ObjectiveLittle is known about which women are at greatest risk of adverse psychological after-effects following colposcopy. This study examined time trends in, and identified predictors of, anxiety and specific worries over 12months.
MethodsWomen attending two hospital-based colposcopy clinics for abnormal cervical cytology were invited to complete psychosocial questionnaires at 4, 8 and 12months following colposcopy. General anxiety and screening-specific worries (about cervical cancer, having sex and future fertility) were measured. Generalised estimating equations were used to assess associations between socio-demographic, lifestyle and clinical variables and risk of psychological outcomes.
ResultsOf 584 women initially recruited, 429, 343 and 303 completed questionnaires at 4, 8 and 12months, respectively. Screening-specific worries declined significantly over time but were still relatively high at 12months: 23%, 39% and 18% for worries about cervical cancer, fertility and having sex, respectively. Anxiety remained stable (20%) over time. Risks of cervical cancer worry and anxiety were both almost double in women without private health insurance (cervical cancer worry: OR=1.80, 95% CI 1.25-2.61; anxiety: OR=1.84, 95% CI 1.20-2.84). Younger women (<40years) had higher risk of fertility worries. Non-Irish women had higher risk of anxiety (OR=2.13, 95% CI 1.13-4.01).
ConclusionsScreening-specific worries declined over time but anxiety remained stable. Notable proportions of women still reported adverse outcomes 12months following colposcopy, with predictors varying between outcomes. Women in socio-demographically vulnerable groups were at greatest risk of adverse psychological outcomes. This information could inform development of interventions to alleviate psychological distress post-colposcopy. Copyright (c) 2015 John Wiley & Sons, Ltd.