Physical after-effects of colposcopy and related procedures and their inter-relationships with distress: a longitudinal survey study

Background: Colposcopy has been, and is likely to remain, the cornerstone of follow-up for women with abnormal screening results. In addition to experiencing psychological after-effects of colposcopy, some women may also experience physical after-effects. In a longitudinal study, we estimated prevalence of post-colposcopy physical after-effects and investigated associations with distress.

Methods: Surveys were mailed to women at 4-, 8- and 12-months post-colposcopy. Details of physical after-effects (pain, bleeding, discharge) experienced post-colposcopy were collected at 4-months. Colposcopy-specific distress was measured at all three time points using the Process Outcome Specific Measure. Linear mixed effects regression models were used to identify relationships between physical after-effects and distress over the 12-month follow-up period, adjusting for socio-demographic and clinical variables.

Results: 584 women were recruited (response rate=73%, 59%, 52% at 4, 8 and 12 months respectively). 80% of women reported ≥1 physical after-effect and multiple physical after-effects were common (3 after-effects=28%). Distress scores declined over time. Over the follow-up period, women who experienced two physical after-effects had on average a distress score that was 2.20 points higher than those who experienced none. Women who experienced all three physical after-effects had on average a 4.58 higher distress score than those who experienced no physical after-effects. Women who were unaware of the possibility of experiencing after-effects had heightened distress.

Conclusions: The prevalence of physical after-effects of colposcopy and related procedures is high. The novel findings of inter-relationships between experiencing multiple physical after-effects, and awareness of the possibility of after-effects, and post-colposcopy distress may be relevant to the development of interventions to alleviate post-colposcopy distress.