title: Psychological effects of a low-grade abnormal cervical smear test result: anxiety and associated factors.
abstract: Receipt of an abnormal cervical smear result often generates fear and confusion and can have a negative impact on a woman's well-being. Most previous studies have focussed on high-grade abnormal smears. This study describes the psychological and psychosocial effects, on women, of having received a low-grade abnormal smear result. Over 3500 women recruited to TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) participated in this study. Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS) at recruitment. Socio-demographic and lifestyle factors, locus of control and factors associated with the psychosocial impact of the abnormal smear result were also assessed. Women reported anxiety levels consistent with those found in previous studies of women with high-grade smear results. Women at highest risk of anxiety were younger, had children, were current smokers, or had the highest levels of physical activity. Interventions that focus particularly on women's understanding of smear results and pre-cancer, and/or directly address their fears about cancer, treatment and fertility might provide the greatest opportunity to reduce the adverse psychosocial impact of receiving a low-grade abnormal cervical smear result.
authors.affiliation: Department of General Practice and Primary Care, Foresterhill Health Centre, University of Aberdeen and Grampian University Hospitals, Aberdeen, UK. n.gray@abdn.ac.uk
authors.forename: N M
authors.initials: NM
authors.lastname: Gray
authors.forename: L
authors.initials: L
authors.lastname: Sharp
authors.forename: S C
authors.initials: SC
authors.lastname: Cotton
authors.forename: L F
authors.initials: LF
authors.lastname: Masson
authors.forename: J
authors.initials: J
authors.lastname: Little
authors.forename: L G
authors.initials: LG
authors.lastname: Walker
authors.forename: M
authors.initials: M
authors.lastname: Avis
authors.forename: Z
authors.initials: Z
authors.lastname: Philips
authors.forename: I
authors.initials: I
authors.lastname: Russell
authors.forename: D
authors.initials: D
authors.lastname: Whynes
authors.forename: M
authors.initials: M
authors.lastname: Cruickshank
authors.forename: C M
authors.initials: CM
authors.lastname: Woolley
mesh_terms: D000328:Adult; D001007:Anxiety; D003863:Depression; D005260:Female; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D012307:Risk Factors; D012923:Social Class; D002583:Uterine Cervical Neoplasms / Q000523:psychology*; D014626:Vaginal Smears / Q000523:psychology*