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Lindquist S, Kjær SK, Frederiksen K, Ørnskov D, Petersen LK, Munk C, Waldstrøm M. Clinical performance of human papillomavirus based cervical cancer screening algorithm: The result of a large Danish implementation study. Acta Obstet Gynecol Scand 2024; 103:1781-1788. [PMID: 39012789 DOI: 10.1111/aogs.14915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/18/2024]
Abstract
INTRODUCTION In Denmark, where human papillomavirus (HPV) -based cervical cancer screening is being implemented, the aim of this pilot implementation study was to test a specific screening algorithm, assess follow-up examination attendance, and measure the proportion of precancer lesions found in relation to the number of women referred for colposcopy. MATERIAL AND METHODS From May 2017 to December 2020, 36 417 women in the uptake area of the Department of Pathology, Vejle Hospital, Region of Southern Denmark, were included in the HPV group. Women positive for HPV16/18 irrespective of cytology and women positive for other high-risk HPV (hrHPV) types having concomitant abnormal cytology were referred directly to colposcopy. Women positive for other hrHPV types and normal cytology were referred to repeat screening after 12 months, and hrHPV negative to routine screening after three years. We obtained information on screening results and subsequent histological diagnosis from the Danish Pathology Databank through September 2022. RESULTS 3.6% of the women were referred to colposcopy after primary screening, 5% to repeat screening after 12 months, and 91.4% back to routine screening. High follow-up rates were observed: 96% attended colposcopy after primary screening, with 91% attending colposcopy after repeat screening. CIN3+ was detected at colposcopy following the primary screening in 28.1% of HPV16/18-positive women and 18.2% of those positive for other hrHPV types with concomitant abnormal cytology. Of the women with other hrHPV and simultaneous ASCUS/LSIL, 8% had CIN3+. At the repeat screening, 43% had become hrHPV negative, 55% were persistently positive for other hrHPV, and 2% had turned positive for HPV16/18. At the colposcopy following repeat screening, 10.1% of the women positive for other hrHPV were diagnosed with CIN3+, in comparison with 11.1% of the HPV16/18-positive women. CONCLUSIONS In this pilot implementation study, an algorithm for HPV-based screening was evaluated in a Danish setting. The results demonstrated high attendance at follow-up examinations and provided insights into the number of colposcopy referrals and the detection of CIN2 and CIN3+ cases. The results suggest that women testing positive for other hrHPV in combination with ASCUS/LSIL at primary screening could potentially be referred to repeat screening instead of an immediate colposcopy.
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Affiliation(s)
- Sofie Lindquist
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Institute, Copenhagen, Denmark
| | - Susanne K Kjær
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Institute, Copenhagen, Denmark
- Department of Gynecology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kirsten Frederiksen
- Unit of Statistics, Biostatistics, and Registry, Danish Cancer Institute, Copenhagen, Denmark
| | - Dorthe Ørnskov
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Lone Kjeld Petersen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
- Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark
| | - Christian Munk
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Institute, Copenhagen, Denmark
| | - Marianne Waldstrøm
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Taavela K, Eriksson T, Huhtala H, Bly A, Harjula K, Heikkilä K, Hokkanen M, Nummela M, Kotaniemi-Talonen L, Lehtinen M, Louvanto K. The quality of life of frequently vs. infrequently screened HPV vaccinated women. Qual Life Res 2024; 33:941-949. [PMID: 38238599 PMCID: PMC10973058 DOI: 10.1007/s11136-023-03575-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 07/25/2024]
Abstract
PURPOSE Cervical lesions caused by human papillomavirus (HPV) are related to decreased quality of life (QoL) of women. Also, cervical cancer (CC) screening can cause psychological adverse effects. It has been assumed that by decreasing the HPV-related disease burden, HPV vaccinations would increase the QoL. This study compares the effect of CC screening on QoL of HPV vaccinated women in two different screening protocols. METHODS A total of 753 HPV16/18 vaccinated women were randomized to frequent (22/25/28 years of age) and infrequent (28 years of age) CC screening arms. QoL questionnaires (EQ VAS, RAND 36, amended CECA 10) were sent at the age of 28. RESULTS Median EQ VAS scores were 80 (Q1-Q3 75-90) in both screening arms. Mean RAND 36 scores of frequently and infrequently screened women were 78.13/81.64 in Physical role functioning domain and, respectively, 77.93/80.18 in Pain, 69.10/69.12 in General Health, 54.67/53.61 in Energy, 83.72/85.11 in Social functioning, 69.53/69.68 in Emotional role functioning, and 68.16/69.29 in Emotional well-being domain. Among women with a self-reported history of Pap cytology abnormalities, overall mean scores of amended CECA 10 were 69.52/72.07, and among women with a self-reported history of genital warts, 60.09/66.73, respectively. CONCLUSION There was no significant difference in the QoL of HPV vaccinated women between the two CC screening arms. Women were mostly satisfied with the screening experience despite the screening frequency. This information is important for the future screening program planning as we need to reach the best possible balance with screening benefits and harms. TRIAL REGISTRATION NUMBER NCT02149030, date of registration 29/5/2014.
