title: Long-Term Worries after Colposcopy: Which Women Are at Increased Risk?
abstract: BACKGROUND
  A colposcopy examination is the main management option for women with an abnormal cervical screening test result. Although some women experience adverse psychological effects after colposcopy, those at greatest risk are unknown. We investigated predictors of worries about cervical cancer, sex, future fertility and general health during 12 to 30 months after colposcopy.
  
  
  METHODS
  We invited 1,515 women, aged 20 to 59 years with low-grade cervical cytology who attended colposcopy to complete questionnaires at recruitment (∼8 weeks after cytology result) and after 12, 18, 24, and 30 months of follow up. Outcomes were worries about having cervical cancer, having sex, future fertility, and general health at any time during follow-up. Factors significantly associated with each outcome were identified using multiple logistic regression.
  
  
  RESULTS
  At one or more time points during follow-up, 40% of women reported worries about having cervical cancer, 26% about having sex, 24% about future fertility, and 60% about general health. For all outcomes except sex, worries reported at recruitment were associated with significantly increased risk of worries during follow-up. Significant anxiety at recruitment was associated with all worries during follow-up. Women diagnosed with CIN2+ had significantly higher risks of worries about cervical cancer and future fertility. Management received was associated significantly with worries about cervical cancer and having sex. Younger women significantly more often reported worries about future fertility, whereas women who had children had reduced risk of future fertility worries but increased risk of cervical cancer worries.
  
  
  CONCLUSIONS
  Clinical, sociodemographic, lifestyle, and psychological factors predicted risk of reporting worries after colposcopy.
authors.affiliation: Research Department, National Cancer Registry Ireland, Cork, Ireland. Electronic address: linda.sharp@ncl.ac.uk.
authors.forename: Linda
authors.initials: L
authors.lastname: Sharp
authors.affiliation: Department of Obstetrics & Gynaecology, University of Aberdeen, Aberdeen, Scotland.
authors.forename: Seonaidh C
authors.initials: SC
authors.lastname: Cotton
authors.affiliation: Department of Obstetrics & Gynaecology, University of Aberdeen, Aberdeen, Scotland.
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Cruickshank
authors.affiliation: Centre of Academic Primary Care, University of Aberdeen, Aberdeen, Scotland.
authors.forename: Nicola M
authors.initials: NM
authors.lastname: Gray
authors.affiliation: Department of Epidemiology & Public Health, University of Nottingham, Nottingham, England.
authors.forename: Keith
authors.initials: K
authors.lastname: Neal
authors.affiliation: Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, England.
authors.forename: Kieran
authors.initials: K
authors.lastname: Rothnie
authors.affiliation: Centre of Academic Primary Care, University of Aberdeen, Aberdeen, Scotland.
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Thornton
authors.affiliation: Medical Research Centre, University of Hull, Kingston upon Hull, England.
authors.forename: Leslie G
authors.initials: LG
authors.lastname: Walker
authors.affiliation: Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada.
authors.forename: Julian
authors.initials: J
authors.lastname: Little
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001008:Anxiety Disorders / Q000523:psychology; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy / Q000523:psychology*; D003863:Depression / Q000523:psychology; D055088:Early Detection of Cancer / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007389:Internal-External Control; D016015:Logistic Models; D008403:Mass Screening; D008875:Middle Aged; D011247:Pregnancy; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000523:psychology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000523:psychology