Adverse psychologic consequences of positive cytologic cervical screening

Article Abstract:

About 13,000 cases of cervical cancer will occur in 1991, from which about 4,500 women will die. Mortality rates are highest among minority and low-income women, groups that are not reached as effectively by screening programs for early detection of the cancer. However, patient and provider education is improving, resulting in greater rates of cervical screening. Besides the obvious gains of early diagnosis, there is a potential negative psychological impact on women with positive results. A study has reported moderate but not long-lasting psychological distress, which may affect patient compliance with further medical evaluation. The psychological effects associated with positive Pap smear results received by 118 of 224 screened patients were evaluated, as was adherence to further medical examination. The patients were screened at a clinic serving a predominantly low-income area. Women with positive results were significantly more likely to be unemployed and to be less educated, while women with negative results were more likely to be black. More women with positive results had a history of having a sexually transmitted disease. Women with positive results, compared with women with negative results, worried more about cervical cancer and had more impairments in daily activities, mood, sexual interest, and sleep. These psychological impairments affected women with positive results who did not obtain further medical evaluation, while those who obtained further examinations were impaired only in daily activities and in sleep. The results indicate that individuals who are highly distressed about positive Pap smear results need to be targeted by health care workers. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects

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Cytologic screening after hysterectomy for benign disease

Article Abstract:

Women who have had hysterectomies do not appear to benefit from routine cancer screening of vaginal smears. A group of 697 patients who had hysterectomies were followed for an average of 14 years. The average number of vaginal cellular smear examinations during follow up was two per patient. Thirty-three women had an abnormal test result, of which 22 had very slight abnormalities. Mild abnormal cellular growth was detected in eight women, moderate abnormal growth in two, and severe abnormality in one. No woman had cancer. Older women were more likely to have abnormal test results as were women with prior cervical cellular abnormalities. Women with a history of cervical abnormality should be screened every five years, and women with no history of cervical abnormality should be screened every ten years.

Vaginal diseases

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The clinical significance of the poor correlation of cervical dysplasia and cervical malignancy with referral cytologic results

Article Abstract:

Many cases of cervical cancer or its precursor, cervical dysplasia, occur in women with only moderately abnormal Pap smears. In a study of 5,585 women who had a Pap smear, 77% of those who had cervical dysplasia or cervical cancer had a minor Pap test abnormality.

Cervical cancer

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