355: Interventions may reduce anxiety during colposcopy

July 04, 2012

PEARLS 355: written by Brian R McAvoy

Clinical question: How effective are interventions aimed at reducing anxiety during colposcopic examination?

Bottom line: Music during colposcopy significantly reduced anxiety levels and pain experienced during the procedure, compared with not listening to music. Video colposcopy (viewing the procedure on a TV monitor) also reduced anxiety significantly. There was no statistically significant difference between anxiety levels prior to colposcopy in women receiving information leaflets versus no leaflets, nor in those receiving information leaflets, video and counselling versus information leaflets and video but no counselling. However, knowledge scores were significantly higher and psychosexual dysfunction scores were significantly lower in women who received leaflets compared with those who did not.

Caveat: Overall, the methodological quality of the trials and the standard of reporting were poor. Some trials suffered from small numbers, and, in most cases, moderate or high risk of bias.

Context: Women can experience high levels of anxiety at all stages of screening for cervical cancer, including colposcopy. Colposcopy has been shown to be associated with high levels of anxiety, even higher than anxiety levels in women before surgery and similar to the anxiety levels in women following an abnormal screening test for foetal abnormalities. High levels of anxiety before and during colposcopy can have psychological consequences, including pain, discomfort and failure to return for follow-up.

Cochrane Systematic Review
Galaal K et al. Interventions for reducing anxiety in women undergoing colposcopy. Cochrane Reviews, 2011, Issue 12. Article
No. CD006013. DOI: 10.1002/14651858.CD006013.pub3.
This review contains 6 studies involving 882 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.