Psychological distress in cervical cancer screening: results from a German online survey
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GYNECOLOGIC ONCOLOGY
Psychological distress in cervical cancer screening: results from a German online survey M. Jentschke1 · R. Lehmann2 · N. Drews2 · A. Hansel3 · M. Schmitz3 · P. Hillemanns1 Received: 11 April 2020 / Accepted: 18 June 2020 © The Author(s) 2020
Abstract Purpose The PODCAD study aimed at assessing the degree of psychological stress that women experience due to notification of an abnormal Papanicolaou (Pap) smear finding or a positive human papillomavirus (HPV) test result. Methods We designed a survey to address the question of psychological burden due to abnormal Pap smear results and/or positive HPV tests. In this online campaign approach, we aimed to reach > 2000 women all over Germany irrespective of kind and number of abnormal screening findings. We asked for different kinds of anxiety, distress and uncertainty regarding both, Pap and HPV status. Results A total of 3753 women completed the survey at least partially, and almost 2300 fully completed the survey. Of these, more than 50% were affected already since more than 1 year, and almost half of them had experienced at least three Pap smears in follow-up examinations. Almost 70% of the women were afraid of developing cancer. Intriguingly, almost half of the women with abnormal findings were not aware of their stage of the Pap smear. Furthermore, almost 30% of the women displayed signs of a post-traumatic stress disorder. Conclusion Abnormal results in cervical cancer screening have an impact on patients’ psychology, irrespective of the knowledge and severity of the findings. Better information concerning risks and benefits of cervical cancer screening and about the meaning of the outcome of its procedures are required to decrease this anxiety. Keywords Psychological distress · Cervical cancer screening · Pap smear · HPV test
Introduction Cervical cancer is the fourth most common cancer in women worldwide, with more than 500,000 new cases and > 260,000 deaths reported annually [1]. In developed countries, the established screening routines with Pap and/or HPV testing
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00404-020-05661-9) contains supplementary material, which is available to authorized users. * M. Jentschke Jentschke.Matthias@mh‑hannover.de 1
Department of Gynaecology and Obstetrics, Hannover Medical School, Carl‑Neuberg‑Str. 1, 30625 Hannover, Germany
2
DontBePatient Intelligence GmbH, c/o GCI Management, Brienner Str. 7, 80333 Munich, Germany
3
Oncgnostics GmbH, Winzerlaer Str. 2, 07745 Jena, Germany
have led to a drastic decrease of incidence and mortality of cervical cancer over the last 5 decades. On the other hand, both, Pap smear and HPV testing, have relatively low specificity [2–4] leading to a high rate of women with abnormal Pap smear findings or positive HPV results without needing treatment. In Germany, Pap smear is still commonly used and, many women receive notification of abnormal Pap smear results [5]. Cervical cancer is caused by infecti
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