Health-related quality of life in women after colposcopy: Results from a patient survey

Background: Information concerning the health-related quality of life consequences of colposcopy is limited. As health care providers look to re-evaluate cervical cancer screening strategies and protocols to reflect vaccinated populations in the coming years, we present evidence from a patient survey.

Methods: Questionnaire packs covering anxiety, worry and health-related quality of life were mailed to women four months following an initial colposcopy at two large Dublin hospitals. Health-related quality of life was measured using the EQ-5D. Socio-demographic, clinical and treatment variables were examined for associations with health-related quality of life.

Results: In total, 429 women were recruited (response rate=73%). Of these, 415 completed the EQ-5D in full. The mean index ED-5D score for the sample was 0.90 (sd=0.16). Third level education (0.93 versus 0.88, F<0.001) and possession of a medical card or GP visit card (0.93 versus 0.83, F>0.0001) were associated with higher mean EQ-5D index score while being a current smoker (0.86 versus 0.92, F<0.001), being employed/self-employed (0.86 versus 0.92, F<0.001) or suffering from depression (0.68 for those currently suffering from depression versus 0.94 in those who had never suffered from depression, F>0.0001) were all associated with lower mean EQ-5D index scores. Of the treatment and clinical factors, mean index EQ-5D score was lower in those women whose referral cytology was “high-grade” rather than “low grade” (0.86 versus 0.91, F=0.0056). With respect to treatments received, women who underwent loop electrical excision (LLETZ) had the lowest mean EQ-5D index scores compared to women who received other treatments (0.86, versus 0.92 in those who received colposcopy only, F=0.0220).

Conclusions: A number of socio-demographic, treatment and clinical factors were found to be associated with health-related quality of life in our study. As research emerges in the coming years with respect evolving practice in cervical cancer screening programmes, consideration should be given to these factors.