title: Psychological response to cervical screening.
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).
  
  
  CONCLUSIONS
  A positive cervical smear may by psychologically traumatic for a significant minority of women, irrespective of management strategy.
authors.affiliation: Department of Mental Health, University of Aberdeen, United Kingdom.
authors.forename: S
authors.initials: S
authors.lastname: Bell
authors.forename: M
authors.initials: M
authors.lastname: Porter
authors.forename: H
authors.initials: H
authors.lastname: Kitchener
authors.forename: C
authors.initials: C
authors.lastname: Fraser
authors.forename: P
authors.initials: P
authors.lastname: Fisher
authors.forename: E
authors.initials: E
authors.lastname: Mann
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000523:psychology*; D016022:Case-Control Studies; D003127:Colposcopy; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012649:Self Concept; D002578:Uterine Cervical Dysplasia / Q000517:prevention & control / Q000523:psychology*; D014626:Vaginal Smears / Q000523:psychology*