Impact of alternative management policies on health-related quality of life in women with low-grade abnormal cervical cytology referred for colposcopy

David K Whynes, Linda Sharp, Seonaidh C Cotton, Margaret Cruickshank, Nicola M Gray, Julian Little, Norman Waugh

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVE: To assess the health-related quality of life (HRQoL) over 30 months among women who received colposcopy following low-grade abnormal cervical cytology. DESIGN: 751 women with low-grade abnormal cytology were seen for colposcopy. Of these, 350 additionally underwent either immediate treatment by large loop excision of the transformation zone (LLETZ) or investigation by punch biopsy followed by treatment of high-grade cervical intraepithelial neoplasia if present. The HRQoL of the women was assessed on seven separate occasions over 30 months by means of the EQ-5D instrument. Outcomes for women receiving colposcopy only, colposcopy with biopsy and colposcopy with LLETZ were compared. RESULTS: Women experienced modest short-term increases in HRQoL, statistically significant for the colposcopy only and biopsy groups but not for the LLETZ group. HRQoL in all three groups thereafter fell until 12 months following recruitment, significantly so for the LLETZ group. Changes in EQ-5D index score arose primarily from changes in severities in the "pain and discomfort" and "anxiety and depression" domains. Changes in the visual analogue scale (VAS) representations of quality of life corresponded closely to those of the index scores and most of the VAS scores themselves did not differ from VAS population norms. All inter-assessment changes in index scores were smaller than the minimum important difference for the instrument. Beyond 18 months from recruitment, HRQoL stabilised in all three groups. CONCLUSION: Women referred to colposcopy following a low-grade abnormal smear test result experienced a short-term improvement in their health-related quality of life, but the long-term effect was insubstantial. HRQoL over the post-recruitment follow-up period did not vary by intervention.
Original languageEnglish
Pages (from-to)88-92
Number of pages5
JournalEuropean Journal of Obstetrics & Gynecology and Reproductive Biology
Volume169
Issue number1
DOIs
Publication statusPublished - Jul 2013

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Colposcopy
Cell Biology
Quality of Life
Visual Analog Scale
Biopsy
Cervical Intraepithelial Neoplasia
Anxiety
Depression
Pain
Therapeutics

Keywords

  • cervical cancer
  • colposcopy
  • EQ-5D
  • health-related quality of life
  • large loop excision
  • screening

Cite this

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title = "Impact of alternative management policies on health-related quality of life in women with low-grade abnormal cervical cytology referred for colposcopy",
abstract = "OBJECTIVE: To assess the health-related quality of life (HRQoL) over 30 months among women who received colposcopy following low-grade abnormal cervical cytology. DESIGN: 751 women with low-grade abnormal cytology were seen for colposcopy. Of these, 350 additionally underwent either immediate treatment by large loop excision of the transformation zone (LLETZ) or investigation by punch biopsy followed by treatment of high-grade cervical intraepithelial neoplasia if present. The HRQoL of the women was assessed on seven separate occasions over 30 months by means of the EQ-5D instrument. Outcomes for women receiving colposcopy only, colposcopy with biopsy and colposcopy with LLETZ were compared. RESULTS: Women experienced modest short-term increases in HRQoL, statistically significant for the colposcopy only and biopsy groups but not for the LLETZ group. HRQoL in all three groups thereafter fell until 12 months following recruitment, significantly so for the LLETZ group. Changes in EQ-5D index score arose primarily from changes in severities in the {"}pain and discomfort{"} and {"}anxiety and depression{"} domains. Changes in the visual analogue scale (VAS) representations of quality of life corresponded closely to those of the index scores and most of the VAS scores themselves did not differ from VAS population norms. All inter-assessment changes in index scores were smaller than the minimum important difference for the instrument. Beyond 18 months from recruitment, HRQoL stabilised in all three groups. CONCLUSION: Women referred to colposcopy following a low-grade abnormal smear test result experienced a short-term improvement in their health-related quality of life, but the long-term effect was insubstantial. HRQoL over the post-recruitment follow-up period did not vary by intervention.",
keywords = "cervical cancer, colposcopy, EQ-5D, health-related quality of life, large loop excision, screening",
author = "Whynes, {David K} and Linda Sharp and Cotton, {Seonaidh C} and Margaret Cruickshank and Gray, {Nicola M} and Julian Little and Norman Waugh",
note = "Copyright {\circledC} 2013 Elsevier Ireland Ltd. All rights reserved.",
year = "2013",
month = "7",
doi = "10.1016/j.ejogrb.2013.02.006",
language = "English",
volume = "169",
pages = "88--92",
journal = "European Journal of Obstetrics & Gynecology and Reproductive Biology",
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TY - JOUR

