Objective: To estimate prevalence of post-colposcopy physical after-effects and investigate associations between these and subsequent psychological distress.
Design: Longitudinal survey.
Setting: Two hospital-based colposcopy clinics.
Population: Women with abnormal cytology who underwent colposcopy (±related procedures).
Methods: Questionnaires were mailed to women 4, 8 and 12 months post-colposcopy. Details of physical after-effects (pain, bleeding and discharge) experienced post-colposcopy were collected at 4 months. Colposcopy-specific distress was measured using the Process Outcome-Specific Measure at all time-points. Linear mixed-effects regression was used to identify associations between physical after-effects and distress over 12 months, adjusting for socio-demographic and clinical variables.
Main outcome measures: Prevalence of post-colposcopy physical after-effects. Associations between the presence of any physical after-effects, awareness of after-effects, and number of after-effects and distress.
Results: Five-hundred and eighty-four women were recruited (response rate = 73, 59 and 52% at 4, 8 and 12 months, respectively). Eighty-two percent of women reported one or more physical after-effect(s). Multiple physical after-effects were common (two after-effects = 25%; three after-effects = 25%). Psychological distress scores declined significantly over time. In adjusted analyses, women who experienced all three physical after-effects had on average a 4.58 (95% CI: 1.10-8.05) higher distress scored than those who experienced no after-effects. Women who were unaware of the possibility of experiencing after-effects scored significantly higher for distress during follow-up.
Conclusions: The prevalence of physical after-effects of colposcopy and related procedures is high. The novel findings of inter-relationships between awareness of the possibility of after-effects and experiencing multiple after-effects, and post-colposcopy distress may be relevant to the development of interventions to alleviate post-colposcopy distress.
Tweetable abstract: Experiencing multiple physical after-effects of colposcopy is associated with psychological distress.
Keywords: Colposcopy; longitudinal survey; physical after-effects; post-colposcopy distress.
© 2017 Royal College of Obstetricians and Gynaecologists.