After-effects reported by women having follow-up cervical cytology tests in primary care: A cohort study within the TOMBOLA trial

Abstract

Background: Although it is recognised that some women experience pain or bleeding during a cervical cytology test, few studies have quantified physical after-effects of these tests. Aim: To investigate the frequency, severity, and duration of after-effects in women undergoing follow-up cervical cytology tests, and to identify subgroups with higher frequencies in Grampian, Tayside, and Nottingham. Design: Cohort study nested with amulti-centre individually randomised controlled trial. Method : The cohort included 1120 women, aged 20-59 years, with low-grade abnormal cervical cytology who completed a baseline sociodemographic questionnaire and had a follow-up cervical cytology test in primary care 6months later. Six weeks after this test, women completed a postal questionnaire on pain, bleeding, and discharge experienced after the test, including duration and severity. The adjusted prevalence of each after-effect was computed using logistic regression. Results : A total of 884 women (79%) completed the aftereffects questionnaire; 30%of women experienced one ormore after-effect: 15% reported pain, 16%bleeding, and 7%discharge. The duration of discharge was &λε;2 days for 66%, 3-6 days for 22%, and &γε;7 days for 11%of women. Pain or bleeding lasted &λε;2 days inmore than 80%of women. Severe after-effects were reported by <1%of women. The prevalence of pain decreased with increasing age. Bleeding wasmore frequent among nulliparous women. Discharge wasmore common among oral contraceptive users. Conclusion : Pain, bleeding, and discharge are not uncommon in women having follow-up cervical cytology tests. Informing women about possible after-effects could better prepare themand provide reassurance, therebyminimising potential non-adherence with follow-up or nonparticipation with screening in the future. ©British Journal of General Practice.