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. 2020 May;96(3):166-172.
doi: 10.1136/sextrans-2019-054290. Epub 2020 Jan 30.

Levels of anxiety and distress following receipt of positive screening tests in Australia's HPV-based cervical screening programme: a cross-sectional survey

Rachael Helen Dodd  1 , Olivia Mac  2 , Julia M L Brotherton  3   4 , Erin Cvejic  2 , Kirsten J McCaffery  2
Affiliations

Levels of anxiety and distress following receipt of positive screening tests in Australia's HPV-based cervical screening programme: a cross-sectional survey

Rachael Helen Dodd et al. Sex Transm Infect. 2020 May.

Abstract

Objective: From December 2017, the Australian National Cervical Screening Program commenced 5 yearly primary human papillomavirus (HPV) screening; one of the first high-income countries to implement primary HPV screening. This study aimed to examine the psychosocial impact of self-reporting testing HPV positive in a sample of women screened since the renewal of the programme.

Methods: Women in Australia aged 25-74 years who reported participating in cervical screening since December 2017 were recruited through an online market research company to complete a cross-sectional survey. The primary outcomes were anxiety and general distress.

Results: 1004 women completed the online survey; 80.9% reported testing HPV negative (HPV-), 6.5% reported testing HPV positive (HPV+) and 12.9% did not know/remember their test result. Women who reported testing HPV+ had significantly poorer psychological outcomes on a range of measures. Those who reported testing HPV+ had higher anxiety scores (53.03 vs 43.58 out of 80, p<0.001), showed more general distress (3.94 vs 2.52 out of 12, p=0.004), concern about their test result (5.02 vs 2.37, p<0.001), expressed greater distress about their test result (7.06 vs 4.74, p<0.001) and cancer worry (quite or very worried 35.4% vs 11.6%, p<0.001) than women who reported testing HPV-. Concern regarding test results was also significantly higher in women who did not know/remember their test result (3.20 vs 2.37, p<0.001) compared with women who reported testing HPV-. Women who reported testing HPV+ had greater knowledge of HPV (9.25 vs 6.62, p<0.001) and HPV testing (2.44 vs 1.30, p<0.001) than women who reported testing HPV-.

Conclusions: Receipt of an HPV+ test result was associated with high levels of anxiety and distress, which reached clinical significance. Further work is needed to understand whether distress and concern could be reduced by ensuring all women receive high-quality standardised information with their results or by other interventions.

Keywords: HPV; cervical cytology; screening.

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Conflict of interest statement

Competing interests: JMLB’s employer VCS Foundation has received donated human papillomavirus (HPV) tests kits and equipment for unrestricted research purposes from HPV test manufacturers including Roche, Cepheid, Seegene and Becton Dickinson.

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