Cervical screening program and the psychological impact of an abnormal Pap smear: a self-assessment questionnaire study of 590 patients.
PURPOSE
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.


METHODS
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.


RESULTS
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.


CONCLUSION
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.
['Thangarajah|Fabinshy|F|', 'Einzmann|Thomas|T|', 'Bergauer|Florian|F|', 'Patzke|Jan|J|', 'Schmidt-Petruschkat|Silke|S|', 'Theune|Monika|M|', 'Engel|Katja|K|', 'Puppe|Julian|J|', 'Richters|Lisa|L|', 'Mallmann|Peter|P|', 'Kirn|Verena|V|']
D000328:Adult D000368:Aged D001007:Anxiety D018290:Cervical Intraepithelial Neoplasia D055088:Early Detection of Cancer D005060:Europe D005260:Female D006801:Humans D008875:Middle Aged D065006:Papanicolaou Test D010817:Physician-Patient Relations D011788:Quality of Life D012647:Self-Assessment D011795:Surveys and Questionnaires D002578:Uterine Cervical Dysplasia D002583:Uterine Cervical Neoplasms D014626:Vaginal Smears D055815:Young Adult
Psychological impact Pap smear Cervical cancer screening