I dread the pap smear appointment. Is there another way?

Dear Doctor, I am in my late 30s and I have never gone for cervical cancer screening. My worry is the inconvenience and discomfort. Do I have a way out?

Answer

Screening for cancer of the cervix (neck of the womb) is recommended in every woman. This is because cancer of the cervix is one of the most preventable and curable cancers. But it remains the fourth most common cancer affecting women worldwide.

Countries with well-organised screening programs have very low rates of deaths from cervical cancer. But developing countries, where screening programs are disparate, continue to have unacceptably high rates of cervical cancer. Pap smear testing is the common phrase for cervical cancer screening test. Traditionally, it involves making a clinic appointment and undergoing a procedure that includes visualising the cervix, and taking some cells from there.

The nature of the test is thus inevitably invasive. No wonder many women find it intrusive, uncomfortable, inconvenient, and even embarrassing. This has been the basis for the drive to search for alternative ways of undergoing the test. You may already have heard of self-taken pap smears. You essentially get supplied with a testing kit with easy to follow instructions. This means you can do the test at your convenience, either at home, in the office, or wherever else you choose. Once you take the test sample as instructed, all you do thereafter is to drop the specimen at the lab. Results will get back to you and your nominated doctor. In some places, you can even order testing kits online and mail back the specimen, then wait for the results to come through.

To make it even easier, there’s new research indicating reliable screening via a urine sample. Yes, you read it right! You give out a urine sample, it gets screened for the viruses responsible for causing cervical cancer, and you get a result and further recommendations. This negates the discomfort, and removes any cultural barriers that some communities may harbour with the traditional pap smear. Again, urine samples can be collected at desired locations and sent to the lab. All you need is the testing kit, either collected from a testing lab or ordered online.

There is no running away from the fact that some women have deferred cervical cancer screening due to the nature of the test. New ways of testing give you more control. But the newer tests may not yet be readily available in your locality. Does that mean waiting till a more agreeable method of testing gets to you?

Unfortunately for you the recommendation would be not to wait longer due to your age, and the fact that you have never had a pap smear done. Shop around where you are, you may find a facility already offering a more acceptable self-service.

Dr Alfred Murage is a consultant gynecologist and fertility specialist; [email protected]

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