Understanding women's responses to treatment for cervical intra-epithelial neoplasia.

Laser treatment is held to prevent the development of cervical intra-epithelial neoplasia, or CIN, into invasive carcinoma of the cervix. Recent work has found that such treatment represents a considerable emotional upset in the lives of many women. In this study, the impact of treatment was further investigated, using a control group to separate the effects of diagnosis from those of treatment. The main findings showed that the diagnosis of CIN is traumatic. Women experience high levels of intrusive thoughts and avoidance, and in response to perceived threats to their health, and existing beliefs about themselves, they also experience high levels of anger. An impact of treatment over and above that of diagnosis was not found. From the interview data, diagnosis has its traumatic impact through women's understanding of CIN's association with cervical cancer, a potentially life-threatening disease. Interview data also suggest that body image and sexual relationships suffer following diagnosis because of CIN's postulated causal relationship to the sexually transmitted wart virus. Fear of the progression of CIN to cervical cancer is consistent with the medical model which provides the rationale for preventative laser treatment. It is speculated that once women are diagnosed as having CIN, the spectre of cancer is raised and their anxiety may be such that being monitored and not immediately treated may cause them great distress.