Anxiety and borderline PAP smear results.
OBJECTIVE
Low-grade abnormalities after cervical cancer screening, i.e. borderline (Pap 2) or mildly (Pap 3a1) dyskaryotic (BMD) smear results, are found in considerable numbers of women annually. We compared quality of life and anxiety in women with BMD and a reference group of screening participants who were awaiting smear taking.


METHODS
Five hundred and fifty women with BMD in the preceding 6-24 months, identified through a regional screening organisation, were sent a questionnaire addressing generic quality of life (12-item Short-Form Health Survey [SF-12], EuroQol classification [EQ-5D]), generic anxiety (STAI-6) and screen-specific anxiety (Psychological Consequences Questionnaire [PCQ]).


RESULTS
After adjustment for differences in background characteristics, women with BMD (n=270) reported more generic anxiety (44.4 versus 32.6) and screen-specific anxiety (5.0 versus 1.4) than the reference group (n=352). The differences indicated statistical (p<0.001) and clinical significance. High anxiety (STAI-6>44) was reported by 49% of the BMD group. Mental quality of life was worse in the BMD than in the reference group (44.2 versus 52.0, p<0.001). The BMD group considered screening more often frightening (27% versus 10%) and reported 'fear for cervical cancer' more frequently as their reason for having a (repeat) smear taken (62/270, 23% versus 12/346, 4%).


CONCLUSIONS
BMD smears were consistently associated with considerable excess anxiety in the period of 6-24 months after the original BMD Pap smears had been taken.
Korfage
Ida J
IJ
Dept. of Public Health, Erasmus MC, University Medical Center Rotterdam, Room Ae-108, PO Box 2040, 3000 CA Rotterdam, The Netherlands. i.korfage@erasmusmc.nl
van Ballegooijen
Marjolein
M
Huveneers
Hans
H
Essink-Bot
Marie-Louise
ML
D000328:Adult; D001007:Anxiety / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000523:psychology; D008875:Middle Aged; D009426:Netherlands; D065006:Papanicolaou Test; D011230:Precancerous Conditions / Q000175:diagnosis / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011788:Quality of Life; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000523:psychology*; D014626:Vaginal Smears / Q000523:psychology*