Cervical cancer is the second most common cancer for Thai females. After screening, women diagnosed with atypical squamous cells of undetermined significance (ASC-US) are referred for colposcopy or human papillomavirus (HPV) testing for further diagnostics. The impact of colposcopy and HPV testing on quality of life (QOL) is not well documented. The objective of this study was to evaluate the impact of both diagnostic procedures, to fill the knowledge gap and inform healthcare professionals and decision makers.

This was a cross-sectional study conducted between August 2017 and January 2019 at a university hospital. One hundred and twenty-four and forty-two women were referred for colposcopy and HPV testing, respectively. QOL was assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) and the 5-level EuroQol questionnaire (EQ-5D-5L). Socio-demographic details were collected. The WHOQOL-BREF and EQ-5D-5L scores were compared between colposcopy and HPV testing using independent t-test or Mann-Whitney test, depending on data distribution.

The EQ-5D-5L score and four domains (mobility, self-care, usual activity, anxiety/depression) of EQ-5D-5L responses of the colposcopy and HPV testing groups were not significantly different (p > 0.05). However, the pain/discomfort domain of EQ-5D-5L in the colposcopy group was significantly higher than the HPV testing group (p = 0.032). The overall QOL and four domains (physical, psychological, social relationships, and environmental) of WHOQOL-BREF were not significantly different (p > 0.05).

The QOL scores between the colposcopy and HPV testing groups were similar. HPV testing is more expensive and is not included in all health benefit packages, thus most ASC-US patients are referred to colposcopy according to reimbursement. Some women in the colposcopy group judged their social and working impact worse from the pain. Nevertheless, HPV testing would be alternative option in terms of less pain. The findings from this study may assist in promoting QOL in this group of women.