title: The psychosocial impact of human papillomavirus testing in primary cervical screening-a study within a randomized trial.
abstract: The purpose of the study was to assess the psychosocial impact of human papillomavirus (HPV) testing as an adjunct to cytology in routine primary cervical screening. A controlled study of the psychosocial impact of HPV testing within a randomized trial of HPV testing to assess its efficacy in cervical screening was carried out. The trial provides a randomized setting of revealed HPV results versus concealed results permitting valid comparisons for assessing true psychosocial impact. The setting comprised a large number of general practices in primary care. Women aged 20-64 years who underwent routine cervical screening participated in the study. The intervention was a revealed high-risk HPV test result in addition to cervical cytology. The main outcome was measured using General Health Questionnaire (GHQ-28), Spielberger State-Trait Anxiety Inventory, and Sexual Rating Scale (SRS). Among women with either mildly abnormal or normal cytology, receiving an HPV(+ve) result did not impact significantly on GHQ caseness and mean scores or on Spielberger State and Trait scores when compared with women in whom the HPV(+ve) test result was concealed. Among women with normal cytology, receiving an HPV(+ve) result was associated with a reduction in the Sexual Rating Scale compared with similar women whose HPV(+ve) result was concealed. HPV testing does not add significant psychologic distress when combined with cytology in routine primary cervical screening.
authors.affiliation: Division of Human Development, Academic Unit of Obstetrics and Gynaecology, University of Manchester, Manchester, United Kingdom. henry.kitchener@cmmc.nhs.uk
authors.forename: H C
authors.initials: HC
authors.lastname: Kitchener
authors.forename: I
authors.initials: I
authors.lastname: Fletcher
authors.forename: C
authors.initials: C
authors.lastname: Roberts
authors.forename: P
authors.initials: P
authors.lastname: Wheeler
authors.forename: M
authors.initials: M
authors.lastname: Almonte
authors.forename: P
authors.initials: P
authors.lastname: Maguire
mesh_terms: D000328:Adult; D052685:Alphapapillomavirus / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000523:psychology; D011230:Precancerous Conditions / Q000175:diagnosis / Q000523:psychology; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000523:psychology; D014626:Vaginal Smears / Q000523:psychology*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000523:psychology