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24 November, 2009
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Pap tests and women with disabilities

 
 

Women with disabilities may be less likely to have regular Pap tests than other women in the community. They may experience a range of barriers in accessing cervical screening services. The Pap test is a quick and simple test used to check for changes to the cells of the cervix that may lead to cervical cancer. It is a woman’s best protection against cervical cancer.

All women between the ages of 18 and 70 years who have ever been sexually active should have a Pap test every two years. However, Australian and overseas studies suggest that women with sensory, physical, intellectual or psychiatric disabilities are less likely to have regular Pap tests than other women.

Barriers to Pap testing
Women with disabilities may experience a number of barriers in accessing cervical screening services. Some of these barriers include:

  • Lack of clear, accessible information
  • Difficulties with transport and access to buildings
  • Lack of money, particularly when living in areas with few or no bulkbilling services
  • Pain when undergoing the Pap test – for example, some women with cerebral palsy experience severe pain caused by muscular spasms
  • Difficulties finding a suitable doctor or nurse Pap test provider – for example, a hearing-impaired woman may not be able to find a doctor or nurse Pap test provider who can communicate using sign language
  • Demands of coping with the disability, which may mean that little time or thought can be devoted to other health matters, such as Pap tests
  • Previous experience – a woman who has had a negative experience with medical staff in the past may be reluctant to have a Pap test
  • Reliance on a carer or attendant to attend tests
  • Lack of emotional support from partner, family and friends.
Attitudes of health care professionals
Some women with disabilities also find the attitudes of some health professionals a barrier. Issues may include:
  • An ill-informed assumption that women with disabilities are not sexually active and don’t need Pap tests
  • Health professionals who have difficulty in meeting the needs of women with disabilities
  • Lack of information on general health matters (such as regular Pap tests) for women in institutions
  • Health care professionals who focus on treating the disability, but neglect to discuss other health care matters.
Suggestions for overcoming barriers
Suggestions include:
  • Ring around the various medical and community health services to find one that is appropriate for you.
  • Tell the receptionist about the nature of your disability, so that you can discuss your support needs in advance of your appointment. For example, you may need to book a longer consultation time.
  • Ask if there is an outreach or home visit service.
  • Visit PapScreen Victoria to search for an appropriate service provider. You can search for a provider based on disability access including ramped entry and disabled parking.
  • Take a family member or friend to your appointment.
  • Discuss your concerns with your health care professional and tell them how they can provide a better service for you.
  • Tell your doctor what position is most comfortable for you when you have a Pap test. Pap tests are usually taken with the woman lying on her back, but let your doctor or health carer know if being on your side is more comfortable for you.
  • Ask the service for appointment reminders.
  • Ask for a Sign interpreter if you need one. They are available from VicDeaf on 1800 287 526 (voice) or (03) 9473 1143 (TTY), but need to be booked well in advance. Online information is also available through the VicDeaf website.
Breast screening
Evidence suggests that women with sensory, physical, intellectual or psychiatric disabilities are also less likely to receive breast screening. One American study found that disability was a key factor for lack of breast screening and Pap tests among Medicare patients.

Where to get help
  • Your doctor
  • Your women’s health nurse
  • Your gynaecologist
  • Family Planning Victoria Tel. (03) 9257 0100
  • The Cancer Council of Victoria Information and Support Line Tel. 13 11 20
  • PapScreen Victoria – for online advice and information
  • Women with Disabilities Australia Tel. (03) 6244 8288
  • VicDeaf Tel. 1800 287 526 (voice) or (03) 9473 1143 (TTY) – to book a Sign interpreter
  • Multilingual Cancer Information Line, Victoria ­ see the Cancer Council Victoria’s website for contact details
Things to remember
  • All women between the ages of 18 and 70 years who have ever been sexually active should have a Pap test every two years.
  • Australian and overseas studies suggest that women with sensory, physical, intellectual or psychiatric disabilities are less likely to have regular two-yearly Pap tests.
  • Some of the barriers experienced by women with disabilities in accessing cervical screening services include lack of information, transport and access difficulties, and negative experiences with health care professionals.
You might also be interested in:
Disability - support services.
Pap test abnormalities.
Pap tests after hysterectomy.
Pap tests and older women.
Pap tests explained.
Pap tests for all women.

Want to know more?
Go to More information for support groups, related links and references.

This page has been produced in consultation with and approved by:

PapScreen Victoria
(Logo links to further information)






  
 


This page has been produced in consultation with, and approved by:

PapScreen Victoria
 
PapScreen Victoria - Cancer Council Victoria

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This Better Health Channel fact sheet has passed through a rigorous approval process. For the latest updates and more information visit www.betterhealth.vic.gov.au.
  
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Last updated: November 2009

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