Open Access Research article

Psychological impact, support and information needs for women with an abnormal Pap smear: comparative results of a questionnaire in three European countries

Joseph Monsonego1*, Javier Cortes2, Daniel Pereira da Silva3, Anna Francisca Jorge3 and Patrick Klein4

Author Affiliations

1 Institut of the Cervix, 174 rue de Courcelles, 75017 Paris, France

2 Spanish Society of Obstetrics and Gynaecology, Alfonso el Magnánimo 29, 07004 Palma de Mallorca, Spain

3 Cervical Pathology Unit, Portuguese Institute of Oncology in Coimbra, Santo António dos Olivais, 3030 Coimbra, Portugal

4 Vision Critical, 61, rue de Monceau, 75008 Paris, France

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BMC Women's Health 2011, 11:18  doi:10.1186/1472-6874-11-18

Published: 25 May 2011



Extensive information on cervical cancer is currently available. Its effectiveness in reducing anxiety in women receiving abnormal Pap tests is not clear. We investigated current practices of communicating abnormal Pap results to evaluate women's reactions and determine the sources of information they use subsequently.


A self-administered questionnaire-based study was performed in 1475 women in France, Spain and Portugal who had received an abnormal Pap smear result in the 12 months prior to completing the questionnaire. Questions covered methods of communication of the result, emotional reactions, support received (from the physician and entourage), and information sources, using pre-specified check box options and rating scales. Data were analyzed by country.


Pap test results were mostly communicated by phone to Spanish women (76%), while physician letters were common in France (59%) and Portugal (36%). Frequent reactions were anxiety, panic and stress, which were less common in Spanish women than their French and Portuguese counterparts. After discussing with their physician, half of the participants were worried, despite rating highly the psychological support received. Over 90% of women in each country discussed their results with family or friends. Partners provided a high level of support. Overall, the abnormal diagnosis and consequences had a low to medium impact on daily, professional and family life and their relationships with their partner. Impact was higher in Spanish women than the French or Portuguese. Information on the diagnosis and its treatment was rated average, and nearly 80% of participants wanted more information, notably French women. Preferred sources were the physician and the Internet.


Women expressed a strong wish for more information about cervical cancer and other HPV-related diseases, and that their physician play a major role in its provision and in support. There was a heavy reliance on the close entourage and the Internet for information, highlighting the need for dissemination of accurate material. Differences between countries suggest information management strategies may need to be tailored to different geographical regions.