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The psychosocial impact of human papillomavirus testing in primary cervical screening— a study within a randomized trial
  1. H. C. Kitchener*,
  2. I. Fletcher,
  3. C. Roberts§,
  4. P. Wheeler*,
  5. M. Almonte and
  6. P. Maguire
  1. *Academic Unit of Obstetrics and Gynaecology, Division of Human Development, University of Manchester, Manchester, United Kingdom;
  2. CRC Psychological Medicine Group, Christie CRC Research Centre, Stanley House, Withington, Manchester, United Kingdom;
  3. § Biostatistics Group, University of Manchester, Manchester, United Kingdom; and
  4. Non-Communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, United Kingdom
  1. Address correspondence and reprint requests to: Henry C. Kitchener, MD, Division of Human Development, St. Mary's Hospital, First Floor, Hathersage Road, Manchester M13 0JH, UK. Email: henry.kitchener{at}cmmc.nhs.uk

Abstract

The purpose of the study was to assess the psychosocial impact of human papillomavirus (HPV) testing as an adjunct to cytology in routine primary cervical screening. A controlled study of the psychosocial impact of HPV testing within a randomized trial of HPV testing to assess its efficacy in cervical screening was carried out. The trial provides a randomized setting of revealed HPV results versus concealed results permitting valid comparisons for assessing true psychosocial impact. The setting comprised a large number of general practices in primary care. Women aged 20–64 years who underwent routine cervical screening participated in the study. The intervention was a revealed high-risk HPV test result in addition to cervical cytology. The main outcome was measured using General Health Questionnaire (GHQ-28), Spielberger State–Trait Anxiety Inventory, and Sexual Rating Scale (SRS). Among women with either mildly abnormal or normal cytology, receiving an HPV(+ ve) result did not impact significantly on GHQ caseness and mean scores or on Spielberger State and Trait scores when compared with women in whom the HPV(+ ve) test result was concealed. Among women with normal cytology, receiving an HPV(+ ve) result was associated with a reduction in the Sexual Rating Scale compared with similar women whose HPV(+ ve) result was concealed. HPV testing does not add significant psychologic distress when combined with cytology in routine primary cervical screening.

  • cervical screening
  • HPV
  • psychologic

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Footnotes

  • ‡Peter Maguire died October 2006.

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