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Affiliation(s)
- Kaisa Taavela
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33014, Tampere, Finland
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland
| | | | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | | | | | | | | | | | - Laura Kotaniemi-Talonen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33014, Tampere, Finland
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland
| | - Matti Lehtinen
- Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Karolina Louvanto
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33014, Tampere, Finland.
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.
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Sparić R, Bukumirić Z, Stefanović R, Tinelli A, Kostov S, Watrowski R. Long-term quality of life assessment after excisional treatment for cervical dysplasia. J OBSTET GYNAECOL 2022; 42:3061-3066. [PMID: 35695230 DOI: 10.1080/01443615.2022.2083486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We evaluated factors influencing long-term health-related quality of life (HRQoL) after excisional treatments of low- and high grade squamous intraepithelial cervical lesions (SIL) in three groups of women (n = 160): nulliparas interested in reproduction (A), parous women interested in reproduction (B) and women without pregnancy desire (C). The HRQoL was assessed using the disease-specific FACIT-CD and the generic SF36v2 questionnaires. Anxiety and depression were evaluated by Beck's inventories. After median follow-up of 5 (2-18) years, FACIT-CD total score and the score for Emotional Well-Being (EWB) were significantly lower in group A. The total, EWB and REL (Relationships) scores of FACIT-CD were the highest in group B. Women operated for HSIL demonstrated lower REL quality in comparison to those with LSIL. Neither SF36v2 nor FACIT-CD total scores differed in relation to SIL grade or type of excision. 'SF36v2 Mental Component Summary Score' and 'being parous and interested in fertility' were independent predictors of disease-specific FACIT-CD score.Impact StatementWhat is already known on this subject? Long-term consequences of excisional treatments for cervical dysplasia on health-related quality of life (HRQoL) are not well reported.What do the results of this study add? Our study provides data on HRQoL in women treated with large loop excision of the transformation zone (LLETZ) or cold knife conization (CKC) obtained during the longest (median 5 years) follow-up as reported to date. We were able to show that having children and planning further pregnancies positively influenced HRQoL in these patients. In addition, we identified nulliparas with pregnancy desire as psychologically the most vulnerable group within the studied cohort.What are the implications of these findings for clinical practice and/or further research? Even several years after LLETZ or CKC, women may suffer from impaired Emotional Well-Being and reduced HRQoL. Awareness and assessment of these long-term consequences should be part of surveillance after excisional treatments for cervical dysplasia.
