Abstract
AIM: Human papillomavirus (HPV) infection carries a high risk of developing cervical intraepithelial neoplasia (CIN) and cancer in women. For women with CIN, follow-up examinations and treatment are necessary and pose a psychosocial burden. This study investigated the psychosocial burden among women with CIN in Japan. METHODS: This observational, cross-sectional, online survey enrolled women aged 20-49 years in Japan who used a mobile health app (Kencom) linked to an employment-based health insurance association database. Participants completed a screening questionnaire on cervical screening history and CIN status. Eligible women then completed the HPV Impact Profile (HIP) to assess their psychosocial burden. CIN status was confirmed using diagnostic codes recorded in the Kencom database. RESULTS: A total of 404 women were eligible for the study, comprising 121 with confirmed CIN and 283 without CIN. The baseline characteristics were similar, although women with CIN were slightly younger (39.8 vs. 41.5 years) and less likely to be married (55.4% vs. 70.0%). Women with CIN had significantly higher total HIP scores, indicating greater burden than those without CIN (42.2 vs. 24.5; p < 0.001). The burden was evident in women with CIN grade 1 (p < 0.001) and more pronounced in younger women (trend for age groups; p < 0.001). CONCLUSIONS: This study is the first to report a significant psychosocial burden of CIN in Japan, irrespective of CIN severity, with a greater impact in younger women. This psychosocial burden can be alleviated by HPV vaccination with evidence of preventing CIN.