Cervical cancer screening ‘does not impair life quality’
MedWire News: Cervical cancer screening does not adversely affect quality of life in women with normal test results, although many report some unpleasant effects, say researchers.
IJ Korfage (Erasmus MC, Rotterdam, the Netherlands) and team found lower levels of screening-specific anxiety in 789 women who underwent screening than in 567 control participants who did not, which "may indicate a reassurance effect or a selection effect, which needs to be addressed in more depth," they write in the British Journal of Obstetrics and Gynecology.
Nineteen percent of women who participated in the study reported being bothered by feelings of shame, pain, inconvenience, and/or nervousness during smear taking. In addition, 13% of women experienced lower abdominal pain, vaginal bleeding, discharge, and/or urinary problems for at least 2 days following the smear.
However, Korfage et al found that there were no adverse health-related quality of life (HRQoL) consequences of the cervical cancer screening procedure among women with a normal test result.
The women who underwent screening were followed from when they were sent the screening invitation until after the receipt of their normal Pap smear screening test result. Questionnaires were sent to the home address of each woman before screening, after screening, and again with the screening test result.
The three questionnaires included validated measures on generic HRQoL (according to the EuroQoL classification [EQ-5D] and 12-item Short-Form Health Survey [SF-12]), generic anxiety (validated short version of State Trait Anxiety Inventory), and screen-specific anxiety (Psychological Consequences Questionnaire).
The findings were compared with those from the reference cohort of age-matched control women who were not due for cervical cancer screening within the following 2 years. These women were sent a similar questionnaire to the initial prescreening one sent to the screening group.
Generic HRQoL and anxiety scores were similar in the study and reference groups.
However, screening participants reported less screen-specific anxiety than the reference group, at mean scores of 1.5 versus 5.0, a difference which was of clinical relevance, say the authors.
Following the procedure, reported symptoms such as pain, feeling sick, and vaginal bleeding were considered very painful by 79 (12%) women and very annoying by 81 (12%) women.
After receiving the smear result, 219 (32%) women reported considering the entire screening procedure to be fairly stressful and seven (1%) considered it very stressful.
The authors say that the similar scores for HRQoL and anxiety observed between the screening and control groups as well as the lower screen-related anxiety levels in the screening group demonstrates that cervical screening possibly "offers reassurance to those who participated."
Alternatively, it could also mean that that the participants involved represented a selection of women who are more relaxed about being screened and the risk for being diagnosed.
By Piriya Mahendra