Proportion and factors associated with anxiety in women with abnormal cervical cancer screening at King Chulalongkorn Memorial Hospital (KCMH)

Abstract

Objective:  To examine the proportion of anxiety among women who had abnormal cervical cancer screening result and those who underwent routine cervical cancer screening at KCMH.

Secondary objective:  To study the associated factors of anxiety and determine issues of concern in women after cervical cancer screening.

Material and Methods:  A cross-sectional study was performed.  From sample size calculation, 118 participants per group were needed.  While adding 10% dropout, therefore 130 participants per group were recruited.  We recruited 130 women who had abnormal cervical cancer screening result who visited colposcopy clinic and 130 asymptomatic participants who underwent cervical cancer screening. Self-administered questionnaire composed of 6 parts and 104 items.  Thai version Spielberger State-Trait Anxiety Inventory was used to determine anxiety with the cutoff score of 40.  Thai-version of Jalowiec Coping Scale was used to assess coping style. Statistical analysis was performed by SPSS version 22.0.  Univariable and multivariable analysis with p-value of <0.05 was used.

Results:  One hundred and nineteen women who had abnormal cervical cancer screening and 121 asymptomatic participants were enrolled.  The proportion of anxiety in the abnormal cervical cancer screening group was significantly higher than the asymptomatic group (65.5% vs. 47.1%; p=0.002). Multivariable analysis that showed abnormal Pap smear result and anxiety trait were significantly associated with anxiety (OR=3.39; 95% CI 1.58-7.26 and OR=16.68; 95% CI 7.76-35.88, respectively).  Concern of having cancer was found to be high in both groups, but it was significantly higher among those with anxiety (43.8% vs. 18.4%, p=0.026).

Conclusion: Women with abnormal cervical screening had significantly higher anxiety. Therefore, counselling and psychological support were required in this group.