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30-01-2011 | Gynaecology | Article

No long-term psychosocial effects of delayed versus immediate cervical treatment


Free abstract

MedWire News: There are no short- or long-term psychosocial effects on women who are treated with punch biopsies and subsequent selective recall as opposed to immediate large loop excision (LLETZ) during colposcopy, study results show.

"The most effective management of women with low-grade abnormal cytology who have a visible abnormality at colposcopy is controversial," say Linda Sharp (National Cancer Registry, Cork, Ireland) and colleagues.

The researchers asked 989 women referred to colposcopy with low-grade cervical cytology to complete seven psychosocial assessments before, during, and 6 weeks, 12, 18, 24, and 30 months after recruitment. The women were randomly assigned to receive a biopsy with selective recall (n = 502) or immediate LLETZ (n = 487).

The cumulative prevalence of significant depression (hospital anxiety and depression subscale [HADS] score ≥8) was slightly lower in the immediate LLETZ group (16.7 percent) compared with the biopsy group (21.5 percent); a borderline significant difference that was lost after adjustment for confounders.

The overall prevalence of significant anxiety (HADS score ≥11) fell significantly from 22.3 percent at recruitment to 13.8 percent at pre-colposcopy, and then to 8.0 percent 6 weeks after the procedure.

As with depression, however, the cumulative prevalence of significant anxiety did not differ between treatment groups (odds ratio = 0.83).

"The debate as to which strategy offers the best balance between harms and benefits... is likely to continue" conclude Sharp et al.

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Sarah Guy

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