T1 - Impact of alternative management policies on health-related quality of life in women with low-grade abnormal cervical cytology referred for colposcopy

AU - Whynes, David K

AU - Sharp, Linda

AU - Cotton, Seonaidh C

AU - Cruickshank, Margaret

AU - Gray, Nicola M

AU - Little, Julian

AU - Waugh, Norman

N1 - Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

PY - 2013/7

Y1 - 2013/7

N2 - OBJECTIVE: To assess the health-related quality of life (HRQoL) over 30 months among women who received colposcopy following low-grade abnormal cervical cytology. DESIGN: 751 women with low-grade abnormal cytology were seen for colposcopy. Of these, 350 additionally underwent either immediate treatment by large loop excision of the transformation zone (LLETZ) or investigation by punch biopsy followed by treatment of high-grade cervical intraepithelial neoplasia if present. The HRQoL of the women was assessed on seven separate occasions over 30 months by means of the EQ-5D instrument. Outcomes for women receiving colposcopy only, colposcopy with biopsy and colposcopy with LLETZ were compared. RESULTS: Women experienced modest short-term increases in HRQoL, statistically significant for the colposcopy only and biopsy groups but not for the LLETZ group. HRQoL in all three groups thereafter fell until 12 months following recruitment, significantly so for the LLETZ group. Changes in EQ-5D index score arose primarily from changes in severities in the "pain and discomfort" and "anxiety and depression" domains. Changes in the visual analogue scale (VAS) representations of quality of life corresponded closely to those of the index scores and most of the VAS scores themselves did not differ from VAS population norms. All inter-assessment changes in index scores were smaller than the minimum important difference for the instrument. Beyond 18 months from recruitment, HRQoL stabilised in all three groups. CONCLUSION: Women referred to colposcopy following a low-grade abnormal smear test result experienced a short-term improvement in their health-related quality of life, but the long-term effect was insubstantial. HRQoL over the post-recruitment follow-up period did not vary by intervention.

AB - OBJECTIVE: To assess the health-related quality of life (HRQoL) over 30 months among women who received colposcopy following low-grade abnormal cervical cytology. DESIGN: 751 women with low-grade abnormal cytology were seen for colposcopy. Of these, 350 additionally underwent either immediate treatment by large loop excision of the transformation zone (LLETZ) or investigation by punch biopsy followed by treatment of high-grade cervical intraepithelial neoplasia if present. The HRQoL of the women was assessed on seven separate occasions over 30 months by means of the EQ-5D instrument. Outcomes for women receiving colposcopy only, colposcopy with biopsy and colposcopy with LLETZ were compared. RESULTS: Women experienced modest short-term increases in HRQoL, statistically significant for the colposcopy only and biopsy groups but not for the LLETZ group. HRQoL in all three groups thereafter fell until 12 months following recruitment, significantly so for the LLETZ group. Changes in EQ-5D index score arose primarily from changes in severities in the "pain and discomfort" and "anxiety and depression" domains. Changes in the visual analogue scale (VAS) representations of quality of life corresponded closely to those of the index scores and most of the VAS scores themselves did not differ from VAS population norms. All inter-assessment changes in index scores were smaller than the minimum important difference for the instrument. Beyond 18 months from recruitment, HRQoL stabilised in all three groups. CONCLUSION: Women referred to colposcopy following a low-grade abnormal smear test result experienced a short-term improvement in their health-related quality of life, but the long-term effect was insubstantial. HRQoL over the post-recruitment follow-up period did not vary by intervention.

KW - cervical cancer

KW - colposcopy

KW - EQ-5D

KW - health-related quality of life

KW - large loop excision

KW - screening

U2 - 10.1016/j.ejogrb.2013.02.006

DO - 10.1016/j.ejogrb.2013.02.006

M3 - Article

VL - 169

SP - 88

EP - 92

JO - European Journal of Obstetrics & Gynecology and Reproductive Biology

JF - European Journal of Obstetrics & Gynecology and Reproductive Biology

SN - 0301-2115

IS - 1

ER -