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Psychological effects of a low-grade abnormal cervical smear test result: anxiety and associated factors.

Gray, N.M.; Sharp, L.; Cotton, S.C.; Masson, L.F.; Little, J.; Walker, L.G.; Avis, M.; Philips, Z.; Russell, I.; Whynes, D.; Cruickshank, M.; Woolley, C.M.


N.M. Gray

L. Sharp

S.C. Cotton

J. Little

L.G. Walker

M. Avis

Z. Philips

I. Russell

D. Whynes

M. Cruickshank

C.M. Woolley


Receipt of an abnormal cervical smear result often generates fear and confusion and can have a negative impact on a woman's well-being. Most previous studies have focussed on high-grade abnormal smears. This study describes the psychological and psychosocial effects, on women, of having received a low-grade abnormal smear result. Over 3500 women recruited to TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) participated in this study. Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS) at recruitment. Socio-demographic and lifestyle factors, locus of control and factors associated with the psychosocial impact of the abnormal smear result were also assessed. Women reported anxiety levels consistent with those found in previous studies of women with high-grade smear results. Women at highest risk of anxiety were younger, had children, were current smokers, or had the highest levels of physical activity. Interventions that focus particularly on women's understanding of smear results and pre-cancer, and/or directly address their fears about cancer, treatment and fertility might provide the greatest opportunity to reduce the adverse psychosocial impact of receiving a low-grade abnormal cervical smear result.


GRAY, N.M., SHARP, L., COTTON, S.C., MASSON, L.F., LITTLE, J., WALKER, L.G., AVIS, M., PHILIPS, Z., RUSSELL, I., WHYNES, D., CRUICKSHANK, M. and WOOLLEY, C.M. 2006. Psychological effects of a low-grade abnormal cervical smear test result: anxiety and associated factors. British journal of cancer [online], 94(9), pages 1253-1262. Available from:

Journal Article Type Article
Acceptance Date Mar 9, 2006
Online Publication Date Apr 4, 2006
Publication Date May 8, 2006
Deposit Date Sep 4, 2023
Publicly Available Date Sep 22, 2023
Journal British journal of cancer
Print ISSN 0007-0920
Electronic ISSN 1532-1827
Publisher Springer
Peer Reviewed Peer Reviewed
Volume 94
Issue 9
Pages 1253-1262
Keywords Patient anxiety; Smear tests; Cervical cancer
Public URL


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