THE MILDLY ABNORMAL CERVICAL SMEAR - PATIENT ANXIETY AND CHOICE OF MANAGEMENT

Argument continues over the best management of women with a first mild ly dyskaryotic cervical smear: should they be referred for prompt colp oscopy, or should they be kept under cytological review, with recourse to colposcopy if the abnormality persists? One consideration is the a mount pf anxiety generated. We measured anxiety, retrospectively, in t wo groups of women who had been managed by one or other method. Colpos copy caused more anxiety than cytological surveiliance. When told that their smear was mildly abnormal, 47% of the immediate-colposcopy grou p (n=182), compared with 33% of the surveillance group (n=163), though t they had cancer,none the less, there was a general preference for im mediate colposcopy. Whatever the relative merits of these two strategi es for clinical management, it is clear that both forms of screening, and especially colposcopy, demand better information for patients.