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Sunday, October 19, 2008
Columbus A-C (Hyatt Regency Penns Landing)
Purpose
Evidence-based changes in the Dutch cervical cancer screening program in 1996 aimed at improving the program’s performance and efficiency. As a result percentages of referrals decreased. Currently 1.8% of women participating in the Dutch cervical cancer screening program are referred for borderline (Pap 2) and mildly (Pap 3a1) dyskaryotic smears (BMD) annually. We assessed quality of life and anxiety of women with BMD and compared it with a reference group of participants in cervical cancer screening.
Methods
550 women with BMD in the preceding 6-24 months were identified through the regional screening organisation in Maastricht, the Netherlands, and were sent a questionnaire addressing generic quality of life (SF-12), anxiety (STAI-6), distress (PCQ), and reasons to have a smear.
Results
Women with BMD (n=270) were younger, had paid jobs more frequently, and had partners and children less frequently than the reference group (n=352). After adjustment for these differences women with BMD still had worse mental SF-12 sumscores than the reference group (p=0.009), and they reported more anxiety and distress (p <0.001). Differences in distress scores exceeded the Minimal Important Difference (MID), indicating clinical significance. Women with BMD considered screening more often frightening (27%) than the reference group (10%) and more frequently reported ‘fear for cervical cancer’ as their reason to have a (repeat) smear (23% vs. 3%).
Conclusion/Discussion
We conclude that BMD were associated with excess anxiety and distress, even 6-24 months after the Pap smears had been taken. Our findings suggest that the policy to decrease the rate of referrals reduced the population burden of screening induced anxiety and distress.
Evidence-based changes in the Dutch cervical cancer screening program in 1996 aimed at improving the program’s performance and efficiency. As a result percentages of referrals decreased. Currently 1.8% of women participating in the Dutch cervical cancer screening program are referred for borderline (Pap 2) and mildly (Pap 3a1) dyskaryotic smears (BMD) annually. We assessed quality of life and anxiety of women with BMD and compared it with a reference group of participants in cervical cancer screening.
Methods
550 women with BMD in the preceding 6-24 months were identified through the regional screening organisation in Maastricht, the Netherlands, and were sent a questionnaire addressing generic quality of life (SF-12), anxiety (STAI-6), distress (PCQ), and reasons to have a smear.
Results
Women with BMD (n=270) were younger, had paid jobs more frequently, and had partners and children less frequently than the reference group (n=352). After adjustment for these differences women with BMD still had worse mental SF-12 sumscores than the reference group (p=0.009), and they reported more anxiety and distress (p <0.001). Differences in distress scores exceeded the Minimal Important Difference (MID), indicating clinical significance. Women with BMD considered screening more often frightening (27%) than the reference group (10%) and more frequently reported ‘fear for cervical cancer’ as their reason to have a (repeat) smear (23% vs. 3%).
Conclusion/Discussion
We conclude that BMD were associated with excess anxiety and distress, even 6-24 months after the Pap smears had been taken. Our findings suggest that the policy to decrease the rate of referrals reduced the population burden of screening induced anxiety and distress.
See more of: Poster Session I
See more of: 30th Annual Meeting of the Society for Medical Decision Making (October 19-22, 2008)