{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T20:53:23Z","timestamp":1783112003273,"version":"3.54.6"},"reference-count":21,"publisher":"BMJ","license":[{"start":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T00:00:00Z","timestamp":1627948800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["DRF\u20102017\u201010\u2010105"],"award-info":[{"award-number":["DRF\u20102017\u201010\u2010105"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002141","name":"Public Health England","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002141","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["C49896\/A17429"],"award-info":[{"award-number":["C49896\/A17429"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["C7492\/A17219"],"award-info":[{"award-number":["C7492\/A17219"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Many countries are now using primary human papillomavirus (HPV) testing for cervical screening, testing for high-risk HPV and using cytology as triage. An HPV-positive result can have an adverse psychological impact, at least in the short term. In this paper, we explore the psychological impact of primary HPV screening over 12 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women were surveyed soon after receiving their results (n=1133) and 6 (n=762) and 12 months (n=537) later. Primary outcomes were anxiety (Short-Form State Anxiety Inventory-6) and distress (General Health Questionnaire-12). Secondary outcomes included concern, worry about cervical cancer and reassurance. Mixed-effects regression models were used to explore differences at each time point and change over time across four groups according to their baseline result: control (HPV negative\/HPV cleared\/normal cytology and not tested for HPV); HPV positive with normal cytology; HPV positive with abnormal cytology; and HPV persistent (ie, second consecutive HPV-positive result).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Women who were HPV positive with abnormal cytology had the highest anxiety scores at baseline (mean=42.2, SD: 15.0), but this had declined by 12\u2009months (mean=37.0, SD: 11.7) and was closer to being within the \u2018normal\u2019 range (scores between 34 and 36 are considered \u2018normal\u2019). This group also had the highest distress at baseline (mean=3.3, SD: 3.8, scores of 3+ indicate case-level distress), but the lowest distress at 12\u2009months (mean=1.9, SD: 3.1). At 6 and 12 months, there were no between-group differences in anxiety or distress for any HPV-positive result group when compared with the control group. The control group were less concerned and more reassured about their result at 6 and 12 months than the HPV-positive with normal cytology group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings suggest the initial adverse impact of an HPV-positive screening result on anxiety and distress diminishes over time. Specific concerns about the result may be longer lasting and efforts should be made to address them.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2020-054780","type":"journal-article","created":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T17:22:20Z","timestamp":1628011340000},"page":"sextrans-2020-054780","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Patterns of anxiety and distress over 12 months following participation in HPV primary screening"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1709-2397","authenticated-orcid":false,"given":"Laura A V","family":"Marlow","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"McBride","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Ridout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9933-7919","authenticated-orcid":false,"given":"Alice S","family":"Forster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Kitchener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4025-9132","authenticated-orcid":false,"given":"Jo","family":"Waller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,3]]},"reference":[{"key":"2021080310201304000_sextrans-2020-054780v1.1","article-title":"Cytology versus HPV testing for cervical cancer screening in the general population","volume":"8","author":"Koliopoulos","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"2021080310201304000_sextrans-2020-054780v1.2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31261"},{"key":"2021080310201304000_sextrans-2020-054780v1.3","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2018-000161"},{"key":"2021080310201304000_sextrans-2020-054780v1.4","unstructured":"Hpv primary screening pilot protocol algorithm, 2016. 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