PSYCHOLOGICAL CONSEQUENCES OF POSITIVE RESULTS IN CERVICAL-CANCER SCREENING

This study was carried out to assess the psychological impact of abnor mal cervical smear results. Existing literature contain only uncontrol led studies or controlled studies with non-standardised measures. Subj ects were recruited from women attending two general practices for rou tine cervical smears over a six month period. A comparison was made be tween women with positive results who were referred for colposcopy, wi th mild abnormalities who were asked to return for a repeat smear in s ix months, or negative smear results. Psychometric assessment by posta l questionnaire was carried out one week after receiving the result. T he measures used were the 28-item General Health Questionnaire (GHQ-28 ), Spielberger State Anxiety (STAT), and a measure designed specifical ly for use in the study, the Cervical Screening Questionnaire (CSQ). R esults indicated that women with positive smear test results who were referred for colposcopy had significantly higher scores on GHQ (p<.01) STAI-S (p<.05) and CSQ (p<.001) than women with mild abnormalities or negative results. Significant differences between the groups with mil d abnormalities and negative results were found on the CSQ (p<.05). Th ese findings suggest that positive results on cervical screening are a ssociated with a significant psychological impact including a range of specific concerns about gynaecological health and cancer, increased a nxiety and impaired well-being. Even mildly abnormal results, which in volve a recommendation for early repeat screening, cause raised concer n about cancer for the recipients. The procedures for providing smear results should be organised to minimise the level of distress.