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J R Soc Med. 1996 May; 89(5): 257–260.
PMCID: PMC1295776

The mildly abnormal cervical smear: patient anxiety and choice of management.


Argument continues over the best management of women with a first mildly dyskaryotic cervical smear: should they be referred for prompt colposcopy, or should they be kept under cytological review, with recourse to colposcopy if the abnormality persists? One consideration is the amount of anxiety generated. We measured anxiety, retrospectively, in two groups of women who had been managed by one or other method. Colposcopy caused more anxiety than cytological surveillance. When told that their smear was mildly abnormal, 47% of the immediate-colposcopy group (n = 182), compared with 33% of the surveillance group (n = 163), thought they had cancer. None the less, there was a general preference for immediate colposcopy. Whatever the relative merits of these two strategies for clinical management, it is clear that both forms of screening, and especially colposcopy, demand better information for patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Campion MJ, Brown JR, McCance DJ, Atia W, Edwards R, Cuzick J, Singer A. Psychosexual trauma of an abnormal cervical smear. Br J Obstet Gynaecol. 1988 Feb;95(2):175–181. [PubMed]
  • Jones MH, Jenkins D, Cuzick J, Wolfendale MR, Jones JJ, Balogun-Lynch C, Usherwood MM, Singer A. Mild cervical dyskaryosis: safety of cytological surveillance. Lancet. 1992 Jun 13;339(8807):1440–1443. [PubMed]
  • Marteau TM, Walker P, Giles J, Smail M. Anxieties in women undergoing colposcopy. Br J Obstet Gynaecol. 1990 Sep;97(9):859–861. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press