Women 'Poorly Informed' on Cervical Cell Change Treatment

Peter Russell

June 10, 2019

Women having treatment for cervical cell changes should be better informed about side effects, a leading charity said, after survey results showed many were unprepared for impacts such as bleeding, pelvic pain, anxiety, and loss of sex life.

The survey, by Jo's Cervical Cancer Trust, found that a large number of women remained fearful of their risk of developing cancer many years after treatment.

Out of a total of 1622 women surveyed online:

  • One in 5 said possible impacts of treatment were not explained to them at all, with variation in the number aware of specific side effects

  • 86% experienced bleeding or spotting for up to 6 weeks, and 15% were unaware of this common side effect

  • Only 9% were told they could experience changes to their sex life, despite 46% reporting profound psychological changes, including loss of desire, and 33% reporting they experienced pain during or after sex

Call for Better Advice on Treatment

The survey results also revealed a significant psychological impact on many women treated for cervical cell changes, with 71% reporting anxiety, 24% depression, and 86% fearing cancer.

However, only 10% were made aware that they might experience those feelings, the results showed.

"We know from even before this research was done, from the women ringing Jo's support line asking for help, that they are extremely fearful and worried, and those worries are very broad," said Dr Philippa Kaye, GP ambassador for Jo's Cervical Cancer Trust.

She told Medscape News UK that while women could seek advice from their GP if they had concerns, better initial information could be offered in the first place. "What Jo's are calling for is standardised information – maybe even something as simple as an information leaflet – that comes with your results letter, that goes home with you from colposcopy, in order to inform women what they might be feeling."

Responses from women surveyed showed that 45% had concerns about their fertility, including miscarriage or being unable to conceive following diagnosis and treatment.

Also 29% felt that their treatment had affected their relationship.

The survey results also suggested limitations in how treatment options were conveyed to patients. Almost two thirds (60%) said they were not told about different treatment types. Also, the number of women having treatments other than large loop excision of the transformation zone (LLETZ) was low, which the charity said raised questions around the availability and perception of other treatment methods in colposcopy.

Treatment 'Highly Effective'

Jo's Cervical Cancer Trust said that with around 220,000 women diagnosed with cell changes in the UK each year, the results should not undermine the successful and highly effective treatment given to prevent the development of cervical cancer. This had around a 90% success rate, it said.

Commenting on the women's concerns, Dr Kaye said: "All of this has to be weighed up against the risks of doing nothing, and the risks of doing nothing are far, far greater because if your pre-cancerous changes change to cancerous changes, the side effects and the long-term complication impact of that treatment is far more significant.

"But we just need to be clear that women are informed because if you're not informed you can't make a true decision."

Jo's also called for more consistent pathways, especially in the treatment of CIN2, where it said there was inconsistency over whether treatment is given or a more conservative 'watch and wait' approach adopted.

Rebecca Shoosmith, head of support services at Jo's Cervical Cancer Trust, commented: "While treatment for cell changes remains highly effective, we must start to see it as more than just a simple procedure and acknowledge the impact diagnosis and treatment can have on women.

"There has been lots of focus on the needs of those attending screening, and of those with a cancer diagnosis, but this is a group who have previously been overlooked. Better information provision and support for those having treatment is essential."

The survey results were released to coincide with Cervical Screening Awareness Week which runs from 10th to 16th June.

Not so simple: The impact of cervical cell changes and treatment, Jo's Cervical Cancer Trust. Report .

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