Psychosocial burden in women with positive human papillomavirus testing after abnormal cervical cytology: atypical squamous cells of undetermined significance (ASC-US)

Abstract

Objective: To evaluate the psychosocial burden in the woman with positive human papillomavirus (HPV) testing following abnormal cervical cytology: atypical squamous cells of undetermined significance (ASC-US). Methods: This prospective cross-sectional study includes Thai women who visited Ramathibodi Hospital for routine cervical screening with the result of ASC-US cervical cytology and reflex HPV testing between July 2021 to March 2022. All participants are required to complete the self-administered HPV Impact Profile (HIP) questionnaires to evaluate their psychosocial burden within a month after receiving their HPV testing results. There are 7 domains in HIP questionnaires: worries and concerns, emotional impact, sexual impact, self-image, partner issues and transmission, interactions with doctors, and control/life impact. The higher scores indicate more burden status. Results: One-hundred and four participants were eligible: 50 participants with positive HPV testing, and 54 participants with negative HPV testing. The participants’ characteristics in both groups were similar. HPV-positive women had significant higher median HIP scores than HPV-negative women (50.0, interquartile range [IQR]=43.1–57.9 and 43.1, IQR=36.6–47.6, p<0.001). Three domain scores: worries and concerns, emotional impact, and partner issues and transmission were also significantly higher in HPV-positive women. The women aged less than 50 years, single/divorced/widowed, or sexually active experienced more psychosocial burden than those aged older than 50 years, married, or sexually inactive. Conclusion: Women with positive HPV testing after ASC-US cervical cytology has more psychosocial distress than HPV-negative women, especially in women who are younger than 50 years old, single/divorced/widowed, or sexually active.