Impact of post-colposcopy management on women's long-term worries: results from the UK population-based TOMBOLA trial. Issue 1 (16th September 2015)

• Record Type: Journal Article
• Authors: Sharp, Linda; Cotton, Seonaidh; Cruickshank, Margaret; Gray, Nicola; Smart, Louise; Whynes, David; Little, Julian
• Other Names: author non-byline.; Cruickshank Maggie author non-byline.; Murray Graeme author non-byline.; Parkin David author non-byline.; Smart Louise author non-byline.; Walker Eric author non-byline.; Waugh Norman author non-byline.; Avis Mark author non-byline.; Chilvers Claire author non-byline.; Fielding Katherine author non-byline.; Hammond Rob author non-byline.; Jenkins David author non-byline.; Johnson Jane author non-byline.; Neal Keith author non-byline.; Seth Rashmi author non-byline.; Whynes Dave author non-byline.; Duncan Ian author non-byline.; Robertson Alistair author non-byline.; Little Julian author non-byline.; Sharp Linda author non-byline.; Russell Ian author non-byline.; Walker Leslie author non-byline.; Anthony Breda author non-byline.; Bell Sarah author non-byline.; Bowie Adrienne author non-byline.; Brown Katrina author non-byline.; Brown Joe author non-byline.; Chew Kheng author non-byline.; Cochran Claire author non-byline.; Cotton Seonaidh author non-byline.; Dean Jeannie author non-byline.; Dunn Kate author non-byline.; Edwards Jane author non-byline.; Evans David author non-byline.; Fenty Julie author non-byline.; Finlayson Al author non-byline.; Gallagher Marie author non-byline.; Gray Nicola author non-byline.; Heddle Maureen author non-byline.; Innes Alison author non-byline.; Jobson Debbie author non-byline.; Keillor Mandy author non-byline.; MacGregor Jayne author non-byline.; Mackenzie Sheona author non-byline.; Mackie Amanda author non-byline.; McPherson Gladys author non-byline.; Okorocha Ike author non-byline.; Reilly Morag author non-byline.; Rodgers Joan author non-byline.; Thornton Alison author non-byline.; Yeats Rachel author non-byline.; Alexander Lindyanne author non-byline.; Buchanan Lindsey author non-byline.; Henderson Susan author non-byline.; Iterbeke Tine author non-byline.; Lucas Susanneke author non-byline.; Manderson Gillian author non-byline.; Nicol Sheila author non-byline.; Reid Gael author non-byline.; Robinson Carol author non-byline.; Sandilands Trish author non-byline.; Adrian Marg author non-byline.; Al-Sahab Ahmed author non-byline.; Bentley Elaine author non-byline.; Brook Hazel author non-byline.; Bushby Claire author non-byline.; Cannon Rita author non-byline.; Cooper Brenda author non-byline.; Dowell Ruth author non-byline.; Dunderdale Mark author non-byline.; Gabrawi Dr author non-byline.; Guo Li author non-byline.; Heideman Lisa author non-byline.; Jones Steve author non-byline.; Lawson Salli author non-byline.; Philips Zoë author non-byline.; Platt Christopher author non-byline.; Prabhakaran Shakuntala author non-byline.; Rippin John author non-byline.; Thompson Rose author non-byline.; Williams Elizabeth author non-byline.; Woolley Claire author non-byline.; Cotton Seonaidh author non-byline.; Harrild Kirsten author non-byline.; Norrie John author non-byline.; Sharp Linda author non-byline.; Day Nicholas author non-byline.; Marteau Theresa author non-byline.; Parmar Mahesh author non-byline.; Patnick Julietta author non-byline.; Woodman Ciaran author non-byline.; Altman Doug author non-byline.; Moss Sue author non-byline.; Wells Michael author non-byline.;
• Is Part Of: Journal of family planning and reproductive health care. Volume 42:Issue 1(2016)
• Page Start: 43
• Page End: 51
• Publication Date: 2015-09-16
• Subjects: cervical neoplasms -- cervical screening -- psychosexual -- service delivery -- epidemiology; Birth control -- Periodicals; Contraception -- Periodicals; Reproductive health -- Periodicals; 613.905
• DOI: 10.1136/jfprhc-2015-101170
• Languages: English
• ISSNs: 1471-1893

Abstract

Abstract : Background: Effective cervical screening reduces cancer incidence and mortality. However, these benefits may be accompanied by some harms, potentially including, adverse psychological impacts. Studies suggest women may have concerns about various specific issues, such as cervical cancer. Aim: To compare worries about cervical cancer, future fertility, having sex, and general health between women managed by alternative policies at colposcopy. Design: Multicentre individually-randomised controlled trial, nested within the National Health Service Cervical Screening Programmes. Setting: UK. Methods: 1515 women, aged 20–59 years, with low-grade cytology who attended colposcopy during February 2001–October 2002, were randomised to immediate loop excision or punch biopsies with recall for treatment if cervical intraepithelial neoplasia (CIN)2/3 was confirmed. Women completed questionnaires at recruitment and after 12, 18, 24 and 30 months. Outcomes were prevalence of worries at each time-point (point prevalence) and at any time-point during follow-up (12–30 months; cumulative prevalence). Primary analysis was by intention-to-treat (ITT); secondary per-protocol analysis compared groups according to management received among women with an abnormal transformation zone. Results: Cumulative prevalence of worries was: cervical cancer 40%; having sex 26%, future fertility 24%, and general health 60%. In ITT analyses, there were no statistically significant differences between management arms in cumulative or point prevalence of any of the worries. In per-protocol analyses, between-group differences were significant only for future fertility; cumulative prevalence was highest in women who underwent punch biopsies and treatment. Conclusions: There is no difference in the prevalence of specific worries in women randomised to alternative post-colposcopy management policies. Clinical trial registration: ISRCTN:34841617.