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Psychological response to cervical screening.

S Bell·M Porter·H Kitchener·C Fraser·P Fisher·E Mann
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Abstract

BACKGROUND: Few studies have examined the psychological costs of cervical screening, despite expressed concern over possible negative sequelae. METHODS: Seventy-five women with mild or moderately dyskaryotic smears, under cytological surveillance, 75 women referred for colposcopy after a first-ever abnormal smear showing severe dyskaryosis, and 75 controls with recent negative cytology were interviewed at home, and their psychological adjustment was assessed. RESULTS: Levels of distress were higher among women with an abnormal smear than among controls with a recent negative smear. Anxiety (Hospital Anxiety and Depression Scale range 0-21, "normal" range 0-7) was highest among those referred for colposcopy (mean 8.12, controls 5.88, P < 0.001); afterward, distress fell (mean 6.61, P < 0.001) but more problems of social adjustment were evident (surveillance vs controls, P < 0.01). High anxiety was associated with social maladjustment (colposcopy, P < 0.001; surveillance, P < 0.01) and negative feelings about the self (P < 0.05). Current anxiety was unrelated to knowledge about abnormal smears, but in the surveillance group was related to satisfaction with the explanation provided (P < 0.05). CONCLUSION: A positive cervical smear may by psychologically traumatic for a significant minority of women, irrespective of management strategy.

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Adaptation, PsychologicalAdultAnxietyCase-Control StudiesColposcopyDepressionFemaleHumansMass ScreeningPsychiatric Status Rating ScalesSelf ConceptUterine Cervical DysplasiaVaginal SmearsJournal ArticleResearch Support, Non-U.S. Gov't

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S Bell, M Porter, H Kitchener, C Fraser, P Fisher, E Mann. 1995. Psychological response to cervical screening.. https://doi.org/10.1006/pmed.1995.1096

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