A longitudinal 2-year follow-up of quality of life in women referred for colposcopy after an abnormal cervical smear

Abstract

Objective To evaluate the long-term impact on quality of life (QoL) in women referred for colposcopy after an abnormal cervical smear. Study design One hundred consecutive women referred for colposcopy for the first time subsequent to receiving notification of an abnormal cervical smear. Women in the study group completed the Swedish Health Survey Short Form-36 (SF-36), the State/Trait Anxiety Inventory (STAI, Form Y), and the Montgomery Åsberg Depression Rating Scale, Self-rate (MADRS-S). The women had follow-up visits at 6 months and 2 years. Results The baseline mean for the mental component summary score and for all mental subscale scores on the SF-36 were statistically significantly lower than Swedish normative data for women. At the end of 2 years, the mental component summary scale and vitality were still significantly lower than such data. There were no differences in QoL between women having had treatment with Large Loop Excision of the Transformation Zone (LLETZ) compared to those who did not. When studied separately, non-depressed women felt no impact on QoL whereas women with higher depression scores judged their mental health QoL worse. Conclusions Women experienced long-lasting negative effects on their mental health, but not on their physical health after referral for colposcopy. LLETZ had no measurable influence on QoL at any of the visits. This indicates that it is not the severity of the lesions or the treatment itself that affects women but the fact of having had an abnormal cervical smear identified. Depressive mood may be a major variable for the perception of low QoL.