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Anxiety and borderline PAP smear results
Ida J Korfage1, Marjolein van Ballegooijen, Hans Huveneers
1Dept. of Public Health, Erasmus MC, University Medical Center Rotterdam, Room Ae-108, PO Box 2040, 3000 CA Rotterdam, The Netherlands. i.korfage@erasmusmc.nl
European Journal of Cancer (Oxford, England : 1990)
|August 18, 2009
Summary
Women with borderline or mild dyskaryotic (BMD) cervical screening results experience significantly higher anxiety and poorer mental quality of life for up to two years post-smear. This highlights the psychological impact of abnormal Pap smear results.
Area of Science:
- Gynecologic Oncology
- Public Health Screening
- Psychological Impact of Medical Tests
Background:
- Low-grade abnormalities, including borderline (Pap 2) or mild (Pap 3a1) dyskaryotic (BMD) results, are common findings in annual cervical cancer screening.
- These results affect a substantial number of women, necessitating an understanding of their long-term impact.
Purpose of the Study:
- To compare the quality of life and anxiety levels in women with a history of BMD smear results versus a control group awaiting cervical screening.
- To assess the persistent psychological effects of abnormal cervical screening results.
Main Methods:
- A questionnaire-based study involving 550 women with BMD results in the past 6-24 months.
- Assessment of generic quality of life (SF-12, EQ-5D), generic anxiety (STAI-6), and screen-specific anxiety (PCQ).
- Comparison with a reference group of 352 women awaiting smear taking.
Main Results:
- Women with BMD reported significantly higher generic anxiety (44.4 vs. 32.6, p<0.001) and screen-specific anxiety (5.0 vs. 1.4, p<0.001) compared to the reference group.
- Mental quality of life was significantly worse in the BMD group (44.2 vs. 52.0, p<0.001).
- Nearly half (49%) of the BMD group experienced high anxiety, and 27% found screening frightening, often citing fear of cervical cancer.
Conclusions:
- Borderline or mild dyskaryotic (BMD) cervical screening results are consistently linked to significant and prolonged excess anxiety.
- The psychological burden, including increased anxiety and reduced mental quality of life, persists for 6-24 months after the initial abnormal Pap smear.
- Findings underscore the need for psychological support for women following low-grade abnormal cervical screening results.
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