Abstract
BackgroundData on the psychosocial burden of human papillomavirus (HPV)-related diseases other than cervical cancer are scarce. The objectives of this study were to measure and compare the psychosocial burden and the impact on health-related quality of life (HRQoL) of HPV-related lower genital tract diseases and genital warts (GW) using several generic and disease-specific instruments.MethodsOverall, 842 individuals with normal cervical cytology (n = 241), borderline nuclear abnormalities and/or mild dyskaryosis (n = 23), cervical intraepithelial neoplasia (CIN)1 (n = 84), CIN2/3 (n = 203), vulval intraepithelial neoplasia (VIN)2/3 (n = 43), GW (n = 186) and a history of GW (non-current) (n = 62) were included. The generic European Quality of Life Index Version 5D (EQ-5D) questionnaire was completed by patients with GW and VIN2/3. Sexual functioning was evaluated using the Change in Sexual Functioning Questionnaire (CSFQ). Psychosocial impact was measured in women using the HPV Impact Profile (HIP) questionnaire. HRQoL was assessed using a GW-specific questionnaire, the Cuestionario Especifico en Condilomas Acuminados (CECA) (completed by patients with GW and history of GW). For each instrument, scores were compared between groups using the Student's t-test. In addition, utility loss due to GW and VIN2/3 was evaluated by comparing mean EQ-5D scores weighted by age and sex with the UK general population normal values.ResultsA significant psychosocial impact was found in women diagnosed with HPV-related genital diseases, particularly in those with GW. The health state of younger adults with GW was significantly impaired compared with UK normal values (mean EQ-5D index score 0.86 vs 0.94, p < 0.001 for 18–24-year-olds; 0.87 vs 0.93, p = 0.030 for 25–34-year-olds). VIN2/3 was found to have a significant negative impact on sexual functioning, and women with VIN2/3 had a highly impaired health state compared with women in the UK general population (weighted mean EQ-5D index score 0.72 vs 0.89, p < 0.001; weighted mean Visual Analogue Scale score 62 vs 85, p < 0.001).ConclusionsHPV-related lower genital tract lesions and GW significantly impair psychosocial wellbeing and HRQoL. The psychosocial aspects of HPV-related diseases need to be considered when evaluating the potential benefit of HPV vaccination.
Highlights
Data on the psychosocial burden of human papillomavirus (HPV)-related diseases other than cervical cancer are scarce
Patients with VIN2/3, genital warts (GW) and history of GW completed at least one item of the European Quality of Life Index Version 5D (EQ-5D) or the Cuestionario Especifico en Condilomas Acuminados (CECA) (n = 290)
In the Papillomavirus ASsociated QUAlity of Life (PasQual) study, a significant negative psychosocial impact was found in women with a range of HPV-related diseases when compared with women with normal cervical cytology
Summary
Data on the psychosocial burden of human papillomavirus (HPV)-related diseases other than cervical cancer are scarce. The main burden of HPV-related diseases is due to cervical cancer. HPV-related precancerous lesions of the lower genital tract (e.g. cervical intraepithelial neoplasia [CIN] grades 1/2/3 and vulval intraepithelial neoplasia [VIN] grades 1/2/3) are potentially serious conditions, requiring repeated health care visits for disease monitoring and treatment. Over the last 40 years, the incidence of VIN and vulval cancer has increased in developed countries, predominantly among women aged
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