Psychosocial impact of inclusion of HPV test on the management of women with atypical squamous cells of undetermined significance: a study within a randomised pragmatic trial in a middle-income country. Issue 6 (2nd June 2020)

• Record Type: Journal Article
• Authors: Garcés-Palacio, Isabel C.; Sanchez, Gloria I.; Baena Zapata, Armando; Córdoba Sánchez, Verónica; Urrea Cosme, Yenny; Rodríguez Zabala, David; Ruiz Osorio, Mario Alberto
• Is Part Of: Psychology & health. Volume 35:Issue 6(2020)
• Page Start: 750
• Page End: 769
• Publication Date: 2020-06-02
• Subjects: Atypical squamous cells of the cervix -- triage -- human papillomavirus -- psychosocial factors; NCT02067468; Clinical health psychology -- Periodicals; Attitude to Health -- Periodicals; Public Opinion -- Periodicals; Psychology -- Periodicals; 150
• DOI: 10.1080/08870446.2019.1678749
• Languages: English
• ISSNs: 0887-0446

Abstract

Abstract: Objective: To assess the psychosocial impact of human papillomavirus (HPV) testing, colposcopy, and Pap-smear, as triage strategies after a Pap-smear with atypical squamous cells of undetermined significance (ASCUS). We also sought to evaluate the psychosocial impact based on the results of the strategies. Methods: Nested within a randomised pragmatic trial, which compared an immediate colposcopy, repeat Pap-smear, and high risk HPV test, we enrolled 675 women between 2012 and 2014. Participants completed surveys at enrollment, two weeks after triage test results, and 1 year thereafter to assess cervical cancer and HPV knowledge, self-esteem, anxiety and HPV impact (HIP). Results: Knowledge, self-esteem, anxiety and HIP improved with no differences among arms. At the baseline, 31.4% and 32.7% of the participants had state anxiety and trait anxiety, respectively, which decreased to 10.7% and 13.3% in the last survey. Compared to HPV-negative women, HPV-positive women in the second survey had worse HIP scores (HPV–: M 22.9 [SD: 15.20]; HPV+: M 35.9 [SD: 19.91]; p < 0.001), trait anxiety (HPV–: M 15.4 [SD 12.73]; HPV+: M 22.9 [SD 13.29]; p = 0.001), and state anxiety (HPV-: M 10.7 [SD 11.25]; HPV+: M 21.4 [SD 14.81]; p < 0.001). Conclusions : HPV testing as a triage strategy for women with ASCUS does not differ from colposcopies or Pap-smears in terms of psychosocial outcomes. Highlights: HPV testing is suitable as a triage strategy for women with ASCUS. Women with ASCUS need education and access to psychosocial support. HPV-positive women as well as women with public health insurance are more in need of psychosocial support.