title: Adverse psychological outcomes following colposcopy and related procedures: a systematic review.
abstract: BACKGROUND
  Although colposcopy is the leading follow-up option for women with abnormal cervical cytology, little is known about its psychological consequences.
  
  
  OBJECTIVE
  We performed a systematic review to examine: (1) what, if any, are the adverse psychological outcomes following colposcopy and related procedures; (2) what are the predictors of adverse psychological outcomes post-colposcopy; and (3) what happens to these outcomes over time.
  
  
  METHODS
  Five electronic databases (PubMed, PsychINFO, CINAHL, Web of Science, Scopus) were searched for studies published in English between January 1986 and February 2014.
  
  
  METHODS
  Eligible studies assessed psychological wellbeing at one or more time-points post-colposcopy.
  
  
  METHODS
  Two reviewers independently screened titles and abstracts. Full texts of potentially eligible papers were reviewed. Data were abstracted from, and a quality appraisal performed of, eligible papers.
  
  
  RESULTS
  Twenty-three papers reporting 16 studies were eligible. Colposcopy and related procedures can lead to adverse psychological outcomes, particularly anxiety. Ten studies investigated predictors of adverse psychological outcomes; management type and treatment had no impact on this. Seven studies investigated temporal trends in psychological outcomes post-colposcopy; findings were mixed, especially in relation to anxiety and distress. Studies were methodologically heterogeneous.
  
  
  CONCLUSIONS
  Follow-up investigations and procedures for abnormal cervical cytology can cause adverse psychological outcomes among women. However, little is known about the predictors of these outcomes or how long they persist. There is a need for a more standardised approach to the examination of the psychological impact of colposcopy, especially longer-term outcomes.
  
  
  CONCLUSIONS
  Follow-up investigations for abnormal cervical cytology can cause adverse psychological outcome among women.
authors.affiliation: National Cancer Registry Ireland, Cork, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: O'Connor
authors.affiliation: School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
authors.forename: P
authors.initials: P
authors.lastname: Gallagher
authors.affiliation: Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Waller
authors.affiliation: Coombe Women and Infants University Hospital, Dublin, Ireland.
authors.forename: C M
authors.initials: CM
authors.lastname: Martin
authors.affiliation: Coombe Women and Infants University Hospital, Dublin, Ireland.
authors.forename: J J
authors.initials: JJ
authors.lastname: O'Leary
authors.affiliation: Institute of Health &/ Society, Newcastle University, Newcastle, UK.
authors.forename: L
authors.initials: L
authors.lastname: Sharp
mesh_terms: D001007:Anxiety / Q000209:etiology*; D003127:Colposcopy / Q000523:psychology*; D055088:Early Detection of Cancer / Q000295:instrumentation / Q000523:psychology*; D005260:Female; D006801:Humans; D013315:Stress, Psychological / Q000209:etiology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000523:psychology*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000523:psychology*
keywords: Adverse psychological outcomes; anxiety; cervix; colposcopy; screening; systematic review