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Patient Educ Couns. 2008 Dec;73(3):473-9, 481. doi: 10.1016/j.pec.2008.07.021. Epub 2008 Aug 30.

HPV testing versus repeat Pap testing for the management of a minor abnormal Pap smear: evaluation of a decision aid to support informed choice.

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Screening and Test Evaluation Program, School of Public Health, University of Sydney, NSW 2006, Australia.



To examine women's informed preference for the management of a mildly abnormal Pap smear and the impact of a decision aid.


Women (n=106) were given a choice of management supported by a decision aid and surveyed before, and after decision making to evaluate predictors of choice and decision aid impact.


HPV triage was preferred by most women (65%) although a substantial minority selected repeat Pap testing (35%). Women who chose HPV triage were more likely to have had children, have had a previous abnormal Pap smear and were more distressed than women who chose a repeat Pap test. In total, 68% of women made an informed choice. Rapid timing of follow-up was important for women choosing HPV testing. The lower chance of colposcopy and greater opportunity for regression, were rated as important by women choosing Pap testing. Decisional conflict was lower among women who chose HPV triage. No other differences in short-term psychological outcomes were found.


The decision aid supported informed choice among the majority of women. Women tailored their choice to their practical, health and psychological needs.


Offering women an informed choice for a mildly abnormal Pap smear may enable women to select the management that best suits their circumstances.

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