Testing positive for human papillomavirus in routine cervical screening: examination of psychosocial impact

BJOG. 2004 Dec;111(12):1437-43. doi: 10.1111/j.1471-0528.2004.00279.x.


Objective: To examine the psychosocial impact of testing positive for high risk human papillomavirus (HPV) among women attending primary cervical screening.

Design: Cross sectional survey. Measures were taken at baseline and one week after the receipt of HPV and cytology screening results.

Setting: Well women's clinic in London, UK. Population or Sample Four hundred and twenty-eight women aged 20-64 years.

Methods: Postal questionnaire survey.

Main outcome measures: Psychosocial and psychosexual outcomes were anxiety, distress and feelings about current, past and future sexual relationships.

Results: Women with normal cytology who tested positive for HPV (HPV+) were significantly more anxious and distressed than women who were negative (HPV-) using both a state anxiety measure [F(1,267) = 29, P < 0.0001] and a screening specific measure of psychological distress [F(1,267) = 69, P < 0.0001]. Women with an abnormal or unsatisfactory smear result, who tested HPV+, were significantly more distressed than HPV- women with the same smear result [F(1,267) = 8.8, P = 0.002], but there was no significant difference in state anxiety. Irrespective of cytology result, HPV+ women reported feeling significantly worse about their sexual relationships. Approximately one-third of women who tested positive reported feeling worse about past and future sexual relationships compared with less than 2% of HPV- women.

Conclusion: The findings suggest that testing positive for HPV may have an adverse psychosocial impact, with increased anxiety, distress and concern about sexual relationships. Psychosocial outcomes of HPV testing need further investigation and must be considered alongside clinical and economic decisions to include HPV testing in routine cervical screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / etiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Mass Screening / psychology*
  • Middle Aged
  • Papillomaviridae
  • Papillomavirus Infections / prevention & control
  • Papillomavirus Infections / psychology*
  • Sexual Behavior / psychology
  • Stress, Psychological / etiology
  • Uterine Cervical Dysplasia / prevention & control
  • Uterine Cervical Dysplasia / psychology*
  • Uterine Cervical Neoplasms / prevention & control
  • Uterine Cervical Neoplasms / psychology*
  • Uterine Cervical Neoplasms / virology