[Abstract]
Background,
After the early detection of cervical intraepithelial neoplasia (CIN), medical surveillance of
the precancerous lesions is carried out to control risk factors to avoid the development of
cervical cancer.
Objective.
To explore the effects of medical surveillance on the personal and social lives of women
undergoing CIN follow-up and treatment.
Methodology.
A generic qualitative study using a poststructuralist perspective of risk management was
carried out in a gynecology clinic in a public hospital of the Galician Health Care System
(Spain). Participants were selected through purposive sampling. The sample consisted of
21 women with a confirmed diagnosis of CIN. Semistructured interviews were recorded and
transcribed, and a thematic analysis was carried out, including researcher triangulation to
verify the results of the analysis.
Findings.
Two main themes emerged from the participants’ experiences: CIN medical surveillance
encounters and risk management strategies are shaped by the biomedical discourse, and
the effects of “risk treatment” for patients include (a) profound changes expected of patients,
(b) increased patient risk management, and (c) resistance to risk management. While doctors’ surveillance aimed to prevent the development of cervical cancer, women felt they
were sick because they had to follow strict recommendations over an unspecified period of
time and live with the possibility of a life-threatening disease. Clinical risk management resulted in the medicalization of women’s personal and social lives and produced great
uncertainty.
Conclusions.
This study is the first to conceptualize CIN medical surveillance as an illness experience for
patients. It also problematizes the effects of preventative practices in women’s lives.
Patients deal with great uncertainty, as CIN medical surveillance performed by gynecologists simultaneously trivializes the changes expected of patients and underestimates the
effects of medical recommendations on patients’ personal wellbeing and social relations
