Psychological effects of a low-grade abnormal cervical smear test result: anxiety and associated factors

Abstract

Receipt of an abnormal cervical smear result often generates fear and confusion and can have a negative impact on a woman's well-being. Most previous studies have focussed on high-grade abnormal smears. This study describes the psychological and psychosocial effects, on women, of having received a low-grade abnormal smear result. Over 3500 women recruited to TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) participated in this study. Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS) at recruitment. Socio-demographic and lifestyle factors, locus of control and factors associated with the psychosocial impact of the abnormal smear result were also assessed. Women reported anxiety levels consistent with those found in previous studies of women with high-grade smear results. Women at highest risk of anxiety were younger, had children, were current smokers, or had the highest levels of physical activity. Interventions that focus particularly on women's understanding of smear results and pre-cancer, and/or directly address their fears about cancer, treatment and fertility might provide the greatest opportunity to reduce the adverse psychosocial impact of receiving a low-grade abnormal cervical smear result.

Anxiety and associated factors in women with a low-grade abnormal cervical smear test: A prospective study.

“…This result could be explained by women, who have knowledge about cervical screen and possible results or have previous screen, can be less anxious than the others. This is congruent with a recent study of women who had received low grade cytological abnormal results among who were not well trained were found to be a risk factor for anxiety (12) .…”

“…Moreover our findings are higher than those from previous studies of women who had had higher grade abnormal smear results (11,12) . Recently, TOMBOLA Anxiety and associated factors in women with a Low-grade abnormal cervical smear test the HADS than the TOMBOLA study.…”

“…In terms of classifying respondents, investigators have used a variety of schemes, including cut-offs at 8 (12,13) and 11 (14) . We decided to take a score of ≥11 as indicating a level of anxiety that could be considered abnormal and, therefore, may warrant intervention.…”

Understanding Women's Differing Experiences of Distress after Colposcopy: A Qualitative Interview Study

“…Fertility worries among women who receive an abnormal cervical cytology result are well documented (Somerset & Peters, 1998;Quilliam, 1990;Gray et al, 2006) but, as far as we are aware, this is the first time a relationship between fertility worries and post-colposcopy distress has been reported. Colposcopy clinics could seek to identify and "counsel" women who have not yet started or completed their families.…”

Psychosocial aspects of anal cancer screening: a review and recommendations

“…Increased anxiety, worry about cancer and lower sexual well-being has been found with all grades of cervical cytology results [18][19][20] . Rates of return for repeat testing are lower in those who are most anxious 19 .…”