The psychosocial impact of an abnormal cervical smear result

Background Data on the impact of abnormal cervical smear results on health‐related quality of life (HrQoL) are scarce. We aimed to (i) prospectively assess the HrQoL of women who were informed of an abnormal smear result; (ii) identify predictors of greater negative psychosocial impact of an abnorma...

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Published in:Psycho-oncology (Chichester, England) England), 2012-10, Vol.21 (10), p.1071-1081
Main Authors: Drolet, Mélanie, Brisson, Marc, Maunsell, Elizabeth, Franco, Eduardo L., Coutlée, François, Ferenczy, Alex, Fisher, William, Mansi, James A.
Format: Article
Language:English
Subjects:
Adult
Anxiety
Anxiety - etiology
Anxiety - psychology
Canada
Case-Control Studies
Cervical cancer
cervical cancer screening
cervical smear
Female
Health Status
Humans
Mental health
Middle Aged
Oncology
Papillomaviridae
Papillomavirus Infections - diagnosis
Papillomavirus Infections - psychology
Prospective Studies
Psychiatric Status Rating Scales
Psychosocial factors
psychosocial impact
Quality adjusted life years
Quality of life
Quality of Life - psychology
Severity of Illness Index
Social Support
Socioeconomic Factors
Stress, Psychological - etiology
Stress, Psychological - psychology
Surveys and Questionnaires
Uterine Cervical Neoplasms - diagnosis
Uterine Cervical Neoplasms - psychology
Vaginal Smears - psychology
Women
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Summary:Background Data on the impact of abnormal cervical smear results on health‐related quality of life (HrQoL) are scarce. We aimed to (i) prospectively assess the HrQoL of women who were informed of an abnormal smear result; (ii) identify predictors of greater negative psychosocial impact of an abnormal result; and (iii) prospectively estimate the quality‐adjusted life‐years (QALYs) lost following an abnormal result. Methods Between 08/2006 and 08/2008, 492 women with an abnormal result and 460 women with a normal result, frequency matched for age and clinic, were recruited across Canada. HrQoL was measured at recruitment and 4 and 12 weeks later with the EuroQol, Short Form‐12, short Spielberg State‐Trait Anxiety Inventory (STAI) and HPV Impact Profile. Three blocks of potential predictors of higher psychosocial impact were tested by hierarchical modeling: (i) socio‐demographics; (ii) sexual activity; and (iii) smear result severity, communication, and understanding. Results Receiving an abnormal result significantly increased anxiety (STAI mean difference between both groups = 8.3). Initial anxiety decreased over time for the majority of women. However, 35% of women had clinically meaningful anxiety at 12 weeks (i.e. STAI scores ≥0.5 standard deviation of the controls). These women reported a lower socio‐economic level, did not completely understand the information about their result and perceived themselves at higher risk of cancer. QALY lost following an abnormal result were between 0.007 and 0.009. Conclusions Receiving an abnormal smear has a statistically significant and clinically meaningful negative impact on mental health. However, this negative impact subsides after 12 weeks for the majority of women. Copyright © 2011 John Wiley & Sons, Ltd.
ISSN:1057-9249
1099-1611
DOI:10.1002/pon.2003