5 Reasons Women Don't Get Their Cervical Cancer Screening (Pap Smear) and How to Overcome Them

At Teal Health, we’re on a mission to get everyone with a cervix screened for cervical cancer. Despite the fact that cervical cancer is highly curable when caught early, one in four women in the U.S. has not had her screening. In this article, we’ll cover some of the most common reasons for this, as well as how we all can help overcome them. 

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1. Lack of information

One reason people do not get routinely screened for cervical cancer is simple: They aren’t aware that they should be. Whether it’s misinformation about what an HPV test orPap smear is for, lack of awareness about cervical cancer prevention, or not knowing the cervical cancer screening guidelines, we have a long way to go to make sure everyone has the information they need to make informed decisions about their cervical health. 

According to Teal Health’s Medical Director and OB-GYN Liz Swenson, MD, “Education can start as early as middle or high school health classes. It would also be helpful to have more information on frequented media-based and social platforms like Instagram. Lastly, doctors should talk about HPV and cervical cancer screening during preventive exams and follow-up exams so as not to miss an opportunity to educate.” 

While we can’t control how doctors manage their appointments or how teachers manage their curriculum, here are some ways we can all help get the word out about cervical cancer screening: 

• If you’re the parent of a school-aged child, ask your child’s health class teacher whether the curriculum will cover preventive screenings and tests for HPV and cervical cancer. If not, either share information (like this article!) with them, and/or educate your child. 
• Make sure you get the HPV vaccine, or get your child vaccinated against HPV based on medical recommendations. If you have a daughter, speak with her doctor about when she should begin screenings. 
• Ask your doctor(s) about preventative testing, not just for cervical cancer but for anything else you may not even know about! Doctors are busy but they’re here to help—sometimes you may just need to prompt them by asking the right question. 
• Spread the word. Whether it’s resharing statistics or information on social media or openly talking to your friends and family about your latest Pap smear, spreading the word can save lives.

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2. Lack of access (care deserts)

In over nine percent of all U.S. counties, the majority of residents live in an area with a primary care provider shortage. This means roughly 13 million people live in areas where they cannot easily access a doctor’s appointment at a physical location. Further, as of 2017 half of U.S. counties lack a single obstetrician-gynecologist (OB-GYN), and as recently as 2020, 36 percent of U.S. counties had no hospital or birth center offering obstetrics care.

This lack of access to care can have devastating impacts on women. We saw the impact of lack of access to care during the pandemic—cervical cancer screening rates dropped by 94 percent in 2020. One way we can improve care deserts is by making virtual care and self-screen options far more accessible and available. 

We offer an FDA-authorized at-home self-collection option for cervical cancer screening, the Teal Wand. It works with major insurance plans and is HSA/FSA eligible, and the test itself takes less than 5 minutes from the comfort of your own home.

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3. Lack of trust in medical institutions

According to self-reported data compiled by researchers for the Journal of General Internal Medicine, respondents reported a median score of 31 (within a range of 10 to 50) on the Health Care System Distrust scale, indicating generally high levels of distrust. These numbers are even higher among minority communities and people of color. When asked about their own healthcare experiences, 56 percent of Black Americans reported having at least one negative experience, including having to speak up to get proper care and/or being treated with less respect than other patients. 

Again, improving access to virtual care is critical as it opens opportunities to find a provider the patient can trust, as opposed to being limited to the primary care physician physically closest to them. 

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4. Discomfort and fear of the speculum exam

According to Dr. Swenson, fear of the exam itself is a major reason women don’t get screened for cervical cancer. The speculum—the tool used for the Pap smear or standard clinic-based exam —hasn’t been updated in over 150 years. Needless to say, the device can appear intimidating to many women. Additionally, prior sexual trauma can make the process extremely uncomfortable and distressing for women.

In Teal Health's pre-launch research, 87 percent of respondents said they'd get screened on time if a self-collection option like the Teal Wand were available — and now it is. In that same research, 94 percent of participants preferred the Teal Wand to clinician collection with a speculum. We continue to see that people overwhelmingly want the option to perform what has historically been such an intimate and uncomfortable exam from the comfort of their own homes.

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5. Fear of abnormal results

Of course, as with any medical exam, there is always the fear of abnormal or concerning test results. Dr. Swenson mentions the importance of removing the stigma of HPV and abnormal cervical cancer screening results, something we can again do by talking openly about our experiences with the women in our lives. 

While cervical cancer is a frightening diagnosis, when caught early it is curable 92 percent of the time. This is a highly curable type of cancer that can be eradicated if we ensure everyone with a cervix gets screened on time, every time. 

Teal Health offers an FDA-authorized, comfortable self-collection option for cervical cancer screening that you can conveniently do in the privacy of your own home Check medical eligibility to get started and see if Teal is right for you