Dept. of Public Health, Erasmus MC, University Medical Center Rotterdam, Room Ae-108, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Eur J Cancer. 2010 Jan;46(1):134-41. doi: 10.1016/j.ejca.2009.07.003.
Low-grade abnormalities after cervical cancer screening, i.e. borderline (Pap 2) or mildly (Pap 3a1) dyskaryotic (BMD) smear results, are found in considerable numbers of women annually. We compared quality of life and anxiety in women with BMD and a reference group of screening participants who were awaiting smear taking.
Five hundred and fifty women with BMD in the preceding 6-24 months, identified through a regional screening organisation, were sent a questionnaire addressing generic quality of life (12-item Short-Form Health Survey [SF-12], EuroQol classification [EQ-5D]), generic anxiety (STAI-6) and screen-specific anxiety (Psychological Consequences Questionnaire [PCQ]).
After adjustment for differences in background characteristics, women with BMD (n=270) reported more generic anxiety (44.4 versus 32.6) and screen-specific anxiety (5.0 versus 1.4) than the reference group (n=352). The differences indicated statistical (p<0.001) and clinical significance. High anxiety (STAI-6>44) was reported by 49% of the BMD group. Mental quality of life was worse in the BMD than in the reference group (44.2 versus 52.0, p<0.001). The BMD group considered screening more often frightening (27% versus 10%) and reported 'fear for cervical cancer' more frequently as their reason for having a (repeat) smear taken (62/270, 23% versus 12/346, 4%).
CONCLUSION/DISCUSSION: BMD smears were consistently associated with considerable excess anxiety in the period of 6-24 months after the original BMD Pap smears had been taken.
宫颈癌筛查后出现低度异常，即交界性（巴氏涂片 2 级）或轻度（巴氏涂片 3a1 级）不典型增生（BMD）涂片结果，每年在相当数量的女性中发现。我们比较了 BMD 妇女和等待涂片检查的筛查参与者参考组的生活质量和焦虑情况。
通过区域筛查组织，在过去 6-24 个月内识别出 550 名 BMD 女性，向她们发送了一份问卷，内容涉及一般生活质量（12 项简明健康调查 [SF-12]、欧洲五维健康量表 [EQ-5D]）、一般焦虑（STAI-6）和筛查特异性焦虑（心理后果问卷 [PCQ]）。
调整背景特征差异后，BMD 组（n=270）报告的一般焦虑（44.4 比 32.6）和筛查特异性焦虑（5.0 比 1.4）高于参考组（n=352）。差异表明具有统计学意义（p<0.001）和临床意义。BMD 组中有 49%报告存在高焦虑（STAI-6>44）。BMD 组的心理健康状况比参考组差（44.2 比 52.0，p<0.001）。BMD 组认为筛查更可怕（27%比 10%），并更频繁地报告“害怕宫颈癌”作为他们进行（重复）涂片检查的原因（270 名中有 62 名，23%比 346 名中有 12 名，4%）。
结论/讨论：在最初的 BMD 巴氏涂片检查后 6-24 个月期间，BMD 涂片一直与相当大的过度焦虑相关。
