Women don't like to do Pap smears

Ok, so we already know that Jamaican men don't like to do the digital rectal examination to screen for prostate cancer, but similarly, are women doing the equally invasive Pap smear examination to screen for cervical cancer? To get an idea of what women were thinking, I placed two questions on my Facebook (FB) wall:

"Do you ladies do your Pap smear exam (the one for cervical cancer)? and "How do you feel about doing the exam?"

I know my FB friends won't mind me sharing some of their edited comments since I indicated I was doing research for an article and I have omitted their names. So here goes:

1. "Yes. After three kids, I don't care who looks anymore - lol. But yes, the exam is very routine and matter-of-fact for me now. They even have students sometimes - hate when they are good looking though - lol."

2. "Ok, how juicy do you want my tale? As you know, I have a child and people say once you have a child, you have no shame, but this is such a delicate matter, almost intimate that I don't agree with that mindset. For a while, I was ambivalent about whether or not I want a male or female "looking up there". When I was younger, I only had male gyn, but I have had female gyn and if you can treat the experience as if they are examining just a part of your body - kind of trick your mind, then it should be over and done like a quickie and, hopefully, you only repeat the process annually,"

3. "Ok. My two cents kinda late. My doctor makes this experience classic ... he has origami mobiles in the exam room and he asks for any special requests in music you might want to hear. Then he tells jokes about delivering babies and about crazy women - after all that, you kinda forget he's poking around up in your ying yang!"

So uncomfortable

Interesting right? You see women are uncomfortable too about the doctor poking around in "their ying yang" ... lol; they just grin and bear it. Some FB friends even "inboxed" me expressing how dreadfully scared they were about doing this examination and these were all educated and professional women. In fact, since last November, when I purposefully started doing this nonrandom, unscientific, survey only one woman actually said that "she likes doing her Pap smear".

The Pap smear checks for changes (which may be cancerous) in the cells of cervix, the lower part of the womb that leads into the vagina. Fairly recently, scientists have linked cervical cancer to the human papillomavirus (HPV) which can be sexually transmitted.

From as far back as 1999, University of the West Indies' Dr Horace Fletcher had published research indicating that 90 per cent of women who die from cervical cancer have never been screened despite the availability of the Pap smear screening.

He indicated that the effectiveness of Pap smear screening "depends on women's knowledge of and attitudes toward screening, the availability of this service, the adequacy of laboratory facilities to process the smears, staffing of clinics and laboratories, quality control, a system of recall of women with positive smears, and economic factors".

He noted that screening rates are low among poor, uneducated women. As a result of staff shortages in government laboratories, there is a long delay before Pap smear results are returned. And I would add that even when screening is done in some private gynaecologist office, there is no clear system to inform women of their results.

Other more recent studies have also indicated a low turnout among Jamaica's women for Pap smears though it appears that qualitative studies are needed to explore exactly why women aren't taking the test. However, maybe health educators and the medical community, especially gynaecologists and nurses doing these examinations, should make it more comfortable for women and not assume that we like people "poking around in our ying yang".

Eulalee Thompson is freelance health editor and a professional counsellor; email: eulalee.thompson@gleanerjm.com.

"Do you ladies do your Pap smear exam (the one for cervical cancer)?" and, "How do you feel about doing the exam?"

I know my FB friends won't mind me sharing some of their edited comments since I indicated I was doing research for an article and I have omitted their names. So here goes:

1. "Yes. After three kids, I don't care who looks anymore - lol. But yes, the exam is very routine and matter-of-fact for me now. They even have students sometimes - hate when they are good looking though - lol."

2. "Ok, how juicy do you want my tale? As you know, I have a child and people say, once you have a child, you have no shame, but this is such a delicate matter, almost intimate that I don't agree with that mindset. For a while, I was ambivalent about whether or not I want a male or female "looking up there". When I was younger, I only had male gyn, but I have had female gyn and, if you can treat the experience as if they are examining just a part of your body - kind of trick your mind, then it should be over and done like a quickie and, hopefully, you only repeat the process annually,"

3. "Ok. My two cents kinda late. My doctor makes this experience classic ... he has origami mobiles in the exam room and he asks for any special requests in music you might want to hear. Then he tells jokes about delivering babies and about crazy women - after all that, you kinda forget he's poking around up in your yin yang!"

So uncomfortable

Interesting, right? You see women are uncomfortable too about the doctor poking around in "their yin yang" ... lol; they just grin and bear it. Some FB friends even "inboxed" me expressing how dreadfully scared they were about doing this examination and these were all educated and professional women. In fact, since last November, when I purposefully started doing this non-random, unscientific survey, only one woman actually said that she "likes doing her Pap smear".

The Pap smear checks for changes (which may be cancerous) in the cells of the cervix, the lower part of the womb that leads into the vagina. Fairly recently, scientists have linked cervical cancer to the human papillomavirus, which can be sexually transmitted.

From as far back as 1999, the University Hospital of the West Indies' Dr Horace Fletcher had published research indicating that 90 per cent of women who die from cervical cancer have never been screened, despite the availability of the Pap smear screening.

He indicated that the effectiveness of Pap smear screening "depends on women's knowledge of and attitudes towards screening, the availability of this service, the adequacy of laboratory facilities to process the smears, staffing of clinics and laboratories, quality control, a system of recall of women with positive smears, and economic factors".

He noted that screening rates are low among poor, uneducated women. As a result of staff shortages in government laboratories, there is a long delay before Pap smear results are returned. And I would add that, even when screening is done in some private gynaecologist's office, there is no clear system to inform women of their results.

Other more recent studies have also indicated a low turnout among Jamaica's women for Pap smears, though it appears that qualitative studies are needed to explore exactly why women aren't taking the test. However, maybe health educators and the medical community, especially gynaecologists and nurses doing these examinations, should make it more comfortable for women and not assume that we like people "poking around in our yin yang".

Eulalee Thompson is a freelance health editor and a professional counsellor; email: eulalee.thompson@gleanerjm.com.