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Psychosexual distress following routine primary human papillomavirus testing: a longitudinal evaluation within the English Cervical Screening Programme
Author(s) -
Bennett KF,
Waller J,
McBride E,
Forster AS,
Di Gessa G,
Kitchener H,
Marlow LAV
Publication year - 2021
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.16460
Subject(s) - psychosexual development , medicine , distress , gynecology , psychosocial , cervical screening , cytology , human papillomavirus , obstetrics , cervical cancer , cancer , clinical psychology , psychology , psychiatry , pathology , psychoanalysis
Objective To assess psychosexual distress over a 12‐month period among women receiving different human papillomavirus (HPV) and cytology results in the context of the English HPV primary screening pilot. Design Longitudinal, between‐group study. Setting Five sites in England where primary HPV testing was piloted. Population Women aged 24–65 years ( n = 1133) who had taken part in the NHS Cervical Screening Programme. Methods Women were sent a postal questionnaire soon after receiving their screening results (baseline) and 6 and 12 months later. Data were analysed using linear regression models to compare psychosexual outcomes between groups receiving six possible combinations of HPV and cytology screening results, including a control group with normal cytology and no HPV test. Main outcome measures Psychosexual distress, assessed using six items from the Psychosocial Effects of Abnormal Pap Smears Questionnaire (PEAPS‐Q). Results At all time points, there was an association between screening result group and psychosexual distress (all P < 0.001). At baseline, mean psychosexual distress score (possible range: 1–5) was significantly higher among women with HPV and normal cytology ( B = 1.15, 95% CI 0.96–1.34), HPV and abnormal cytology ( B = 1.02, 95% CI: 0.78–1.27) and persistent HPV ( B = 0.90, 95% CI 0.70–1.10) compared with the control group (all P < 0.001). At the 6 and 12 month follow ups the pattern of results were similar, but coefficients were smaller. Conclusions Our findings suggest receiving an HPV‐positive result can cause psychosexual distress, particularly in the short‐term. Developing interventions to minimise the psychosexual burden of testing HPV‐positive will be essential to avoid unnecessary harm to the millions of women taking part in cervical screening. Tweetable abstract Receiving an HPV‐positive result following primary HPV testing can cause psychosexual distress, particularly in the short‐term.