Long-Term Worries after Colposcopy: Which Women Are at Increased Risk?

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• 作者：Linda Sharp ; PhD^a ; ¹ ; ^{linda.sharp@ncl.ac.uk" class="auth_mail" title="E-mail the corresponding author}Author Vitae ; Seonaidh C. Cotton ; PhD^b ; ¹Author Vitae ; Margaret E. Cruickshank ; MBChB ; MD ; FRCOG^bAuthor Vitae ; Nicola M. Gray ; PhD^cAuthor Vitae ; Keith Neal ; PhD^dAuthor Vitae ; Kieran Rothnie ; MSc^eAuthor Vitae ; Alison J. Thornton ; MSc ; MA (Oxon)^cAuthor Vitae ; Leslie G. Walker ; MA ; PhD ; FBPsS ; FRSM ; FSB^fAuthor Vitae ; Julian Little ; MA ; PhD^gAuthor Vitae ; on behalf of the TOMBOLA GroupMaggie Cruickshank ; Graeme Murray ; David Parkin ; Louise Smart ; Eric Walker ; Norman Waugh ; Mark Avis ; Claire Chilvers ; Katherine Fielding ; Rob Hammond ; David Jenkins ; Jane Johnson ; Keith Neal ; Rashmi Seth ; Dave Whynes ; Ian Duncan ; Alistair Robertson ; Julian Little ; Linda Sharp ; Ian Russell ; Leslie Walker ; Breda Anthony ; Sarah Bell ; Adrienne Bowie ; Katrina Brown ; Joe Brown ; Kheng Chew ; Claire Cochran ; Seonaidh Cotton ; Jeannie Dean ; Kate Dunn ; Jane Edwards ; David Evans ; Julie Fenty ; Al Finlayson ; Marie Gallagher ; Nicola Gray ; Maureen Heddle ; Alison Innes ; Debbie Jobson ; Mandy Keillor ; Jayne MacGregor ; Sheona Mackenzie ; Amanda Mackie ; Gladys McPherson ; Ike Okorocha ; Morag Reilly ; Joan Rodgers ; Alison Thornton ; Rachel Yeats ; Lindyanne Alexander ; Lindsey Buchanan ; Susan Henderson ; Tine Iterbeke ; Susanneke Lucas ; Gillian Manderson ; Sheila Nicol ; Gael Reid ; Carol Robinson ; Trish Sandilands ; Marg Adrian ; Ahmed Al-Sahab ; Elaine Bentley ; Hazel Brook ; Claire Bushby ; Rita Cannon ; Brenda Cooper ; Ruth Dowell ; Mark Dunderdale ; Gabrawi ; Li Guo ; Lisa Heideman ; Steve Jones ; Salli Lawson ; Zoë ; Philips ; Christopher Platt ; Shakuntala Prabhakaran ; John Rippin ; Rose Thompson ; Elizabeth Williams ; Claire Woolley ; Seonaidh Cotton ; Kirsten Harrild ; John Norrie ; Linda Sharp ; Nicholas Day ; Theresa Marteau ; Mahesh Parmar ; Julietta Patnick ; Ciaran Woodman ; Doug Altman ; Sue Moss ; Michael Wells
• 刊名：Women's Health Issues
• 出版年：2015
• 出版时间：September-October 2015
• 年：2015
• 卷：25
• 期：5
• 页码：517-527
• 全文大小：311 K

文摘

A colposcopy examination is the main management option for women with an abnormal cervical screening test result. Although some women experience adverse psychological effects after colposcopy, those at greatest risk are unknown. We investigated predictors of worries about cervical cancer, sex, future fertility and general health during 12 to 30 months after colposcopy.

Methods

We invited 1,515 women, aged 20 to 59 years with low-grade cervical cytology who attended colposcopy to complete questionnaires at recruitment (∼8 weeks after cytology result) and after 12, 18, 24, and 30 months of follow up. Outcomes were worries about having cervical cancer, having sex, future fertility, and general health at any time during follow-up. Factors significantly associated with each outcome were identified using multiple logistic regression.

Results

At one or more time points during follow-up, 40% of women reported worries about having cervical cancer, 26% about having sex, 24% about future fertility, and 60% about general health. For all outcomes except sex, worries reported at recruitment were associated with significantly increased risk of worries during follow-up. Significant anxiety at recruitment was associated with all worries during follow-up. Women diagnosed with CIN2+ had significantly higher risks of worries about cervical cancer and future fertility. Management received was associated significantly with worries about cervical cancer and having sex. Younger women significantly more often reported worries about future fertility, whereas women who had children had reduced risk of future fertility worries but increased risk of cervical cancer worries.

Conclusion

Clinical, sociodemographic, lifestyle, and psychological factors predicted risk of reporting worries after colposcopy.