Cervical screening program and the psychological impact of an abnormal Pap smear: a self-assessment questionnaire study of 590 patients

Thangarajah, Fabinshy; Einzmann, Thomas; Bergauer, F.; Patzke, J; Schmidt-Petruschkat, S.; Theune, M; Engel, Katja; Puppe, Julian; Richters, Lisa; Mallmann, Peter; Kirn, Verena

doi:10.1007/s00404-015-3821-z

Cited by 27 publications

(18 citation statements)

References 23 publications

(27 reference statements)

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“…Notification of an abnormal Pap smear finding psychologically impacts women, and previous research has aimed at assessing women’s health-related quality of life after such a notification [ 9 – 11 ]. These studies have highlighted that abnormal Pap smear findings evoke negative emotions ranging from anxiety to fear of developing or even having cancer [ 11 – 14 ]. The awareness of the infectious nature of HPV may even increase these emotions [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Psychological distress in cervical cancer screening: results from a German online survey

Jentschke

Lehmann²,

Drews³

et al. 2020

Arch Gynecol Obstet

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Purpose The PODCAD study aimed at assessing the degree of psychological stress that women experience due to notification of an abnormal Papanicolaou (Pap) smear finding or a positive human papillomavirus (HPV) test result. Methods We designed a survey to address the question of psychological burden due to abnormal Pap smear results and/or positive HPV tests. In this online campaign approach, we aimed to reach > 2000 women all over Germany irrespective of kind and number of abnormal screening findings. We asked for different kinds of anxiety, distress and uncertainty regarding both, Pap and HPV status. Results A total of 3753 women completed the survey at least partially, and almost 2300 fully completed the survey. Of these, more than 50% were affected already since more than 1 year, and almost half of them had experienced at least three Pap smears in follow-up examinations. Almost 70% of the women were afraid of developing cancer. Intriguingly, almost half of the women with abnormal findings were not aware of their stage of the Pap smear. Furthermore, almost 30% of the women displayed signs of a post-traumatic stress disorder. Conclusion Abnormal results in cervical cancer screening have an impact on patients’ psychology, irrespective of the knowledge and severity of the findings. Better information concerning risks and benefits of cervical cancer screening and about the meaning of the outcome of its procedures are required to decrease this anxiety. Electronic supplementary material The online version of this article (10.1007/s00404-020-05661-9) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Psychological distress in cervical cancer screening: results from a German online survey

Jentschke

Lehmann²,

Drews³

et al. 2020

Arch Gynecol Obstet

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“…Previous studies have also shown that among patients with dysplasia, Pap tests may be a source of additional office visits, procedures, and anxiety (6–9). No studies have specifically evaluated the anxiety associated with surveillance Pap tests among patients with a history of cervical cancer, but it is likely that these patients also experience a significant amount of anxiety associated with routine Pap tests for surveillance.…”

Section: Discussionmentioning

confidence: 99%

Role of cervical cytology in surveillance after radical trachelectomy for cervical cancer

Brown

Shah

Fleming

et al. 2016

Gynecologic Oncology

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Objective There are currently no standard guidelines on the use of Papanicolaou (Pap) tests for surveillance after radical trachelectomy for cervical cancer. The goal of this study was to determine the usefulness of Pap tests in routine surveillance after radical trachelectomy for cervical cancer. Methods Cervical cancer patients who underwent radical trachelectomy from January 2004 through October 2015 and subsequently had at least one Pap test were retrospectively identified. Demographic and clinical characteristics were described and compared between patients with and without at least one abnormal Pap test. The Kaplan-Meier method was used to estimate time to first abnormal Pap test. Results Forty-one patients met inclusion criteria. Of these, 30 (73%) had at least one year in which more than one Pap test per year was obtained. Twenty-four (59%) had at least one abnormal Pap test. Of 238 total Pap tests collected, 44 (18%) were abnormal. The most common abnormality was ASCUS (52%, n=23). Other findings included LSIL (20%, n=9), HSIL (2%, n=1), and AGUS (25%, n=11). Median time from radical trachelectomy to first abnormal Pap test was 17.2 months (range, 11.8–86.3). No patient had disease recurrence. Surgery type (laparoscopic, open, or robotic), trachelectomy specimen size, histology, device for stenosis prevention (pediatric Foley catheter or Smit Sleeve), and cerclage placement were not significant predictors of an abnormal Pap test. Conclusions The rate of abnormal Pap tests after radical trachelectomy is high; however, the clinical significance of such abnormalities appears limited. The routine use of cervical cytology as surveillance after radical trachelectomy does not appear to substantially impact management decisions.

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“…Previous research shows that notification of an abnormal Pap smear result can elicit negative emotions, such as anxiety and fear of cancer, among women (Dominiak‐Felden et al, ; Oscarsson, ; Rask, Oscarsson, Lindell, & Swahnberg, ; Rask, Swahnberg, Lindell, & Oscarsson, ; Thangarajah et al, ). These emotions can be increased by an awareness of HPV as a sexually transmitted infection and add feelings of blame, anger and fears of being stigmatised (Barnack‐Tavlaris, Serpico, Ahluwalia, & Ports, ; Rask, Swahnberg, et al, ).…”

Section: Introductionmentioning

confidence: 99%

Notification of an abnormal Pap smear result: An intervention study

2018

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This study aims to assess whether notification of an abnormal Pap smear result via a phone call, delivered by a trained healthcare provider, has an effect on women's HRQoL, coping and awareness of HPV. For this intervention study, women were consecutively recruited from a women's health clinic in Sweden. Women in the intervention group (n = 113) were notified of their Pap smear result via a phone call by a trained healthcare provider, while those in the comparison group (n = 122) were notified via a standard letter. A questionnaire was used to collect data. The results found no significant differences between the groups for HRQoL. However, 42.5% of women in the intervention group versus 48.3% in the comparison group reported anxiety. Women in the intervention group were more satisfied with the manner in which they were notified of their abnormal result than those in the comparison group (92.0% vs. 67.2%; p < 0.001), more aware of HPV (71% vs. 50%; p = 0.001), and called healthcare services less often (10.6% vs. 18.0%; p = 0.113), no significance. In conclusion, notification of an abnormal Pap smear result via a phone call does not increase women's HRQoL or reduce their anxiety.

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Cervical screening program and the psychological impact of an abnormal Pap smear: a self-assessment questionnaire study of 590 patients

Cited by 27 publications

References 23 publications

Psychological distress in cervical cancer screening: results from a German online survey

Psychological distress in cervical cancer screening: results from a German online survey

Role of cervical cytology in surveillance after radical trachelectomy for cervical cancer

Notification of an abnormal Pap smear result: An intervention study

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