Psychological burden of testing positive for high-risk human papillomavirus on women with atypical cervical cytology: a prospective study

Kwan, Tze-Hoi; Cheung, Annie N.Y.; Lo, Stephen T.H.; Lee, Peter W. H.; Tam, Kar-Fai; Ky, Chan; Ngan, Hextan Y.S.

doi:10.1111/j.1600-0412.2011.01092.x

Cited by 40 publications

(55 citation statements)

References 25 publications

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“…Studies in women with low-grade abnormal cytology results, who may already have elevated anxiety from learning of these results, have reported similar findings. In these studies, anxiety, distress, and intrusive thoughts were also more common in HPV-positive women than those testing negative [8], [11]. In studies comparing women with normal and abnormal cytology, however, a greater difference in anxiety and psychological distress was observed between HPV-positive and HPV-negative women in the group with normal cytology than in those with abnormal results [9], [12].…”

Section: Introductionmentioning

confidence: 82%

Human Papillomavirus Infection and Anxiety: Analyses in Women with Low-Grade Cervical Cytological Abnormalities Unaware of Their Infection Status

et al. 2011

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BackgroundWomen testing positive for human papillomavirus (HPV) infection experience increased levels of anxiety that have been attributed to fears of stigmatization and developing cervical cancer. The objective of this study was to investigate the association between HPV infection and anxiety in women who were unaware they had been tested specifically for HPV, to determine if any anxiety experienced by HPV-positive women could be due to causes other than learning of test results.MethodsThis study was nested within a randomised controlled trial of management of women with abnormal cervical cytology conducted in the United Kingdom with recruitment between 1999 and 2002. At baseline, prior to having a sample taken for HPV testing, the results of which were not disclosed, women were assessed for anxiety using the Hospital Anxiety and Depression Scale and asked about fears of developing cervical cancer (“cancer worries”); this assessment was repeated at 12, 18, 24, and 30 months of follow-up. Logistic regression and generalized estimating equations were used for the cross-sectional (baseline) and longitudinal analyses, respectively.ResultsAmong the 2842 participants, there was no association between HPV status and anxiety among white women. Among non-white women, however, anxiety was less common among HPV-positive than HPV-negative women (adjusted odds ratio 0.41, 95% confidence interval 0.22 to 0.77). Among non-smokers, cancer worry was more common in HPV-positive than HPV-negative women; the opposite association was observed among ex-smokers.ConclusionsAssociations between HPV status and anxiety may be explained by factors other than learning of test results and may vary by ethnicity and lifestyle factors.

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Section: Introductionmentioning

confidence: 82%

Human Papillomavirus Infection and Anxiety: Analyses in Women with Low-Grade Cervical Cytological Abnormalities Unaware of Their Infection Status

et al. 2011

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“…First-trimester Pap smears are part of the routine prenatal screening programs in most countries, and abnormal cervical cytology results may cause psychological distress [7]. The prevalence rate does not differ from nongravid women and is estimated to range from 5 to 20% [2,4].…”

Section: Discussionmentioning

confidence: 99%

“…However, the diagnostic accuracy of prenatal cytology and colposcopy can be reduced by pregnancy-related changes [3,6]. Uncertainty about the diagnosis and the further clinical course is likely to be of concern for the obstetrician and causes psychological distress in pregnant women [7]. …”

Section: Introductionmentioning

confidence: 99%

p16/Ki-67 Dual-Stained Cytology Testing May Predict Postpartum Outcome in Patients with Abnormal Papanicolaou Cytology during Pregnancy

Trutnovsky¹,

Kolovetsiou-Kreiner²,

Reich³

2014

Acta Cytologica

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Objective: To evaluate the use of a new immunocytochemical dual-staining protocol, which allows for the detection of coexpression of the p16^INK4a (p16) and Ki-67 biomarkers in prenatal care. It was hypothesized that dual-staining cytology may predict postpartum outcome in patients with abnormal cervical Papanicolaou (Pap) smears during pregnancy. Study Design: In this retrospective pilot study, 27 abnormal Pap smears collected from women during early pregnancy were destained and subsequently stained for p16/Ki-67. Results were correlated with histologic outcome collected during postpartum follow-up. Results: Fourteen of 20 abnormal Pap smears during pregnancy showed a positive p16/Ki-67 dual-stained cytology result, whereas 6 specimens tested negative. Seven cases were excluded due to technical reasons. All 14 patients who were positive for p16/Ki-67 dual stain had cervical intraepithelial neoplasia (CIN) on postpartum histology. In contrast, 5 out of 6 patients negative for p16/Ki-67 dual-staining had a negative histology postpartum and during follow-up, and the remaining patient showed a CIN1 (p < 0.001). Conclusion: p16/Ki-67 dual-stained cytology may provide a valuable novel approach to identify pregnant women with persistent or progressing CIN disease and may help improve the management of abnormal Pap cytology results during pregnancy.

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“…However, it appears that interventions designed to mitigate disease-associated distress are underutilized or ineffective, as patients frequently report worsening anxiety during the course of their treatment [71]. Consider also that women with HPV-associated cervical dysplasia or invasive carcinoma may suffer from feelings of confusion, fear, and guilt in response to their diagnosis [72, 73]. It has also been demonstrated that feelings that contribute to self-blame and isolation may negatively affect information-seeking behaviors during physician–patient interactions, and may impair patient adherence to treatment recommendations [74].…”

Section: Hpv Testing In Hnc: Rationale For Testing and Patient Counsementioning

confidence: 99%

Counseling the Patient with Potentially HPV-Related Newly Diagnosed Head and Neck Cancer

Finnigan

Sikora

2014

Curr Oncol Rep

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The recent emergence of a clinically distinct subset of head and neck cancers (HNC) caused by infection with the human papillomavirus (HPV) necessitates critical reevaluation of the existing counseling paradigm for patients with newly diagnosed HNC. Herein we propose a structural framework for patient counseling in which HPV testing is incorporated and the impact of HPV-status is discussed in the context of multiple medical and psychosocial domains. We strive to maintain a balance between making recommendations based on the best available scientific evidence and acknowledgment of uncertainty for both patients and providers. We anticipate that both the standard-of-care diagnostic workup and treatment, and counseling guidelines for these patients will change rapidly in the years ahead, as data from ongoing and planned prospective clinical trials become available.

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Psychological burden of testing positive for high-risk human papillomavirus on women with atypical cervical cytology: a prospective study

Cited by 40 publications

References 25 publications

Human Papillomavirus Infection and Anxiety: Analyses in Women with Low-Grade Cervical Cytological Abnormalities Unaware of Their Infection Status

Human Papillomavirus Infection and Anxiety: Analyses in Women with Low-Grade Cervical Cytological Abnormalities Unaware of Their Infection Status

p16/Ki-67 Dual-Stained Cytology Testing May Predict Postpartum Outcome in Patients with Abnormal Papanicolaou Cytology during Pregnancy

Counseling the Patient with Potentially HPV-Related Newly Diagnosed Head and Neck Cancer

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