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 all women screened for cervical cancer. Despite the fact that cervical cancer is highly curable when caught early, one in three 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—as community members, voters, sisters, mothers, daughters, and friends—can help overcome them. 

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1. Lack of information

One of the most prominent reasons women do not get screened for cervical cancer is simple: They aren’t aware that they should be. Whether it’s misinformation about what a Pap 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 every girl and woman has the information they need to make informed decisions about their cervical health. 

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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.” 

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While we can’t control how doctors manage their appointments or teachers 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. 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.

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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. One way we can improve care deserts is by making virtual care and self-screen options far more accessible and available. 

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At Teal Health, we’re working to bring women an at-home self-collection option for cervical cancer screening at no cost to the patient. This is a test that can be done in less than 5 minutes, from the comfort of your own home. We’re inspired by the efforts and innovations of other medical tech companies, all with accessibility and quality patient care at the forefront of their missions. 

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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. 

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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 (Pap smear)

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 —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 for women. 

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Teal Health data indicates that 89 percent of respondents would get screened on time if the Teal self-collection Wand were available. Of the women who have tested Teal’s Wand, 91 percent preferred it to clinician collect with a speculum. Women have spoken: We want the option to perform what has historically been such an intimate and uncomfortable exam from the comfort of our 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 Pap smears, 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 every woman gets screened on time, every time. 

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Teal Health is working to bring you a comfortable self-collection option for cervical cancer screening that you can conveniently do in the privacy of your own home—sign up for our waitlist to be informed when we’re FDA-approved and available in your state. 

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