They are a bit awkward. A bit uncomfortable. A bit embarrassing. But Pap tests are an important part of health care for women. Hiranthi Perera is the manager of PapScreen Victoria. She says all women who have been sexually active – even once – should have a Pap test every two years.
For some women with disabilities there are barriers that still prevent them from having regular tests. These include a lack of clear information about the tests and difficulty accessing this. It is a problem because Pap tests can save lives.
The importance of regular tests
Pap tests are also known as Pap smears. They are named after George Papanicolaou. He was the scientist who devised the test. A Pap test involves the insertion of a device called a speculum into the vagina. This enables the health care provider to see a woman's cervix. It is located at the top of the vagina at the opening of the uterus. A swab is used to collect cells from the surface of the cervix.
Many people believe a Pap test can diagnose cervical cancer. But Hiranthi explains it is "simply a screening test that checks for changes to the cells of the cervix". Further testing can be done if any changes are observed. Untreated changes can lead to cervical cancer. This is why regular testing is so important.
PapScreen Victoria estimates cervical screening saves 1200 Australian women from developing cervical cancer every year. Nine out of ten women who are diagnosed with this type of cancer have not had regular Pap tests. Hiranthi knows that "women with disabilities are less likely to be screened for cervical cancer". Yet she also says the decision to have a Pap test is up to the individual. The problem occurs when a woman wants to have a test but can not access one.
Barriers to access
Just getting to a clinic for a Pap test is the first barrier a woman may face. Once there, she might have difficulty getting onto an examination table. She may have trouble understanding the procedure. A translator could be needed. Sometimes a longer appointment is necessary.
The cost of visiting a doctor can be another barrier for some women. Reliance on carers might also be a problem. Then there is the incorrect assumption that women with disabilities are not sexually active. Doctors, carers and family members may all mistakenly believe this.
Fortunately, PapScreen Victoria is aware of these difficulties. Over the past decade they have worked hard to improve access to Pap tests for all women. Hiranthi says specific resources, webpages and training workshops have been developed. These help "carers, friends and family members understand the needs for cervical screening for women with disabilities".
PapScreen also has resources for women with disabilities themselves. There are plain English and large print booklets that explain Pap tests. Braille and audiovisual materials are also available. In addition, women can use PapScreen Victoria's website to locate accessible clinics.
"They can find information about services in relation to disability parking, wide doorways, hoists and adjustable beds", Hiranthi says. The website also notes clinics where languages other than English are spoken.
Making informed decisions
All of this helps make Pap tests more accessible. But Hiranthi believes more can still be done. Additional resources and materials could be developed. Access at clinics could be upgraded. Better training could also be given to health, welfare and disability sector staff.
The best thing, however, is to provide proper information, support and access for women. This is the only way to enable women to make their own decisions about their health. It is important to do this. Even if it can be a bit awkward sometimes.