Patients’ psychological reactions to colposcopy and LLETZ treatment for cervical intraepithelial neoplasia

Objectives. To compare intra-procedural distress between colposcopy and see-and-treat LLETZ patients, and to assess patients’ perceptions of possible non-pharmacological interventions to reduce distress.

Study design. Retrospective postal questionnaire survey. A total of 151 women aged 20–60 with high-grade cervical intraepithelial neoplasia (CIN), of which 86 had undergone colposcopy, and 65 had undergone LLETZ treatment, recruited from the Department of Obstetrics and Gynaecology, University Hospital Galway, Ireland. Colposcopy- and LLETZ-related distress and pain, and patient perceptions of helpfulness of suggested interventions.

Results. Respondents reported high levels of colposcopy-related anxiety and worry. Those who reported fear of cancer, and concerns about fertility, colposcopy procedure itself and embarrassment had higher anxiety levels than those not reporting these concerns. LLETZ treatment was perceived as distressing, and as more painful than colposcopy. Women's perceptions of certain interventions were associated, and distinct coping profiles were identified.

Conclusions. Colposcopy elicits high levels of anxiety, and see-and-treat LLETZ patients experience greater negative psychological consequences than colposcopy patients. Finding suitable interventions to reduce anxiety levels is recommended.