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Affiliation(s)
- Radmila Sparić
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic of Gynecology and Obstetrics, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Zoran Bukumirić
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Institute of Medical Statistics and Informatics, Belgrade, Serbia
| | - Radomir Stefanović
- Department of Histopathology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Andrea Tinelli
- Department of Obstetrics and Gynaecology, "Ignazio Veris Delli Ponti" Hospital Ringgold Standard Institution, Scorrano, Italy
| | - Stoyan Kostov
- Department of Gynecology, University Hospital "Saint Anna", Medical University of Varna, Varna, Bulgaria
| | - Rafał Watrowski
- Scientific Associate of Medical Faculty, University of Freiburg, Freiburg im Breisgau, Germany
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A V Marlow L, Nemec M, Barnes J, Waller J. Testing key messages about extending cervical screening intervals. PATIENT EDUCATION AND COUNSELING 2022; 105:2757-2762. [PMID: 35440375 PMCID: PMC9925386 DOI: 10.1016/j.pec.2022.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES We tested the impact of different messages about the rationale for extended cervical screening intervals on acceptability of an extension. METHODS Women in England aged 25-49 years (n = 2931) were randomised to a control group or one of 5 groups given different messages about extending cervical screening intervals from 3 to 5 years. Outcome measures were general acceptability and six components from the Theoretical Framework of Acceptability (TFA). RESULTS The groups who saw additional messages (47-63%) were more likely to find the change acceptable than controls (43%). Messages about interval safety, test accuracy and speed of cell changes resulted in more positive affective-attitudes, higher ethicality beliefs, a better understanding of the reasons for extended intervals and greater belief in the safety of 5-year intervals. Being up-to-date with screening and previous abnormal results were associated with finding 5-yearly screening unacceptable. CONCLUSIONS Emphasising the slow development of cell changes following an HPV negative result and the safety of longer intervals, alongside the accuracy of HPV primary screening is important. PRACTICAL IMPLICATIONS Campaigns explaining the rationale for extended cervical screening intervals are likely to improve acceptability. Though women who feel at increased risk, may remain worried even when the rationale is explained.
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Affiliation(s)
- Laura A V Marlow
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.
| | - Martin Nemec
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Jessica Barnes
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Jo Waller
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
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Santos BD, Moreira CS, Teixeira-Santos AC, Carvalho E, Pereira MG. HPV-related quality of life in diagnosed women: A longitudinal study. J Health Psychol 2022; 27:2982-2996. [PMID: 35176887 DOI: 10.1177/13591053211073642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This paper explored changes in the HPV-related quality of life (QoL) of 209 women diagnosed with human papillomavirus (HPV) during 1 year of medical monitoring, at three time points (6-month interval between them). Participants completed the HPV Impact Profile (HIP) questionnaire to assess HPV-related QoL. The relationship between HIP scores and time was moderated by the HPV risk type and infection duration: an HPV diagnosis had a stronger negative effect on patients with an HPV high-risk type and on those living with HPV for a long period of time. Age, condom use, motherhood, and type of family were significant predictors.
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Fornage S, Schweizer A, Lepigeon K, Bianchi Demicheli F, Faouzi M, Jacot-Guillarmod M. Is women's sexual function impaired by an abnormal pap smear? EUR J CONTRACEP REPR 2022; 27:184-188. [PMID: 35102804 DOI: 10.1080/13625187.2021.2012759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Although the stressful psychological impact on women of an abnormal Pap smear is well documented, little research has been undertaken on its sexual impact. Our objective was to assess the impact of an abnormal Pap smear on the sexual function of affected women. METHODS A prospective study compared the sexual function of 48 women with an abnormal Pap smear (case group) with that of 48 women with a normal Pap smear (control group). Sexual function was assessed using the Female Sexual Function Index and the Hospital Anxiety Depression Scale. The questionnaires were mailed to the participants. RESULTS Surprisingly, the risk of sexual dysfunction was comparable between women with and without an abnormal Pap smear (odds ratio [OR] 0.7; p = 0.4). The OR remained statistically non-significant after adjustment for risk factors. Multivariable analysis showed that only older age at first intercourse, depression and anxiety were identified as factors significantly associated with sexual dysfunction. CONCLUSION Contrary to our clinical experience, female sexual function is not impaired by an abnormal Pap smear. Further research is needed to better understand how sexuality in women with abnormal Pap smears may be affected.
