The effects of avoidance on cytotoxic/suppressor T cells in women with cervical lesions

The purpose of this study was to examine the relationship between avoidant and intrusive ideation about cancer risk and immune responses among women with mild cervical dysplasia. Participants were 54 women undergoing diagnostic follow-up (i.e. colposcopy) for an abnormal Pap smear test result. Baseline assessments, collected prior to the colposcopy appointment, included demographic and medical history, levels of depression, and the intrusion and avoidance subscales of the Revised Impact of Events Scale. In addition, a sample of blood was obtained at baseline and 6-month follow-up for immune assessments. Hierarchical regression analyses revealed that higher levels of cognitive and behavioral avoidance at baseline predicted a significantly lower percentage of circulating cytotoxic/suppressor T cells (CD3⁺/CD8⁺) at 6-month follow-up, after controlling for baseline levels of cytotoxic/suppressor T cells and potential confounding variables (e.g. age, smoking status). Baseline intrusive ideation was unrelated to changes in percentage of cytotoxic/suppressor T cells. Avoidant ideation, but not intrusive ideation or depression, appears to be associated with alterations in immunologic measures in women with cervical lesions. The findings suggest that it may be important to evaluate the impact of cognitive and behavioral avoidance on progression of precancerous cervical lesions.