Adverse outcomes after colposcopy.
BACKGROUND
Colposcopy is an essential part of the National Health Service Cervical Screening Programme (NHSCSP). It is used for both diagnosis and treatment of pre-cancerous cells of the cervix. Despite colposcopy being a commonly performed and relatively invasive procedure, very little research has explored the potential long-term impacts of colposcopic examination upon patient quality of life.The aim of this study is to investigate and quantify any potential reduction in women's quality of life following a colposcopy procedure. More specifically, the degree of female sexual dysfunction and the excess risk of adverse events in those undergoing colposcopy will be explored. If such risks are identified, these can be communicated to women before undergoing colposcopy. It will also assist in identifying whether there are particular sub-groups at greater risk and if so, this may lead to a re-evaluation of current recommendations concerning colposcopically directed treatments.


METHODS
Cohort study using postal surveys to assess sexual function and quality of life in women who have attended for colposcopy (cases), compared with those who have not attended colposcopy (controls). The prevalence and excess risk of female sexual dysfunction will be determined. Logistic regression will identify the predictors of adverse outcomes.


CONCLUSIONS
There are more than 400,000 colposcopy appointments each year in England, of which 134,000 are new referrals. There is some evidence that there may be long-term implications for women treated under colposcopy with respect to adverse obstetric outcomes, persisting anxiety, increased rates of sexual dysfunction and reduced quality of life. Reliably establishing whether such adverse outcomes exist and the excess risk of adverse events will facilitate informed decision-making and patient choice.
Department of Primary Care Clinical Sciences, The University of Birmingham, Edgbaston, UK.
Sarah M
SM
Flanagan
Sue
S
Wilson
David
D
Luesley
Sarah L
SL
Damery
Sheila M
SM
Greenfield
D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000453:epidemiology*; D015984:Causality; D003127:Colposcopy / Q000009:adverse effects / Q000523:psychology* / Q000706:statistics & numerical data*; D015897:Comorbidity; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011788:Quality of Life; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology* / Q000523:psychology; D016387:Women's Health
J Adv Nurs. 1998 Sep;28(3):571-5
9756225
Gynecol Oncol. 1989 Sep;34(3):345-9
2767527
Obstet Gynecol. 2009 Dec;114(6):1232-1238
19935024
Cancer. 2004 Jan 1;100(1):97-106
14692029
J Psychosom Res. 2002 Feb;52(2):69-77
11832252
Acta Psychiatr Scand. 1983 Jun;67(6):361-70
6880820
Cancer. 2003 Nov 1;98(9 Suppl):2009-14
14603537
Br J Obstet Gynaecol. 1988 Feb;95(2):175-81
2831933
Br J Gen Pract. 2004 Jul;54(504):495-502
15239910
J Epidemiol Community Health. 1995 Feb;49(1):79-83
7707011
BJOG. 2002 Apr;109(4):364-8
12013155
Health Visit. 1989 Oct;62(10):308-9
2807944
Acta Obstet Gynecol Scand. 1991;70(3):231-5
1927301
Nurs Stand. 2000 Jul 19-25;14(44):35-7
11975277
Eur J Obstet Gynecol Reprod Biol. 2002 Sep 10;104(2):144-7
12206927
J Adv Nurs. 1993 Jun;18(6):972-9
8320394
Sex Transm Infect. 2005 Oct;81(5):394-9
16199738
Best Pract Res Clin Obstet Gynaecol. 2005 Aug;19(5):779-92
16263330
BJOG. 2006 May;113(5):511-4
16579798
J Sex Marital Ther. 2000 Apr-Jun;26(2):191-208
10782451
Lancet. 2006 Feb 11;367(9509):489-98
16473126
BJOG. 2007 Jan;114(1):70-80
17083653
Obstet Gynecol. 2009 Oct;114(4):727-735
19888028
Br J Clin Psychol. 1993 Feb;32(1):101-12
8467271
J Clin Endocrinol Metab. 2006 Dec;91(12):4809-16
17003083
J Psychosom Obstet Gynaecol. 2000 Mar;21(1):25-30
10907212
Fam Pract. 2008 Feb;25(1):56-62
18048650