C15
Long-term worries about cancer in women who have had a low-grade abnormal cervical smear
Seonaidh Cotton1, Linda Sharp2, Nicola Gray1
1University of Aberdeen, UK, 2National Cancer Registry Ireland, Cork, Ireland
Background
There are more than 250,000 low-grade abnormal cervical smears each year in the NHS Cervical Screening Programmes(CSPs). The immediate adverse psychosocial effects on women following receipt of an abnormal smear result are well documented, but less is known about the longer-term impact. We investigated women's concerns over three years following a low-grade smear result.
Method
3399 women who had an incident low-grade abnormal smear (mild dyskaryosis or borderline nuclear abnormalities (BNA)) and were recruited to the TOMBOLA trial were included. Women were invited to complete questionnaires on their concerns about cancer, fertility and sexual activity, and other issues, at trial recruitment and at 12, 18, 24 and 30 months post-recruitment.
Results
98% of women completed the recruitment questionnaire. 27% had a mild smear prior to recruitment and 73% a BNA smear; 43% were aged 20-29 years, 27% 30-39 years, 21% 40-49 years and 9% 50-59 years. At recruitment, 67% of women agreed with the statement that since getting my smear result I have been worried that I may have cervical cancer. This declined to approximately one-third of women at 12 months and one-quarter at 18 months. At 24 and 30 months one-fifth of women remained worried that they had cancer. At 30 months, 45% were worried that their next smear would be abnormal; 31% were worried about their future fertility; and 13% were worried about having sex. These figures differed little according to the management women had received for their initial smear.
Conclusion
Low-grade smears are associated with a notable adverse long-term psychosocial impact. Our findings suggest that the information available to women following an abnormal smear does provide sufficient reassurance to alleviate worries. Given the large numbers of women who have such smears each year, further research is urgently required into women's information needs.
