Patient choice may improve adherence to follow-up in cervical screening: a randomised-control trial

N Z Med J. 2022 Feb 25;135(1550):146-156.

Abstract

Aims: We investigated whether patient choice of follow-up type improves health-related quality of life (HrQOL) and follow-up attendance in women who have undergone large loop excision of the transformation zone (LLETZ) for cervical intraepithelial neoplasia grade 2 to 3 (CIN 2-3).

Methods: A three-armed randomised controlled trial including women with newly diagnosed CIN 2-3 post-LLETZ treatment was performed. Consenting women were randomised (1:1:1) to either: (a) colposcopy review at the hospital, (b) follow-up with high-risk human papilloma virus (HrHPV) and smear test in the community or (c) a choice of the aforementioned follow-up options, six months post-treatment. HrQOL was measured and participants were surveyed at baseline and six months regarding preferences for follow-up.

Results: Sixty-eight participants were randomised to follow-up (a), 67 to follow-up (b) and 65 to follow-up (c) (n=200). At six months post-treatment, 47% of patients indicated a preference for (a), 24% for (b) and 26% for (c). We found no significant difference in HrQOL between the study arms. Attendance was greater among patients who chose their follow-up (95.5% vs 91.1%, p=0.06).

Conclusion: Choice of follow-up was associated with greater attendance. However, larger studies examining the effects of HrQOL and attendance to different follow-ups are warranted.

Publication types

  • Case Reports
  • Randomized Controlled Trial

MeSH terms

  • Colposcopy
  • Early Detection of Cancer
  • Female
  • Follow-Up Studies
  • Humans
  • New Zealand
  • Patient Preference
  • Pregnancy
  • Quality of Life
  • Uterine Cervical Dysplasia* / diagnosis
  • Uterine Cervical Dysplasia* / surgery
  • Uterine Cervical Neoplasms* / diagnosis
  • Uterine Cervical Neoplasms* / surgery