Psychosocial impact of testing human papillomavirus positive in Australia's human papillomavirus‐based cervical screening program: A cross‐sectional survey

Abstract

Objective To examine the impact of self‐reported human papillomavirus (HPV) test result (HPV negative, HPV positive, HPV result unknown) on a range of psychosocial outcomes. Methods Women and other people with a cervix in Australia aged 25–74 years who reported having participated in cervical screening since December 2017 were recruited through Facebook and Instagram to complete an online survey. The primary outcome measures were anxiety, emotional distress, and general distress. Results Nine hundred fifteen participants completed the online survey; 73.2% reported testing HPV negative (‘HPV−’), 15% reported testing HPV positive (‘HPV+’) and 11.8% reported that they did not know/remember their test result (‘HPV unknown’). Compared to participants testing HPV−, participants testing HPV+ had higher mean anxiety (41.67 vs. 37.08, p < 0.001) and emotional distress scores (11.88 vs. 7.71, p < 0.001). Concern about test result (34.3% vs. 1.3%, p < 0.001), perceived risk compared to average women (55.4% vs. 14.1%, p < 0.001), and cancer worry (27.8% vs. 5.9%, p < 0.001) were also greater among HPV+ participants than participants testing HPV−. Participants testing HPV+ felt less reassured about their screening result than participants testing HPV− (16% vs. 75.1%, p < 0.001). Participants testing HPV+ had greater knowledge of HPV (11.96 vs. 10.36 out of 16, p < 0.001) and HPV testing (3.94 vs 3.28 out of 5, p < 0.001) than participants who reported testing HPV−. Conclusions Elevated levels of anxiety and emotional distress were found in those testing HPV+ compared with those testing HPV−. Future research should examine what strategies should be used to deliver test results and what additional information is provided, in order to alleviate anxiety among individuals testing HPV+.

The Impact of HPV Diagnosis and the Electrosurgical Excision Procedure (LEEP) on Mental Health and Sexual Functioning: A Systematic Review

“…The participants involved in the research had an abnormal cytology result or had received an HPV-positive test result. In order to understand the impact of an abnormal cytology result, HPV infection, and subsequent medical interventions on women’s mental health and sexual life, participants were screened and examined according to Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria, using the Hospital Anxiety and Depression Scale (HADS) [ 15 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ], Beck Depression Inventory (BDI) [ 29 , 30 ], Beck Anxiety Inventory (BAI) [ 29 , 30 , 31 ], Symptom Checklist-Revised (SCL-90) [ 32 ], Psychosocial Effects of Abnormal Pap Smears Questionnaire short-form (PEAPS-Q) [ 11 , 24 , 33 , 34 , 35 ], State-Trait Anxiety Inventory (STAI) [ 6 , 7 , 8 , 9 , 10 , 11 , 16 , 33 , 35 , 36 , 37 , 38 , 39 , 40 ], Female Sexual Function Index (FSFI) [ 15 , 17 , 31 , 39 , 41 , 42 ], HPV Impact Profile (HIP) [ 7 , 9 , 21 , 25 <...…”

“…The observational studies were classified using the ROBINS-E tool. Fourteen of the fifty-six included studies were rated as ‘low risk of bias’ [ 10 , 13 , 15 , 22 , 24 , 25 , 26 , 29 , 30 , 34 , 36 , 40 , 47 , 48 ], sixteen as ‘some concerns’ [ 8 , 9 , 11 , 14 , 17 , 19 , 32 , 39 , 44 , 49 , 52 , 53 , 54 , 55 , 56 , 67 ], twenty as ‘high risk’ [ 6 , 7 , 16 , 27 , 31 , 33 , 35 , 38 , 41 , 42 , 43 , 45 , 46 , 50 , 51 , 57 , 58 , 59 , 60 , 61 ], and five as ‘very high risk’ [ 62 , 63 , 64 ...…”

“…However, it seems that this negative impact may be transient and diminishes in the following months [ 6 , 7 , 8 , 9 , 10 ]. On the other hand, one can also find studies that do not support the transient nature of this problem, indicating anxiety and mood problems long after diagnosis [ 9 , 11 ].…”

The psychological impact of esophageal cancer screening on anxiety and depression in China

“…There was no psychological difference between those who detected polyps and those who received negative results ( 35 , 36 ). (d) Cervical cancer: Several studies have shown that an abnormal diagnosis of cervical cancer caused negative emotions, such as increased anxiety levels ( 16 , 37 ). (e) Gastrointestinal cancer: A prior study in Iran found that informing the results of screening may lead to a psychological burden for screeners ( 38 ).…”

“…Previous studies on the psychological impact of cancer screening are inconsistent. Current research in this field mainly focuses on the following types of cancer: lung cancer, breast cancer, colorectal cancer, cervical cancer and ovarian cancer ( 7 , 16 – 18 ). However, research on the psychological impact caused by EC screening is still limited and unclear.…”