Dysplasia severity, but not experiences during colposcopy, predicts adherence to follow-up colposcopy

Objective: Patient adherence with treatment recommendations is an essential factor for the effectiveness of cervical cancer screening programs. Psychological factors may play a role in patient adherence to cervical cancer screening. The present study aimed to extend knowledge of women's adherence to follow-up colposcopy, by examining possible predictive biopsychosocial variables measured at colposcopy and objective attendance rates from patients' medical files.

Methods: Baseline data on psychosocial factors (e.g. demographic variables, state anxiety, and pain) were collected from 141 women prior to undergoing colposcopy for the first time (M age = 29.63, SD = 8.39). Experiences of colposcopy and adherence to follow-up (within two years) were assessed subsequently.

Results: There were no associations between adherence and demographic variables. Women with severe dysplasia were more likely to adhere to follow-up colposcopy than women with other histology grades. Women who did not attend for follow-up reported significantly greater state anxiety and pain unpleasantness following colposcopy than women who did attend. A multivariate logistic regression analysis revealed that the psychological experiences of colposcopy did not predict adherence status. However, dysplasia severity made a significant contribution to the model. The odds of adhering to colposcopy for patients with severe dysplasia were 3.57 times higher than for patients with normal histology, and 4.35 times higher than for patients with moderate dysplasia (p = 0.005).

Conclusions: Colposcopy-related experiences do not appear to be strong predictors of adherence, but women with dysplasia grades other than ‘severe’ should be targeted for follow-up recommendations and advice.