1. ¹University of Aberdeen and Grampian University Hospitals, Aberdeen, UK
2. ²National Cancer Registry Ireland, Cork, Ireland
3. ³University of Ottawa, Ontario, Canada
4. ⁴The Postgraduate Medical Institute, University of Hull, in association with Hull York Medical School, UK
5. ⁵Universtiy of Nottingham, Queens Medical Centre & City Hospital, Nottingham, UK
6. ⁶Institute of Medical & Social Care Research, University of Wales Bangor, Bangor, UK

Correspondence: NM Gray, Department of General Practice and Primary Care, Foresterhill Health Centre, University of Aberdeen, Westburn Road, Aberdeen, AB25 2AY, UK. E-mail: n.gray@abdn.ac.uk

Received 8 December 2005; Revised 8 March 2006; Accepted 9 March 2006; Published online 4 April 2006.

Abstract

Receipt of an abnormal cervical smear result often generates fear and confusion and can have a negative impact on a woman's well-being. Most previous studies have focussed on high-grade abnormal smears. This study describes the psychological and psychosocial effects, on women, of having received a low-grade abnormal smear result. Over 3500 women recruited to TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) participated in this study. Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS) at recruitment. Socio-demographic and lifestyle factors, locus of control and factors associated with the psychosocial impact of the abnormal smear result were also assessed. Women reported anxiety levels consistent with those found in previous studies of women with high-grade smear results. Women at highest risk of anxiety were younger, had children, were current smokers, or had the highest levels of physical activity. Interventions that focus particularly on women's understanding of smear results and pre-cancer, and/or directly address their fears about cancer, treatment and fertility might provide the greatest opportunity to reduce the adverse psychosocial impact of receiving a low-grade abnormal cervical smear result.