计划会发送信息信件以促进筛查参与度。我们旨在评估女性参与筛查和接受治疗的既定意愿如何随着提供与筛查相关危害的额外信息而改变，并评估女性对这类信息的时机和来源的偏好。我们对一组年龄在25至69岁的挪威女性进行了一项基于网络的问卷调查，并根据在筛查过程中引入额外信息的时间将她们随机分为三组：（i）被邀请进行常规筛查，（ii）在检测到细胞异常后被建议进行额外检测，（iii）被建议进行癌前治疗。第四组（对照组）没有收到任何额外信息。结果显示，在1060名受访者中，额外信息并没有显著改变女性进行筛查的既定意愿。然而，它在建议治疗的时间方面造成了决策不确定性（10分制李克特量表上分别为8.76 - 9.09与9.40；P = 0.004）。超过80%的女性倾向于接收关于危害的信息，59%的女性更希望信息来自合格的公共卫生当局。所有组中近90%的女性高估了女性患宫颈癌的终生风险。总之，关于危害的额外信息并没有改变挪威女性进行宫颈癌筛查的既定意愿；然而，它导致了接受癌前治疗的决策不确定性增加。将关于危害的信息纳入邀请信是有必要的，因为这将增强女性做出明智选择的能力。
