Cervical screening program and the psychological impact of an abnormal Pap smear: a self-assessment questionnaire study of 590 patients
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Invasive cervical cancer is today the fourth most common cancer of women in western civilization. Screening programs have led to a continuously decrease. Nevertheless, both screening and a positive test result are known to be associated with a negative psychological impact. Screening programs in European countries differ and thus psychological impact might as well. The aim of this study was to evaluate the psychological impact of women with an abnormal Pap smear in a German cohort.
Between July 2013 and May 2014, a self-assessment questionnaire was distributed to 595 patients that were referred to a special clinic for cervical dysplasia for further evaluation of an abnormal Pap smear. Patients were recruited in five different centers.
Most patients (45.9 %) were informed about the test result via phone call by their doctor. 68.8 % of the patients felt anxious and 26.3 % even felt panic. After having talked to their physician, 51.4 % of our cohort still felt worried and only 24.4 % felt reassured. Concerning disease management, 48.4 % underwent a control Pap smear in 6 months. The preferred information source was the physician (63.9 %). Compared to the results in other European countries, our study cohort showed differences concerning age distribution, patients living in a partnership, number of children and especially disease management.
Cancer screening itself and abnormal test results have an impact on patient’s feelings. To reduce the psychological impact, patients need to be better informed about the risks and benefits of cancer screening programs and in case of cervical cancer screening about the meaning of an abnormal test result. Our results underline the importance of a trustful physician–patient relationship in that matter.
KeywordsPap smear Psychological impact Cervical cancer screening
Compliance with ethical standards
Conflict of interest
The authors have no conflict of interest to declare.
- 1.ACOG FAQ—Cervical Cancer Screening. http://www.acog.org/-/media/For-Patients/faq085.pdf?dmc=1&ts=20150329T0433495663. Accessed 26 Feb 2015
- 3.Björk S, Hagström HG (2001) Vad betyder cellförändringarna? Dålig information om avvikande cytologprov skapar onödig oro (Of what significance is abnormal result of smear test? Anxiety because of insufficient information in connection with abnormal result of cervical smear test). Lakartidningen 98(23):2796–2800PubMedGoogle Scholar
- 5.Dominiak-Felden G, Cohet C, Atrux-Tallau S, Gilet H, Tristram A, Fiander A (2013) Impact of human papillomavirus-related genital diseases on quality of life and psychosocial wellbeing: results of an observational, health-related quality of life study in the UK. BMC Public Health 13:1065. doi: 10.1186/1471-2458-13-1065 PubMedPubMedCentralCrossRefGoogle Scholar
- 7.Eurostat European Commission (2012) Marriage and divorce statistics. http://epp.eurostat.ec.europa.eu/statistics_explained/index.php/Marriage_and_divorce_statistics. Accessed 1 Sep 2014
- 8.Eurostat Press Office (2013) European demography EU28 population 505.7 million at 1 January 2013 More than 5 million babies born in the EU28 in 2012. http://ec.europa.eu/eurostat. Accessed 1 Sep 2014
- 18.Lerman CE, Rimer BK (1993) Psychosocial impact of cancer screening. Oncology (Williston Park, N.Y.) 7(4):67–72 (discussion 72, 75, 79) Google Scholar
- 20.Maissi E, Marteau TM, Hankins M, Moss S, Legood R, Gray A (2004) Psychological impact of human papillomavirus testing in women with borderline or mildly dyskaryotic cervical smear test results: cross sectional questionnaire study. BMJ 328(7451):1293. doi: 10.1136/bmj.328.7451.1293 PubMedPubMedCentralCrossRefGoogle Scholar
- 22.Monsonego J, Cortes J, da Silva Daniel, Pereira Jorge AF, Klein P (2011) Psychological impact, support and information needs for women with an abnormal Pap smear: comparative results of a questionnaire in three European countries. BMC Womens Health 11:18. doi: 10.1186/1472-6874-11-18 PubMedPubMedCentralCrossRefGoogle Scholar
- 24.Robert Koch Institut (2014) Mitteilung der Ständigen Impfkommission am Robert Koch-Institut (RKI) Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut/Stand: August 2014. Epidemiologisches Bulletin (34):305–340Google Scholar
- 25.Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain J, Garcia Francisco A R, Moriarty AT, Waxman AG, Wilbur DC, Wentzensen N, Downs LS, Spitzer M, Moscicki A, Franco EL, Stoler MH, Schiffman M, Castle PE, Myers ER (2012) American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin 62(3):147–172. doi: 10.3322/caac.21139 PubMedPubMedCentralCrossRefGoogle Scholar