Prevalence and predictors of anxiety and worries in women following colposcopy: results from a longitudinal study

Publication date: 
April, 2013
Presentation type: 
Oral presentation
Related staff: 
Dr Mairead O'Connor (former staff)
Mr Eamonn O'Leary (former staff)
Prof Linda Sharp (former staff)

Background: Longitudinal data on the psychological after-effects of colposcopy and related procedures is limited. We investigated women’s anxiety and worries at three time-points  following colposcopy.

Methods: Questionnaires were mailed to women 4-, 8- and 12-months following an initial colposcopy at two large Dublin hospitals. Anxiety was assessed by the Hospital Anxiety and Depression Scale1 and worries about cervical cancer, future fertility and having sex by the Process Outcome Specific Measure (POSM)2. Prevalence of significant anxiety (HADS anxiety score ≥11) and each worry was estimated at each time-point and multiple logistic regression used to identify factors associated with risk of anxiety or worry.

Results: 584 women were recruited (response rate=73%, 59% and 52% at 4, 8 and 12-months respectively). Prevalence of significant anxiety was steady over time (21%, 23% and 20% at 4, 8 and 12-months). The most common worry concerned future fertility; 56% were worried at 4-months, falling to 47% at 8-months and 39% at 12-months. Worries about cervical cancer fell from 36% at 4-months to 23% at 12-months. Worries about having sex were least frequent and also declined over time (from 29% at 4-months to 18% at 12-months). In adjusted models, nulliparity and age were significantly associated with worries about future fertility. Risk of cervical cancer worries was increased in women who had another abnormal smear before the one(s) which resulted in the recruitment colposcopy and who reporting ever having depression, and was reduced in women without children.  

Conclusions: Significant proportions of women attending colposcopy report anxiety or worries afterwards. While worries declined over time, the proportions affected remain high at 12-months. Interventions are needed that effectively allay women’s concerns thereby helping minimise the adverse (albeit unintended) effects of cervical screening.  

1Snaith RP & Zigmond AS. Acta Psychiatr Scand 1983;67:361-70. 2Gray N et al. Quality of Life Res 2005;14:1553-62.

Published abstract: 
M O'Connor, J Murphy, C White, C Ruttle, C Martin, G Flannelly, G von Bunau, J O'Leary, L Pilkington, M Anglim, M Turner, N Farah, S Cleary, T Darcy, W Prendiville, L Sharp
M O'Connor
Conference/meeting title: 
British Society for Cervical Cytology and Pathology Conference 2013
Event date: 
24 Apr 2013 to 26 Apr 2013
Glasgow, Scotland

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