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The psychosocial burden of human papillomavirus related disease and screening interventions
  1. M Pirotta1,
  2. L Ung2,
  3. A Stein3,
  4. E L Conway3,
  5. T C Mast4,
  6. C K Fairley5,
  7. S Garland
  1. 1
    University of Melbourne, Primary Care Research Unit, Department of General Practice, 200 Berkeley Street, Carlton, Victoria, 3053, Australia
  2. 2
    Royal Women’s Hospital, Melbourne, 20 Flemington Road, Parkville, Victoria, Australia, 3052
  3. 3
    CSL Limited, 45 Poplar Rd Parkville, Victoria, 3052, Australia
  4. 4
    Merck Research Laboratories, PO Box 1000, UG1D-60, North Wales, Pennsylvania, 19454-1099, USA
  5. 5
    University of Melbourne, School of Public Health and Melbourne Sexual Health Centre, 580 Swanston Street, Carlton, Victoria, 3053, Australia
  6. 6
    Microbiology and Infectious Diseases Department, Royal Women's Hospital and Department of Obstetrics and Gynecology, University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Dr Marie Pirotta, University of Melbourne, Department of General Practice, 200 Berkeley Street, Carlton, Victoria, 3053, Australia; mpirotta{at}


Objectives: (i) To assess the psychosocial burden of testing for human papillomavirus (HPV) related genital disease or of a HPV-related diagnosis; (ii) to compare an instrument specifically designed to measure HPV-related psychosocial burden with other generic quality of life (QoL) instruments.

Methods: A cross-sectional design. Researchers recruited women from outpatient clinics at a major tertiary women’s hospital and a sexual health centre who completed surveys within 3 months of receiving results: 331 women, 18–45 years, who had experienced a normal cervical Papanicolaou (Pap) result, an abnormal Pap result, biopsy confirmed cervical intraepithelial neoplasia (CIN) or external genital warts (EGW). Main outcome measures: the HPV impact profile (HIP) designed to assess the psychosocial impact of HPV; two general health-related QoL surveys—the EuroQoL VAS and the Sheehan disability scale; and a HPV knowledge survey.

Results: Response rate was 78%. Significant psychosocial impacts were found for women screened for, or having a diagnosis of, HPV-related genital disease. The largest impact was in women with CIN 2/3 and EGW. This HPV-related psychosocial impact was most sensitively detected with the HIP. Relative to generic measures of QoL, the HIP provided insight into the full range of psychosocial impacts of HPV testing and diagnoses.

Conclusions: Clinicians need to be aware of the potential psychosocial impact of testing for or diagnosing HPV-related genital disease, in particular CIN 2/3 and EGW. The HIP survey is a more sensitive measure of the psychosocial impact of HPV-related genital disease than generic QoL surveys.

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  • ▸ An appendix is published online only at

  • Funding The name of the guarantor and funding agency is CSL Limited. The collection of data, analysis and interpretation of data, and writing of this paper were independent from its funding source.

  • Competing interests AS and ELC are employed by CSL Limited and own stock in CSL Limited. TCM is employed by Merck & Co, Inc. CKF owns shares in CSL Biotherapies, has received honoraria from CSL Biotherapies and Glaxo SmithKline and a research grant from CSL Biotherapies. SG has received advisory board fees and grant support from CSL Limited and GlaxoSmithKline, and lecture and consultancy fees from Merck & Co, Inc. SG reports having previously owned stock in CSL Limited. SG has received grant support through her institution from Merck and GlaxoSmithKline to do clinical trials for HPV/cervical cancer vaccines.

  • Ethics approval Obtained from the relevant committees of the Royal Women’s and Alfred Hospitals.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

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