<p>Patients with cervical intraepithelial neoplasms show different states of health-related quality of life and different coping styles depending on the choice of therapy: findings from the CIN study</p>

Abstract

PurposeTo examine the effects of type of therapy (conservative therapy vs conization) on the psychosocial well-being of patients with cervical intraepithelial neoplasia grade II (CIN II) in a prospective cross-sectional study designed to simplify future choice of therapy.Patients and methodsIn a cross-sectional study comparing 24 CIN II patients who were treated via conservative therapy with 17 CIN II patients who were treated via conization (not randomized), we examined the association between therapy type and psychosocial well-being after the treatment. Scores on the Hospital Anxiety and Depression Scale (HADS) (prevalence of depression/anxiety), SF-12 (health-related quality of life (HRQoL)) and Brief COPE (coping mechanisms) questionnaires were compared between the two subgroups via nonparametric Mann-Whitney U-tests.ResultsThe prevalence of depression/anxiety and mental HRQoL did not differ between patients undergoing conservative therapy and those undergoing conization but differed significantly from those of the healthy population. Regarding physical HRQoL and coping strategies, the conservative therapy subgroup achieved higher scores and better performance.ConclusionPatients with CIN II are at risk of developing depressive or anxiety symptoms. The choice of therapy seems to have an influence on physical HRQoL and coping strategies but not on depression/anxiety and mental HRQoL.

“I feel reassured, but there is no guarantee.” How do women with a future childbearing desire respond to active surveillance of cervical intraepithelial neoplasia grade 2? A qualitative study

“…In a recent Australian study in which women were hypothetically diagnosed with CIN2, 80% of younger women preferred active surveillance over surgery, primarily because they were concerned about reproductive harm 23 . Some women in the present study considered undergoing excisional treatment to get rid of the uncertainty and worry, as also suggested elsewhere 14,15 . However, the previous studies suggest that women’s quality of life does not depend on treatment method.…”

“…However, the previous studies suggest that women’s quality of life does not depend on treatment method. One study found that choice of therapy may have an influence on physical quality of life and coping strategies, but not on risk of depression, anxiety or mental well‐being 14 …”

“…One study found that choice of therapy may have an influence on physical quality of life and coping strategies, but not on risk of depression, anxiety or mental well-being. 14 Preparation and transition to motherhood is considered an important and major life event, and it is a process that affects women on a psychological, social, physical and existential level. 26 Women in the present study did not want to postpone their plans for pregnancy due to CIN, but found it stressful to have to worry about risk of progression while planning a pregnancy.…”

“…During the active surveillance period, women may live with uncertainty and concern about whether CIN2 will regress or progress to CIN3 or cancer. It is well known that many women experience discomfort, worry and anxiety when they are diagnosed with abnormal cytology and during follow‐up 13,14 . Other studies have found that active surveillance of CIN2 does not appear to have an adverse impact on self‐reported mental health‐related quality of life, anxiety, depression and sexual function compared with conventional management 14,15 .…”

Performance of HPV E4 and p16INK4a biomarkers in predicting regression of cervical intraepithelial neoplasia grade 2 (CIN2): protocol for a historical cohort study

“…Furthermore, this information may reduce the psychological burden associated with active surveillance of CIN2, as reported in previous studies. 37 …”