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Impact of human papillomavirus-related genital diseases on quality of life and psychosocial wellbeing: results of an observational, health-related quality of life study in the UK.

Dominiak-Felden G, Cohet C, Atrux-Tallau S, Gilet H, Tristram A, Fiander A - BMC Public Health (2013)

Bottom Line: A significant psychosocial impact was found in women diagnosed with HPV-related genital diseases, particularly in those with GW.VIN2/3 was found to have a significant negative impact on sexual functioning, and women with VIN2/3 had a highly impaired health state compared with women in the UK general population (weighted mean EQ-5D index score 0.72 vs 0.89, p < 0.001; weighted mean Visual Analogue Scale score 62 vs 85, p < 0.001).The psychosocial aspects of HPV-related diseases need to be considered when evaluating the potential benefit of HPV vaccination.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Epidemiology, Sanofi Pasteur MSD, Lyon, France. GDominiak-Felden@spmsd.com.

ABSTRACT

Background: Data on the psychosocial burden of human papillomavirus (HPV)-related diseases other than cervical cancer are scarce. The objectives of this study were to measure and compare the psychosocial burden and the impact on health-related quality of life (HRQoL) of HPV-related lower genital tract diseases and genital warts (GW) using several generic and disease-specific instruments.

Methods: Overall, 842 individuals with normal cervical cytology (n = 241), borderline nuclear abnormalities and/or mild dyskaryosis (n = 23), cervical intraepithelial neoplasia (CIN)1 (n = 84), CIN2/3 (n = 203), vulval intraepithelial neoplasia (VIN)2/3 (n = 43), GW (n = 186) and a history of GW (non-current) (n = 62) were included. The generic European Quality of Life Index Version 5D (EQ-5D) questionnaire was completed by patients with GW and VIN2/3. Sexual functioning was evaluated using the Change in Sexual Functioning Questionnaire (CSFQ). Psychosocial impact was measured in women using the HPV Impact Profile (HIP) questionnaire. HRQoL was assessed using a GW-specific questionnaire, the Cuestionario Especifico en Condilomas Acuminados (CECA) (completed by patients with GW and history of GW). For each instrument, scores were compared between groups using the Student's t-test. In addition, utility loss due to GW and VIN2/3 was evaluated by comparing mean EQ-5D scores weighted by age and sex with the UK general population normal values.

Results: A significant psychosocial impact was found in women diagnosed with HPV-related genital diseases, particularly in those with GW. The health state of younger adults with GW was significantly impaired compared with UK normal values (mean EQ-5D index score 0.86 vs 0.94, p < 0.001 for 18-24-year-olds; 0.87 vs 0.93, p = 0.030 for 25-34-year-olds). VIN2/3 was found to have a significant negative impact on sexual functioning, and women with VIN2/3 had a highly impaired health state compared with women in the UK general population (weighted mean EQ-5D index score 0.72 vs 0.89, p < 0.001; weighted mean Visual Analogue Scale score 62 vs 85, p < 0.001).

Conclusions: HPV-related lower genital tract lesions and GW significantly impair psychosocial wellbeing and HRQoL. The psychosocial aspects of HPV-related diseases need to be considered when evaluating the potential benefit of HPV vaccination.

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Related in: MedlinePlus

Analysis of psychosocial burden and sexual function assessments (crude data, women only). (a) Comparison of mean total HIP scores. Higher scores indicate greater psychosocial impact. (b) Comparison of mean total CSFQ scores. Higher scores indicate better sexual functioning. p value is from analysis of variance. Borderline, borderline nuclear abnormalities and/or mild dyskaryosis; CIN, cervical intraepithelial neoplasia; CSFQ, Change in Sexual Functioning Questionnaire; GW, genital warts; HIP, Human Papillomavirus Impact Profile; Normal, normal cervical cytology; SEM, standard error of the mean; VIN, vulval intraepithelial neoplasia.
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Figure 2: Analysis of psychosocial burden and sexual function assessments (crude data, women only). (a) Comparison of mean total HIP scores. Higher scores indicate greater psychosocial impact. (b) Comparison of mean total CSFQ scores. Higher scores indicate better sexual functioning. p value is from analysis of variance. Borderline, borderline nuclear abnormalities and/or mild dyskaryosis; CIN, cervical intraepithelial neoplasia; CSFQ, Change in Sexual Functioning Questionnaire; GW, genital warts; HIP, Human Papillomavirus Impact Profile; Normal, normal cervical cytology; SEM, standard error of the mean; VIN, vulval intraepithelial neoplasia.

Mentions: Women with HPV-related disease had significantly higher mean total HIP scores than women with normal cervical cytology (Figure 2a, p < 0.001). Similar results were observed for all HIP dimensions (p ≤ 0.001, for all dimensions).