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Affiliation(s)
- Sandra Fornage
- Department of Gynaecology and Obstetrics, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Angélick Schweizer
- Research Centre for Health Psychology, University of Lausanne, Lausanne, Switzerland
| | - Karine Lepigeon
- Department of Gynaecology and Obstetrics, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | | | - Mohamed Faouzi
- Division of Biostatistics, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Martine Jacot-Guillarmod
- Department of Gynaecology and Obstetrics, Lausanne University Hospital (CHUV), Lausanne, Switzerland
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Jørgensen SF, Andersen B, Petersen LK, Rebolj M, Njor SH. Adherence to follow-up after the exit cervical cancer screening test at age 60-64: A nationwide register-based study. Cancer Med 2022; 11:224-237. [PMID: 34766466 PMCID: PMC8704149 DOI: 10.1002/cam4.4420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/14/2021] [Accepted: 10/24/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND In Denmark, human papillomavirus (HPV) testing has replaced cytology in primary cervical cancer screening for women aged 60-64; at this age, women are invited for the last (exit) screening test within the national organized program. AIM We investigated the adherence of these women to the recommended follow-up after a non-negative (positive or inadequate) HPV test and the overall resource use during that follow-up. MATERIALS & METHODS We included all 2926 women aged 60-64 years with nonnegative HPV screening tests between March 2012 and December 2016. All relevant follow-up tests and procedures were retrieved until the end of 2020 from the highly complete Danish administrative health registers, and the data were linked at the individual level. We determined the extent to which the adherence patterns followed the national recommendations for follow-up and estimated the total numbers of tests and diagnostic procedures utilized during the entire process. RESULTS In total, only 26% of women had follow-up in accordance with the recommendations; 4% had no follow-up, 46% had insufficient follow-up, and 24% had more follow-up than recommended. We estimated that 17% of women remained in follow-up for longer than 4 years. The average numbers of diagnostic tests and procedures used after positive HPV screening were higher than expected, even among women who had insufficient follow-up, that is, those who received less invasive procedures than recommended, or experienced delays in receiving those procedures. CONCLUSION To conclude, we found that the patterns of follow-up of women with nonnegative primary HPV screening tests at 60-64 often diverged from the recommendations. Addressing these inconsistencies in follow-up by providing evidence for optimal clinical management should help improve the quality of screening programs and secure an equal and reliable follow-up care service for all women.
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Affiliation(s)
- Susanne F. Jørgensen
- University Research Clinic for Cancer ScreeningDepartment of Public Health ProgrammesRanders Regional HospitalRandersDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Berit Andersen
- University Research Clinic for Cancer ScreeningDepartment of Public Health ProgrammesRanders Regional HospitalRandersDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Lone Kjeld Petersen
- Department of Gynaecology and ObstetricsOdense University HospitalOdenseDenmark
- Open Patient Data Explorative Network (OPEN)University of Southern DenmarkOdenseDenmark
| | - Matejka Rebolj
- Cancer Prevention GroupSchool of Cancer & Pharmaceutical SciencesFaculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Sisse H. Njor
- University Research Clinic for Cancer ScreeningDepartment of Public Health ProgrammesRanders Regional HospitalRandersDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
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Thomsen LT, Kjaer SK, Munk C, Ørnskov D, Waldstrøm M. Benefits and potential harms of human papillomavirus (HPV)-based cervical cancer screening: A real-world comparison of HPV testing versus cytology. Acta Obstet Gynecol Scand 2021; 100:394-402. [PMID: 33566361 DOI: 10.1111/aogs.14121] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Human papillomavirus (HPV) testing as the primary cervical cancer screening method is implemented in several countries. We report data from the first round of a large Danish pilot implementation of HPV-based screening. Our aim was to compare colposcopy referrals, detection of high-grade cervical intraepithelial neoplasia (CIN) and cervical cancer, and positive predictive value (PPV) of colposcopy referral in HPV vs cytology-based screening. MATERIAL AND METHODS From May 2017 to October 2018, women aged 30-59 years attending cervical cancer screening in the uptake area of the Department of Pathology, Vejle Hospital, Region of Southern Denmark were screened by primary HPV testing (n = 16 067) or primary cytology (n = 23 981) depending on municipality of residence. In the HPV group, women with HPV16/18, or other high-risk HPV types and abnormal cytology, were referred to immediate colposcopy. Women with other high-risk HPV types and normal cytology were invited for repeat screening with HPV test and cytology after 12 months. From a nationwide pathology register, we obtained information on screening results and subsequent histological diagnoses during up to 2.9 years after the first screen. PPVs included diagnoses within 1 year after referral. RESULTS In the HPV group, 3.7% were referred to immediate colposcopy and 2.8% were referred at the 12-month repeat screening. The total referral to colposcopy was higher in the HPV (6.6%) than cytology group (2.1%) (age-adjusted relative referral = 3.05, 95% confidence interval [CI] 2.75-3.38). The detection of CIN3+ was higher in the HPV (1.5%) than the cytology group (0.8%) (age-adjusted relative detection = 1.88, 95% CI 1.56-2.28). The probability of CIN3+ among women referred to colposcopy (= PPV) was lower in the HPV (21.1%; 95% CI 18.7%-23.7%) than the cytology group (34.6%; 95% CI 30.7%-38.9%). In the HPV group, the PPV was lower among women referred at repeat screening (12.1%) than among women referred immediately (27.8%). CONCLUSIONS Compared with cytology-based screening, HPV-based screening provided a 90% increased CIN3+ detection at the cost of a threefold increase in colposcopy referrals, when considering complete data from the prevalence round. Our findings support implementation of HPV-based screening in Denmark, but modifications of screening algorithms may be warranted to decrease unnecessary colposcopy referrals.
