title: Trends in, and predictors of, anxiety and specific worries following colposcopy: a 12-month longitudinal study.
abstract: OBJECTIVE
  Little is known about which women are at greatest risk of adverse psychological after-effects following colposcopy. This study examined time trends in, and identified predictors of, anxiety and specific worries over 12 months.
  
  
  METHODS
  Women attending two hospital-based colposcopy clinics for abnormal cervical cytology were invited to complete psychosocial questionnaires at 4, 8 and 12 months following colposcopy. General anxiety and screening-specific worries (about cervical cancer, having sex and future fertility) were measured. Generalised estimating equations were used to assess associations between socio-demographic, lifestyle and clinical variables and risk of psychological outcomes.
  
  
  RESULTS
  Of 584 women initially recruited, 429, 343 and 303 completed questionnaires at 4, 8 and 12 months, respectively. Screening-specific worries declined significantly over time but were still relatively high at 12 months: 23%, 39% and 18% for worries about cervical cancer, fertility and having sex, respectively. Anxiety remained stable (20%) over time. Risks of cervical cancer worry and anxiety were both almost double in women without private health insurance (cervical cancer worry: OR = 1.80, 95% CI 1.25-2.61; anxiety: OR = 1.84, 95% CI 1.20-2.84). Younger women (<40 years) had higher risk of fertility worries. Non-Irish women had higher risk of anxiety (OR = 2.13, 95% CI 1.13-4.01).
  
  
  CONCLUSIONS
  Screening-specific worries declined over time but anxiety remained stable. Notable proportions of women still reported adverse outcomes 12 months following colposcopy, with predictors varying between outcomes. Women in socio-demographically vulnerable groups were at greatest risk of adverse psychological outcomes. This information could inform development of interventions to alleviate psychological distress post-colposcopy.
authors.affiliation: National Cancer Registry Ireland, Kinsale Road, Cork, Ireland.
authors.forename: Mairead
authors.initials: M
authors.lastname: O'Connor
authors.affiliation: National Cancer Registry Ireland, Kinsale Road, Cork, Ireland.
authors.forename: Eamonn
authors.initials: E
authors.lastname: O'Leary
authors.affiliation: Health Behaviour Research Centre, University College London, London, UK.
authors.forename: Jo
authors.initials: J
authors.lastname: Waller
authors.affiliation: School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
authors.forename: Pamela
authors.initials: P
authors.lastname: Gallagher
authors.affiliation: Coombe Women and Infants University Hospital, Dublin 8, Ireland.
authors.forename: Tom
authors.initials: T
authors.lastname: D'arcy
authors.affiliation: National Maternity Hospital, Dublin 2, Ireland.
authors.forename: Grainne
authors.initials: G
authors.lastname: Flannelly
authors.affiliation: Coombe Women and Infants University Hospital, Dublin 8, Ireland.
authors.forename: Cara M
authors.initials: CM
authors.lastname: Martin
authors.affiliation: National Cancer Registry Ireland, Kinsale Road, Cork, Ireland.
authors.forename: Judith
authors.initials: J
authors.lastname: McRae
authors.affiliation: Coombe Women and Infants University Hospital, Dublin 8, Ireland.
authors.forename: Walter
authors.initials: W
authors.lastname: Prendiville
authors.affiliation: Coombe Women and Infants University Hospital, Dublin 8, Ireland.
authors.forename: Carmel
authors.initials: C
authors.lastname: Ruttle
authors.affiliation: Trinity College Dublin, Dublin 2, Ireland.
authors.forename: Christine
authors.initials: C
authors.lastname: White
authors.affiliation: Coombe Women and Infants University Hospital, Dublin 8, Ireland.
authors.forename: Loretto
authors.initials: L
authors.lastname: Pilkington
authors.affiliation: Coombe Women and Infants University Hospital, Dublin 8, Ireland.
authors.forename: John J
authors.initials: JJ
authors.lastname: O'Leary
authors.affiliation: Institute of Health and Society, Newcastle University, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Sharp
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D003127:Colposcopy / Q000523:psychology*; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008137:Longitudinal Studies; D008875:Middle Aged; D011247:Pregnancy; D015995:Prevalence; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000523:psychology