Impact of human papillomavirus-related genital diseases on quality of life and psychosocial wellbeing: results of an observational, health-related quality of life study in the UK.

Dominiak-Felden G, Cohet C, Atrux-Tallau S, Gilet H, Tristram A, Fiander A - BMC Public Health (2013)

Analysis of psychosocial burden and sexual function assessments (crude data, women only). (a) Comparison of mean total HIP scores. Higher scores indicate greater psychosocial impact. (b) Comparison of mean total CSFQ scores. Higher scores indicate better sexual functioning. p value is from analysis of variance. Borderline, borderline nuclear abnormalities and/or mild dyskaryosis; CIN, cervical intraepithelial neoplasia; CSFQ, Change in Sexual Functioning Questionnaire; GW, genital warts; HIP, Human Papillomavirus Impact Profile; Normal, normal cervical cytology; SEM, standard error of the mean; VIN, vulval intraepithelial neoplasia.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4225724&req=5

Figure 2: Analysis of psychosocial burden and sexual function assessments (crude data, women only). (a) Comparison of mean total HIP scores. Higher scores indicate greater psychosocial impact. (b) Comparison of mean total CSFQ scores. Higher scores indicate better sexual functioning. p value is from analysis of variance. Borderline, borderline nuclear abnormalities and/or mild dyskaryosis; CIN, cervical intraepithelial neoplasia; CSFQ, Change in Sexual Functioning Questionnaire; GW, genital warts; HIP, Human Papillomavirus Impact Profile; Normal, normal cervical cytology; SEM, standard error of the mean; VIN, vulval intraepithelial neoplasia.
Mentions: Women with HPV-related disease had significantly higher mean total HIP scores than women with normal cervical cytology (Figure 2a, p < 0.001). Similar results were observed for all HIP dimensions (p ≤ 0.001, for all dimensions).

Bottom Line: A significant psychosocial impact was found in women diagnosed with HPV-related genital diseases, particularly in those with GW.VIN2/3 was found to have a significant negative impact on sexual functioning, and women with VIN2/3 had a highly impaired health state compared with women in the UK general population (weighted mean EQ-5D index score 0.72 vs 0.89, p < 0.001; weighted mean Visual Analogue Scale score 62 vs 85, p < 0.001).The psychosocial aspects of HPV-related diseases need to be considered when evaluating the potential benefit of HPV vaccination.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Epidemiology, Sanofi Pasteur MSD, Lyon, France. GDominiak-Felden@spmsd.com.

ABSTRACT

Background: Data on the psychosocial burden of human papillomavirus (HPV)-related diseases other than cervical cancer are scarce. The objectives of this study were to measure and compare the psychosocial burden and the impact on health-related quality of life (HRQoL) of HPV-related lower genital tract diseases and genital warts (GW) using several generic and disease-specific instruments.

Methods: Overall, 842 individuals with normal cervical cytology (n = 241), borderline nuclear abnormalities and/or mild dyskaryosis (n = 23), cervical intraepithelial neoplasia (CIN)1 (n = 84), CIN2/3 (n = 203), vulval intraepithelial neoplasia (VIN)2/3 (n = 43), GW (n = 186) and a history of GW (non-current) (n = 62) were included. The generic European Quality of Life Index Version 5D (EQ-5D) questionnaire was completed by patients with GW and VIN2/3. Sexual functioning was evaluated using the Change in Sexual Functioning Questionnaire (CSFQ). Psychosocial impact was measured in women using the HPV Impact Profile (HIP) questionnaire. HRQoL was assessed using a GW-specific questionnaire, the Cuestionario Especifico en Condilomas Acuminados (CECA) (completed by patients with GW and history of GW). For each instrument, scores were compared between groups using the Student's t-test. In addition, utility loss due to GW and VIN2/3 was evaluated by comparing mean EQ-5D scores weighted by age and sex with the UK general population normal values.

Results: A significant psychosocial impact was found in women diagnosed with HPV-related genital diseases, particularly in those with GW. The health state of younger adults with GW was significantly impaired compared with UK normal values (mean EQ-5D index score 0.86 vs 0.94, p < 0.001 for 18-24-year-olds; 0.87 vs 0.93, p = 0.030 for 25-34-year-olds). VIN2/3 was found to have a significant negative impact on sexual functioning, and women with VIN2/3 had a highly impaired health state compared with women in the UK general population (weighted mean EQ-5D index score 0.72 vs 0.89, p < 0.001; weighted mean Visual Analogue Scale score 62 vs 85, p < 0.001).

Conclusions: HPV-related lower genital tract lesions and GW significantly impair psychosocial wellbeing and HRQoL. The psychosocial aspects of HPV-related diseases need to be considered when evaluating the potential benefit of HPV vaccination.

Show MeSH
Related in: MedlinePlus