Abstract PO-254: The psychological impact of abnormal Pap smear results among Appalachian women
Authors: Adegboyega Adebola , Sha Shuying , Nkwonta Chigozie , Williams Lovoria , Dignan Mark 
Published: December 2020

Abstract
Background: Due to availability of Pap screening to detect precancerous cells the likelihood of dying from cervical cancer has declined. However, about 7% of the 66 million women screened each year have an abnormal Pap smear warranting further evaluation. Women with an abnormal Pap result may experience negative psychological factors that may deter them from obtaining follow up care. The aim of this study is to examine among women with abnormal Pap smear the relationship between psychological factors and demographic characteristics and determine predictors of negative psychological factors. Methods: We conducted a secondary analysis of data collected from Appalachian Kentucky women (N=521) ages ≥18 enrolled in an intervention to test the effectiveness of patient navigation to follow- up for abnormal Pap tests. Data included sociodemographics, Beck depression and anxiety inventories, fatalism, and personal control measures. Multiple logistic regressions was used to investigate the association between demographic variables and negative psychological factors. Results: Participants were predominantly white (96.2%), mean age 28.93±11.03 years, majority (77%) had yearly income below $20,000 and more than half (57%) were uninsured. Participants had a high prevalence of depression 34.6% (n=173), 10% (n=50) experienced moderate or severe anxiety, 20.6% (n=107) had fatalistic beliefs, and 55.1% (n=289) believed they lacked personal control over cancer. Women with lower income had higher prevalence of depression compared with those with higher income (p =.003).
Women with moderate to severe anxiety were significantly older than those with low to moderate depression (34.44 vs 28.34, p &lt; 0.001). In multiple logistic regression model, age and income were the two most important demographic variables related to the psychological factors of women with abnormal Pap smear. Specifically, as age increased, the odds of fatalistic beliefs increased when controlling for other variables in the model, (95%) =1.042 (1.022, 1.062). When education level increased, the odds of fatalistic beliefs decreased, OR (95%) =0.873 (0.800, 0.952).
Conclusion: Women who had abnormal Pap results had considerable negative psychological factors. Clinicians should address women’s questions and concerns about abnormal Pap and discuss the meaning of the result to mitigate associated negative psychological reactions that may deter them from obtaining timely follow up care. Researchers should develop educational interventions targeted at older and less educated women to address negative psychological factors related to abnormal Pap smear.
Citation Format: Adebola Adegboyega, Shuying Sha, Chigozie Nkwonta, Lovoria Williams, Mark Dignan. The psychological impact of abnormal Pap smear results among Appalachian women [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-254.