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Patterns of anxiety and distress over 12 months following participation in HPV primary screening

Title: Patterns of anxiety and distress over 12 months following participation in HPV primary screening
Authors: Marlow, Laura A.V.; McBride, Emily; Ridout, Deborah; Forster, Alice S.; Kitchener, Henry; Waller, Jo
Source: Marlow, L A V, McBride, E, Ridout, D, Forster, A S, Kitchener, H & Waller, J 2021, 'Patterns of anxiety and distress over 12 months following participation in HPV primary screening', SEXUALLY TRANSMITTED INFECTIONS. https://doi.org/10.1136/sextrans-2020-054780
Publication Year: 2021
Collection: King's College, London: Research Portal
Subject Terms: delivery of health care; primary health care; psychology; public health; women's health services
Description: Objectives: Many countries are now using primary human papillomavirus (HPV) testing for cervical screening, testing for high-risk HPV and using cytology as triage. An HPV-positive result can have an adverse psychological impact, at least in the short term. In this paper, we explore the psychological impact of primary HPV screening over 12 months. Methods: Women were surveyed soon after receiving their results (n=1133) and 6 (n=762) and 12 months (n=537) later. Primary outcomes were anxiety (Short-Form State Anxiety Inventory-6) and distress (General Health Questionnaire-12). Secondary outcomes included concern, worry about cervical cancer and reassurance. Mixed-effects regression models were used to explore differences at each time point and change over time across four groups according to their baseline result: control (HPV negative/HPV cleared/normal cytology and not tested for HPV); HPV positive with normal cytology; HPV positive with abnormal cytology; and HPV persistent (ie, second consecutive HPV-positive result). Results: Women who were HPV positive with abnormal cytology had the highest anxiety scores at baseline (mean=42.2, SD: 15.0), but this had declined by 12 months (mean=37.0, SD: 11.7) and was closer to being within the € normal' range (scores between 34 and 36 are considered € normal'). This group also had the highest distress at baseline (mean=3.3, SD: 3.8, scores of 3+ indicate case-level distress), but the lowest distress at 12 months (mean=1.9, SD: 3.1). At 6 and 12 months, there were no between-group differences in anxiety or distress for any HPV-positive result group when compared with the control group. The control group were less concerned and more reassured about their result at 6 and 12 months than the HPV-positive with normal cytology group. Conclusions: Our findings suggest the initial adverse impact of an HPV-positive screening result on anxiety and distress diminishes over time. Specific concerns about the result may be longer lasting and efforts should be made to address them.
Document Type: article in journal/newspaper
Language: English
ISSN: 1368-4973
Relation: info:eu-repo/semantics/altIdentifier/pissn/1368-4973
DOI: 10.1136/sextrans-2020-054780
Availability: https://kclpure.kcl.ac.uk/portal/en/publications/f33caac7-d84b-48b3-9765-610876379586; https://doi.org/10.1136/sextrans-2020-054780; https://www.scopus.com/pages/publications/85112624041
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.DD0D7D9C
Database: BASE