Active surveillance as a management option for cervical intraepithelial neoplasia 2: An online experimental study
| Autor: | Kirsten I. Black, Megan Smith, Rachael H. Dodd, Kirsten McCaffery, Erin Cvejic, Deborah Bateson, Olivia A Mac, Katy J.L. Bell |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Adult medicine.medical_specialty experimental Uterine Cervical Neoplasms Health literacy Cervical intraepithelial neoplasia 1117 Public Health and Health Services 03 medical and health sciences 0302 clinical medicine Intervention (counseling) Health care Medicine Humans 1112 Oncology and Carcinogenesis Family history Watchful Waiting Papillomaviridae Internet business.industry Papillomavirus Infections active surveillance Obstetrics and Gynecology disease regression medicine.disease Uterine Cervical Dysplasia Framing effect Preference Clinical trial 030104 developmental biology female Oncology 030220 oncology & carcinogenesis Family medicine Female pregnancy business |
| Zdroj: | Gynecologic Oncology |
| Popis: | Objective To investigate framing of active surveillance as a management option for cervical intraepithelial neoplasia (CIN)2 in women of childbearing age. Methods We conducted a between-subjects factorial (2 × 2) randomised experiment. Women aged 25–40 living in Australia were presented with the same hypothetical pathway of testing human papillomavirus (HPV)-positive, high-grade cytology and a diagnosis of CIN2, through an online survey. They were randomised to one of four groups to evaluate the effects of (i) framing (method of explaining resolution of abnormal cells) and (ii) inclusion of an overtreatment statement (included versus not). Primary outcome was management choice following the scenario: active surveillance or surgery. Results 1638 women were randomised. Overall, preference for active surveillance was high (78.9%; n = 1293/1638). There was no effect of framing or providing overtreatment information, or their interaction, on management choice. After adjusting for intervention received, age, education, and other model covariates, participants were more likely to choose active surveillance over surgery if they had not already had children, had plans for children in the future, had no family history of cancer, had no history of endometriosis, had adequate health literacy, and more trust in their GP. Participants were less likely to choose active surveillance over surgery if they were more predisposed to seek health care for minor problems. Conclusions Although we found no framing effect across the four conditions, we found a high level of preference for active surveillance with associations of increased preference that accord with the desire to minimise potential risks of CIN2 treatment on obstetric outcomes. These are valuable data for future clinical trials of active surveillance for management of CIN2 in younger women of childbearing age. Trial registration Australian New Zealand Clinical Trials Registry (ACTRN12618002043213, 20/12/2018, prior to participant enrolment). |
| Databáze: | OpenAIRE |
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