Women's preferences for cervical cancer screening: a study using a discrete choice experiment

Area of Science:

• Gynecologic Oncology
• Public Health Policy
• Health Services Research

Background:

• Recent cervical screening policy recommendations include liquid-based cytology (LBC) and standardized screening intervals.
• LBC may improve laboratory efficiency and reduce test result waiting times.
• Limited quantitative data exists on women's preferences for cervical screening program changes.

Purpose of the Study:

• To elicit women's preferences for alternative cervical screening programs.
• To assess willingness to pay for specific service improvements.
• To inform policy decisions regarding cervical screening implementation.

Main Methods:

• A discrete choice experiment postal questionnaire was administered to 2,000 women in Scotland.
• The study achieved a 44% response rate from women with prior screening history.
• Analysis focused on preferences for recall rates, waiting times, and screening frequency.

Main Results:

• Women significantly preferred reduced recall rates and shorter waiting times for results.
• A preference for more frequent screening was observed, especially among women aged 50 and older.
• Women were willing to pay for reduced recall rates with LBC (41 pounds) and increased screening frequency (42 pounds for women 50+).

Conclusions:

• Transitioning to LBC aligns with women's preferences for fewer repeat smears and reduced waiting times.
• Proposed longer screening intervals for women aged 50+ contradict their preferences for more frequent screening.
• Service attribute modifications, like smear rates and screening frequency, can enhance efficiency without impacting participation.