Anxiety in women referred for colposcopy: a prospective observational study

Julia Wittenborn,Severine Iborra,Laila Najjari,Tomas Kupec,Elmar Stickeler,Lisa Wagels

doi:10.1007/s00404-021-06337-8

Abstract

PurposeTo evaluate the occurrence of anxiety in women attending a colposcopic examination within the new cervical cancer screening in Germany.MethodsOne hundred and fifty-six patients were asked to fill out Spielbergers STAI inventory form prior to their colposcopic examination. For the statistical analysis, a two by two between-group design was applied including the following group factors: the repeat factors included patients, who presented to our centre of dysplasia for the first time (new) and patients who have had an examination in our centre before (repeat). Further, the factor diagnosis included two groups: first, patients with cervical dysplasia and second, patients with vulva diseases.ResultsThe analysis of the STAI results showed that patients presenting with cervical dysplasia for the first time had the highest levels of anxiety, directly followed by new patients in the vulva group. The ANOVA revealed a main effect of the repeat factor, F(1,140) = 7.53, p = 0.007. There was no significant effect of diagnosis.ConclusionRegardless of the diagnosis, patients being transferred for a colposcopy within the cervical cancer screening program for the first time have very high anxiety levels. The prospect of a potentially painful examination seems to be a key factor. Only a scientific evaluation of the new cervical cancer screening will be able to show if the rising numbers of colposcopic examinations is really worth the risk of exposing so many more women to the emotional distress of a colposcopy.

Highlights

Colposcopy is the most important examination in the workup of suspicious cervical cytologies
Anxiety levels of all referred patients were assessed, enabling a comparison between patients presenting for the first time and those who have experienced a colposcopic examination before
Mean age differed between the cervical dysplasia group and the vulva group, F(1,141) = 6.61, p = 0.011, but did not differ with regard to the factor repeat, F(1,141) = 1.40, p = 0.240

Summary

Introduction

Colposcopy is the most important examination in the workup of suspicious cervical cytologies. It is a visualization of the cervix using a stereoscopic binocular microscope with low magnification. Leaving a big question mark to the possible reasons and the best way for reducing the observed high levels of anxiety. Anxiety levels of all referred patients were assessed, enabling a comparison between patients presenting for the first time (new) and those who have experienced a colposcopic examination before (repeat). We aimed to investigate differences in anxiety by age group, by different reasons for referral to colposcopy or by the severity of the cytological abnormalities

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Discussion

Conclusion