title: Does a "one-stop" gynecology screening clinic for women in hereditary nonpolyposis colorectal cancer families have an impact on their psychological morbidity and perception of health?
abstract: Screening programs can reduce the burden of disease, however, they can be associated with raised levels of anxiety. The risk of endometrial and ovarian cancer is increased in hereditary nonpolyposis colorectal cancer (HNPCC). There is no prospective evidence to support screening for gynecological disease in HNPCC, however, current recommendations include the use of ultrasound and endometrial biopsy. This study assesses the impact of screening for gynecological cancer on self-reported symptoms of anxiety, depression, and perceptions of health. Women from HNPCC families attending gynecological screening (n = 26) completed the Hospital Anxiety and Depression Scale and the ShortForm36v2 questionnaires prior to screening with transvaginal ultrasound, outpatient/office hysteroscopy, endometrial biopsy, and ovarian tumor marker assessment (CA125). The same questionnaires were completed at 3 and 6 months following screening (15/26). Women in HNPCC families attending for gynecological screening did not have excess symptoms of anxiety or depression at baseline in subjective comparison to other populations. The process of screening and false positive screening results had no significant impact on symptoms of anxiety and depression or perceptions of health. We conclude that within the limitations of analysis in this small study group, screening for gynecological disease in HNPCC does not appear to be associated with any psychological morbidity.
authors.affiliation: Department of Obstetrics and Gynaecology, St James' University Hospital, Leeds, West Yorkshire, United Kingdom.
authors.forename: N J
authors.initials: NJ
authors.lastname: Wood
authors.forename: S
authors.initials: S
authors.lastname: Munot
authors.forename: E
authors.initials: E
authors.lastname: Sheridan
authors.forename: S R
authors.initials: SR
authors.lastname: Duffy
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology; D001294:Attitude to Health; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000150:complications / Q000523:psychology*; D003863:Depression / Q000209:etiology; D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D006801:Humans; D008403:Mass Screening; D010465:Perception