Cervical Screenings & Assaulted Women

Cervical cancer screening can make abused women feel vulnerable

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Cervical cancer screenings can make some women feel anxious, powerless and seriously uncomfortable. Despite these realities, the screenings are really important because they can save lives!

A recent study asked sexually abused women how often they had cervical screenings and how they felt about them.

Around half said the screenings were too uncomfortable to go through with them at all.

"Tell your doctor which procedures make you uncomfortable."

Louise Cadman, RN, research nurse consultant at the Centre for Cancer Prevention at Queen Mary University, Bart’s and the London School of Medicine in the UK, conducted the research.

For the small study, 135 women who had been sexually abused in childhood completed a survey provided by the National Association for People Abused in Childhood (NAPAC) in the UK.

The survey results showed that 76 percent of women eligible for cervical cancer screening had actually ever gone through with screening.

Of those who had been screened, 49 percent had been at least once in the last 5 years, with 42 percent of women aged 25-49 having gone within the last 3 years.

Compared to the National Health Service Cervical Screening Programme data stating that 79 percent of eligible women in the UK participate in regular cervical screening, the sexually abused women were less likely to get screened.

In the surveys, 21 percent of women claimed cervical screening to be painful, 29 percent reported the test made them feel powerless and 38 percent responded that screening brought similar feelings to those they experienced during abuse.

Fear and anxiety were also reported by one-third of this group.

Authors found that communication, trust, safety and sharing control are barriers for sexually abused women.

Authors suggested that the medical community address these issues to make women feel more comfortable, which would encourage sexually abused women to undergo regular cervical screening.

In a related commentary, training and development manager at the NAPAC, Sarah Kelly, suggests ways in which the cervical screening can be made more comfortable:

• Giving the patient a way to communicate fears and anxieties about the screening.
• Letting the patient bring a person of support to the test.
• Awareness training for healthcare professionals involved in the screening procedure, including appropriate language and terms.
• Ensuring privacy and comfort for the screening.
• Arranging for that the patient to be able to easily halt the test if she were to become uncomfortable and need to stop.

Ms. Kelly said, “Many [sexual abuse] survivors are aware of the increased risk of not being screened and we repeatedly hear that some would rather deal with cervical cancer if it develops than face the experience of regular testing.”

Contributing expert and author of Keep Your Eye on the Prize!: A Young Person's Guide to Adulthood, Barbara Long, MD, PhD, said, “This article addresses an important issue rarely considered by busy healthcare providers."

"Sexual abuse leaves enduring negative emotions related to the sexual organs; these can trip automatically when the area is "invaded," whether in a medical context or not.”

“In addition to the valuable tips offered in the article, the provider also can help equalize the power differential by talking with the patient and asking if the two can be partners in accomplishing this screening that could save her life.”

This study and following commentary was published in October in the Journal of Family Planning & Reproductive Health Care.

 Funding for this study was provided by a grant from Barts CR-UK Centre Development Fund and Cancer Research UK Programme. 

No conflicts of interest were reported.

Reviewed by: 
Review Date: 
October 1, 2012
Last Updated:
October 4, 2012