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Don’t fear the smear – SA needs to help women overcome barriers to Pap smears

17 April 2024 Profmed

As South Africa (and the world) continues to grapple with the prolific challenges related to cancer prevention and treatment, the importance of proactive screening cannot be overstated.

For women, the Pap smear acts as a particularly vital preventative barrier to cervical cancer and Profmed Clinical Executive, Justine Lacy, is here to tell you why.

“Cervical cancer is the fourth most common cancer in women globally, but it is largely preventable through early detection,” says Lacy. “Yet, despite its preventability, we still face various barriers preventing widespread access to and understanding of the infamous Pap smear screening.”

Despite the proven effectiveness of Pap smears in detecting abnormal cells before they progress to cancer, Lacy says South African women have alarmingly low screening rates. She says knowledge gaps, attitudes towards screening, and variables like age, education, employment status, and HIV status are influencing screening behaviours.

“Like any health issue, it’s crucial to effectively communicate the importance of Pap smears, especially those who may be hesitant or uninformed,” says Lacy. “This means we have to tailor communication strategies to convey the benefits, risks, and limitations of screening in a balanced and transparent way.”

She says all women aged 30–49 years should be screened for cervical cancer at least once, yet so many millions of South African women lack access to information and health services. How can this change?

Good prevention begins with solid communication
Lacy believes this power should manifest in the form of targeted screening programmes, social media campaigns, and improved education efforts to effectively increase awareness. For her, just getting women through the clinic doors is the biggest barrier.

“Most women don’t even know that Pap smear technology has advanced with the introduction of the Cervical Screening Test,” notes Lacy. “This detects HPV and has revolutionised screening methods and even expanded the time frame between screenings. We have to incorporate this kind of information into our communications efforts.”

If it’s not accessible it’s not useful
While the technology may be available, is it accessible? For Lacy, ensuring accessibility to Pap smear screenings, particularly in rural or underserved areas, requires a multifaceted approach. Measures such as reducing the cost of tests, employing female healthcare providers, conducting health education sessions, and utilising local language speakers are essential in overcoming barriers to screening.

“When we suggest Pap smear screenings, we have to make sure we are debunking common myths and misconceptions surrounding the procedure. From dispelling notions of extreme pain to clarifying the necessity of screenings, addressing misconceptions is vital in encouraging women to prioritise their reproductive health without fear.”

Culture vs prevention
Lacy says there are also cultural and societal issues to factor in. These significantly influence Pap smear screenings. Issues such as embarrassment, fear of test results, lack of support from family, economic constraints, and social stigma all contribute to low screening uptake.

“If we want to address these factors, we are going to need to integrate culturally sensitive approaches and comprehensive healthcare coverage to ensure equitable access to preventive care services. Promoting Pap smear screenings as a cornerstone of preventive care in South Africa necessitates a concerted effort to overcome barriers, improve awareness, and tailor communication strategies to resonate with a culturally and geographically diverse population of women.

“If we can address these challenges and promoting informed decision-making, we can work towards reducing the burden of cervical cancer and pave a path towards better health outcomes for all women in our nation,” Lacy concludes.

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