Psychosocial factors in risk of cervical intraepithelial lesions

Background: This study examines the relationship among psychosocial factors, behavioral risks for abnormal cervical cytology, and abnormal cervical cytology. Methods: A self-administered questionnaire was used to measure perceived stress, discrimination, lifetime stressful events, optimism, social support, and psychological state. Women with normal Pap smears attending a primary care clinic and women attending a colposcopy clinic because of an abnormal Pap smear were eligible. The scores between the two groups were compared. Results: A total of 265 women participated in the study. There were no significant relationships between psychosocial factors and cervical cytology status. In a regression model, age (B=-0.057, p=0.001) was predictive of having abnormal cervical cytology. Smoking was correlated with an increased family Apgar score (p=0.021), Perceived Stress Scale (PSS) score (p=0.049), and Revised Life Stressor Checklist score (p<0.001). A higher mean number of lifetime male partners was related to increased family Apgar score (p=0.012), Revised Life Stressor Checklist score (p<0.001), and major event discrimination (p<0.001). Earlier age at coitarche was associated with increased family Apgar score (p<0.001). Conclusions: These results do not support that psychosocial factors play a role in the risk of developing abnormal cervical cytology. Behavioral risks for developing abnormal cervical cytology are associated with life stressors, family function, and perceived discrimination.