Abstract
PurposeThe PODCAD study aimed at assessing the degree of psychological stress that women experience due to notification of an abnormal Papanicolaou (Pap) smear finding or a positive human papillomavirus (HPV) test result.MethodsWe designed a survey to address the question of psychological burden due to abnormal Pap smear results and/or positive HPV tests. In this online campaign approach, we aimed to reach > 2000 women all over Germany irrespective of kind and number of abnormal screening findings. We asked for different kinds of anxiety, distress and uncertainty regarding both, Pap and HPV status.ResultsA total of 3753 women completed the survey at least partially, and almost 2300 fully completed the survey. Of these, more than 50% were affected already since more than 1 year, and almost half of them had experienced at least three Pap smears in follow-up examinations. Almost 70% of the women were afraid of developing cancer. Intriguingly, almost half of the women with abnormal findings were not aware of their stage of the Pap smear. Furthermore, almost 30% of the women displayed signs of a post-traumatic stress disorder.ConclusionAbnormal results in cervical cancer screening have an impact on patients’ psychology, irrespective of the knowledge and severity of the findings. Better information concerning risks and benefits of cervical cancer screening and about the meaning of the outcome of its procedures are required to decrease this anxiety.
Highlights
Cervical cancer is the fourth most common cancer in women worldwide, with more than 500,000 new cases and > 260,000 deaths reported annually [1]
Both, Pap smear and human papillomavirus (HPV) testing, have relatively low specificity [2,3,4] leading to a high rate of women with abnormal Pap smear findings or positive HPV results without needing treatment
The results presented below are based on approximately 2300 complete surveys which fulfilled quality criteria and represented the target population, women with at least one abnormal Pap smear
Summary
Cervical cancer is the fourth most common cancer in women worldwide, with more than 500,000 new cases and > 260,000 deaths reported annually [1]. Both, Pap smear and HPV testing, have relatively low specificity [2,3,4] leading to a high rate of women with abnormal Pap smear findings or positive HPV results without needing treatment. In Germany, Pap smear is still commonly used and, many women receive notification of abnormal Pap smear results [5]. Cervical cancer is caused by infection with high-risk HPV, and it develops very slowly via so-called cervical intraepithelial lesions. The fact that vaccination against infection with the most common types of cancer-causing HPV is available has increased the awareness of HPV infection. Many women are still not aware of the connection between HPV infection and abnormal Pap smear results [7, 8]
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