{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T16:34:12Z","timestamp":1762101252354},"reference-count":54,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2011,12,12]],"date-time":"2011-12-12T00:00:00Z","timestamp":1323648000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Little is known about psychological after\u2010effects of colposcopy and associated investigations and treatment in women with low\u2010grade abnormal cervical cytology. We investigated psychological distress following colposcopy and related procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Nine hundred and eighty\u2010nine women aged 20\u201359\u2009years with routine cytology showing low\u2010grade abnormalities were recruited to the Trial of Management of Borderline and other Low\u2010grade Abnormal smears and attended colposcopy. If the cervical transformation zone (TZ) was colposcopically abnormal, women had immediate loop excision or diagnostic punch biopsies, with treatment if these showed cervical intraepithelial neoplasia grade 2\/3 (CIN2\/3). Women completed socio\u2010demographic and psychosocial questionnaires at recruitment and before colposcopy. Six weeks after their last procedure, women completed the Impact of Event Scale (IES). Logistic regression was used to determine factors associated with significant psychological distress (IES\u2009\u2265\u20099). Analyses were stratified by colposcopic impression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The response rate was 74%. Six weeks after the last procedure, 86 (21%) of 391 women with a normal TZ had significant distress compared with 144 (42%) of 337 with an abnormal TZ. In both groups, significant distress was associated with anxiety pre\u2010colposcopy and pain or discharge afterwards. Additional variables predicting distress in women with a normal TZ were worries about having sex and dissatisfaction with support from others. In women with an abnormal TZ, additional predictors of distress were younger age, CIN2\/3, bleeding following colposcopy and worries about having cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Substantial proportions of women experience psychological distress after colposcopy and related procedures, even when the colposcopy is normal. This is an important cost of cervical screening. Interventions to alleviate these adverse psychological effects are required. Copyright \u00a9 2011 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pon.2097","type":"journal-article","created":{"date-parts":[[2011,12,13]],"date-time":"2011-12-13T03:59:49Z","timestamp":1323748789000},"page":"368-380","source":"Crossref","is-referenced-by-count":39,"title":["Factors associated with psychological distress following colposcopy among women with low\u2010grade abnormal cervical cytology: a prospective study within the Trial Of Management of Borderline and Other Low\u2010grade Abnormal smears (TOMBOLA)"],"prefix":"10.1002","volume":"22","author":[{"given":"Linda","family":"Sharp","sequence":"first","affiliation":[{"name":"National Cancer Registry Ireland  Cork Airport Business Park, Kinsale Road Cork Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seonaidh","family":"Cotton","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology University of Aberdeen  Foresterhill Aberdeen Scotland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne\u2010Elie","family":"Carsin","sequence":"additional","affiliation":[{"name":"National Cancer Registry Ireland  Cork Airport Business Park, Kinsale Road Cork Ireland"},{"name":"Centre for Research in Environmental Epidemiology (CREAL)  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Gray","sequence":"additional","affiliation":[{"name":"Centre of Academic Primary Care University of Aberdeen  Foresterhill Aberdeen Scotland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Thornton","sequence":"additional","affiliation":[{"name":"Centre of Academic Primary Care University of Aberdeen  Foresterhill Aberdeen Scotland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Cruickshank","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology University of Aberdeen  Foresterhill Aberdeen Scotland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian","family":"Little","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Community Medicine University of Ottawa  451 Smyth Rd. Ottawa Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the TOMBOLA Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,12,12]]},"reference":[{"volume-title":"Cervix Cancer Screening","year":"2005","author":"IARC Working Group","key":"e_1_2_9_2_1"},{"key":"e_1_2_9_3_1","unstructured":"Cervical Screening Wales. KC53\/61\/65 Statistical Report \u2013 Adroddiad Ystadegol 2009\/10. Available at URLhttp:\/\/www.screeningservices.org.uk\/csw\/prof\/reports\/KC53\u201061\u201065_09\u201010.pdf[Accessed 14 December 2010]."},{"key":"e_1_2_9_4_1","unstructured":"ISD Scotland.Annual workload data. Up to 31st March 2010. Available at URL http:\/\/www.isdscotland.org\/isd\/cancer\u2010cervical\u2010screening.jsp?pContentID=1673&p_applic=CCC&p_service=Content.show& [Accessed 14 December 2010]."},{"key":"e_1_2_9_5_1","unstructured":"NHS National Statistics. 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