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Affiliation(s)
- Louise T Thomsen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Gynecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Christian Munk
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Dorthe Ørnskov
- Department of Pathology, Vejle Hospital, Lillebaelt Hospital, Region of Southern Denmark, Vejle, Denmark
| | - Marianne Waldstrøm
- Department of Pathology, Vejle Hospital, Lillebaelt Hospital, Region of Southern Denmark, Vejle, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Kurebayashi JMY, Barbieri M, Gabrielloni MC. Tracking of cellular atypes of the cut of uterus of women in Primary Care. Rev Bras Enferm 2020; 73:e20190753. [PMID: 33338147 DOI: 10.1590/0034-7167-2019-0753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 07/04/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to analyze the screening for cervical cell atypias in women assisted in Primary Care. METHODS quantitative, retrospective and cross-sectional study, with analysis of 190 medical records of women who had atypical results from the cervical cytopathological exam collection from 2012 to 2014. RESULTS the most frequent atypias found were possibly Non-neoplastic squamous (ASC-US, 57.4%) and Low-grade intraepithelial lesion (LSIL, 23.2%). The time elapsed between the exam and the result was 24 days. The professional's conduct after the result of the last cervical cytopathology was adequate for 51.1% of women. CONCLUSIONS there is a need to improve the cervical cancer screening program and correctly target the atypia identified, aiming at the access of the target population for the diagnostic investigation and treatment of precursor lesions of cervical cancer.
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Affiliation(s)
| | - Márcia Barbieri
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
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Phuakpoolpol S, Suwannarurk K, Jaisin K, Punyashthira A, Pattaraarchachai J, Bhamarapravatana K. Anxiety and Depression in Thai Women with Abnormal Cervical Cytology who Attended Colposcopic Unit in Thammasat University Hospital. Asian Pac J Cancer Prev 2018; 19:2985-2989. [PMID: 30362338 PMCID: PMC6291034 DOI: 10.22034/apjcp.2018.19.10.2985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Colposcopy is the standard investigation for women with abnormal cervical cytology. Waiting time
to colposcopy could impact to psychological distress. Data about anxiety and depression in eastern countries patients
were limited. Aim of this investigation was to evaluate anxiety and depression status in Thai women who were waiting
for colposcopy compared to women who attended gynecology clinic for cervical cancer screening. Materials and
methods: This study was conducted at the outpatient gynecology clinic of Thammasat University Hospital between
January 2017 to March 2018. A Total of 200 women were recruited into the study. The cases were divided into the study
and control group. Study group consisted of one hundred women with abnormal cervical cytology referred to colposcopy.
One hundred of women who attended gynecology clinic for cervical cancer screening was classified as control group.
The Hospital Anxiety and Depression Scale (HADS) was used to determine anxiety in the participants. Results: Total
of 200 women who met criteria of the study were recruited. The mean ages of both groups were 40 years old. Both
groups were significantly different when it came to their education, 30 and 59 percent of study and control group had
education level more than bachelor (p=0.003). The prevalence of anxiety was statistically significantly higher in study
group than the control group (15% and 6%, respectively). There was only one case of depression in study. Waiting time
and abnormal cervical cytology severity did not affected to anxiety level. Conclusions: Colposcopy and appointment
caused anxiety. However anxiety was not associated with waiting time to colposcopy or Pap result’s severity.
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Affiliation(s)
- Sasiwimon Phuakpoolpol
- Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.
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