Psychologic morbidities prior to loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia

Abstract

The objective of this study was to assess and compare anxiety and distress in patients undergoing colposcopic examinations and loop electrosurgical excision procedure (LEEP). Patients seen for evaluation of cervical intraepithelial neoplasia (CIN) and LEEP were recruited. All patients received further teaching with respect to their abnormality right after the colposcopic evaluation by nursing staff. The Hospital anxiety and Depression Scale (HADS) and the Psychosocial Effects of Abnormal Pap Smears (PEAPS) questionnaires were used to measure and compare distress between the two groups. Linear regression models were built to identify significant predictive variables for psychologic morbidities. Twenty-one colposcopy and 20 LEEP patients participated in this study. No significant demographic differences were noted. Eighty-one percent of patients having colposcopy and 65% of those undergoing LEEP can be classified as having significant anxiety and depression based on the HADS questionnaire. Patients undergoing LEEP scored significantly better than colposcopy patients on the mean total PEAPS score and on the self-belief/cancer concern and effects on sexual relationship dimension scores. Significant psychologic morbidities exist in patients diagnosed with CIN. Face-to-face individualized education and support after colposcopy can decrease patients' distress at subsequent treatment visits.

Psychological effects of diagnosis and treatment of cervical intraepithelial neoplasia: a systematic review

“…In the studies by Freeman-Wang et al 18 and Le et al ,20 women appeared to be as anxious and distressed before undergoing CIN treatment as when about to undergo the initial colposcopy; in the study by Le et al ,20 women received additional counselling immediately after colposcopy. Women surveyed by Kola and Walsh25 reported feeling more unpleasantness while undergoing CIN treatment in a see-and-treat setting compared to women who underwent colposcopy and no treatment.…”

3q26 Amplification Is an Effective Negative Triage Test for LSIL: A Historical Prospective Study

“…This high referral rate results from the current management guidelines which acknowledge the inaccuracies of a LSIL cytologic diagnosis and recommend all women be referred to colposcopy because of the fear of missing underlying CIN 2/3 disease [20], [21]. While these conservative guidelines attempt to expedite any precancerous detection, they are costly and may cause psychosocial harm to the majority of women whose LSIL will not indicate a CIN 2/3 lesion before the next screening interval [22], [23].…”

Determinants of pre-procedural state anxiety and negative affect in first-time colposcopy patients: implications for intervention

“…Nevertheless, the sample in the present study was similar to that of others reported in the literature (Jones et al . 1996; Le et al . 2006).…”