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Home Screening and Treatment Testing and Treatment HPV Testing For Cervical Cancer 'Has Psychological Benefits'

HPV Testing For Cervical Cancer 'Has Psychological Benefits'

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Research from Australia suggests women with borderline abnormal Pap test results fare better psychologically when referred to HPV testing rather than a six-month follow-up Pap test.

Unclear or borderline Pap test results occur when abnormal cells are detected but it isn’t clear what might be the cause. Sometimes the abnormalities are due to HPV, but about half of borderline Paps occur for other reasons. Cell samples can be obscured due to presence of yeast or menstrual fluid, or if a woman douches, has intercourse, or inserts a tampon a day or two before having a Pap test. In the U.S., these Pap tests are usually classified as atypical squamous cells of undetermined significance, or ASC-US.Mulling Test Results

ASC-US Paps are seldom dangerous and rarely are due to cervical cancer. Women with these unclear results are often managed either by repeating the Pap at six months, or having an immediate test that checks directly for the presence of “high-risk” types of HPV.

Dr. Kirsten McCaffery and colleagues from the University of Sydney examined the psychosocial impact of both approaches by randomizing women (n=314) with borderline Pap results into three groups: Immediate HPV testing, repeat Pap testing at six months, and an informed consent group that was allowed to choose between the two tests after receiving information on the pros and cons of each (nearly two-thirds of the women in this group chose HPV testing). Subjects were followed for 12 months, and periodically completed questionnaires to assess their psychosocial well being, including specific measures of the women’s anxiety about abnormal Pap results and cervical cancer.

At two weeks following their abnormal Pap, women in the HPV test group had greater psychosocial distress than those in the Pap test group. Over the 12- month course of the study, however, those in the HPV test group fared better psychologically, and along with the informed choice group reported greater satisfaction with their clinical management and care. The authors say women who tested positive for HPV – while initially more anxious - were given “high quality” educational materials about the virus and it’s role in causing cervical cancer, and suggest this may explain why these subjects better adjusted.

K McCaffery, L Irwig, R Turner, SF Chan, P Macaskill, M Lewicka, J Clarke, E Weisberg, A Barratt. Psychosocial Outcomes of Three Triage Methods for the Management of Borderline Abnormal Cervical Smears: An Open Randomised Trial. British Medical Journal, 2010. 340:b4491.