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Saturday, April 20, 2024

Developing Pap test alternatives will save lives

Pap tests are highly effective for detecting cervical cancer, but many find the procedure uncomfortable

By EDEN WINNIFORD — opinion@theaggie.org


Once someone with ovaries turns 21 in the U.S., it is recommended they receive routine cervical cancer screening, commonly known as the Pap test, every three years. Regular Pap tests save lives by detecting cervical cancer at an early stage, which is usually caused by HPV. Although Pap tests are important and effective, the process of completely undressing and having a doctor insert a swab into the vaginal canal and collect a sample from the cervix can feel invasive and uncomfortable.

Some patients also have little choice about when to get a Pap test. Medical providers can (and do) withhold birth control from patients who are overdue for their Pap smears, which takes reproductive autonomy away from people and can make patients feel forced to undergo the test when they are not mentally prepared. This practice ignores that for many, birth control is essential medication. People should be able to make their own reproductive choices no matter what, and using birth control as a bargaining chip is disrespectful toward patients and their bodily autonomy. 

Pap tests can be uncomfortable for anyone, but they can be especially upsetting for transgender individuals, people who have experienced sexual assault and people who have a disability. Body shame also discourages many people from getting regular Pap smears. As of 2019, 23% of women were overdue for Pap tests, compared to 14% in 2009. A different study found that only 27% of transgender men who required cervical cancer screening had one in the past year. Additionally, people of color, low-income individuals, people from rural areas and those without health insurance have limited access to Pap tests. The Pap smear is highly effective for detecting a treatable cancer, but many people still aren’t getting it. 

There are, however, alternatives to the Pap smear and ways to reduce risk for cervical cancer. The HPV vaccine is effective at decreasing HPV transmission rate — although only people with a cervix can get cervical cancer, everyone can spread HPV and should get vaccinated. Some countries have also transitioned to using HPV tests for cervical cancer screening instead of the Pap smear, which can be done at home but also involves vaginal insertion

Additionally, an alternative to the Pap test that does not involve insertion is finally being studied. Research published in 2021 suggests that testing menstrual blood from sanitary pads for high-risk HPV had a higher accuracy rate than the Pap test. Although doctors also tend to perform physical examinations in conjunction with the Pap test, the option to mail or walk in menstrual samples would give people more agency about their bodies. It could also increase the number of people who receive life-saving HIV screening, especially for those who feel uncomfortable about Pap tests.  

There are better ways to encourage regular Pap tests than holding a patient’s birth control hostage. More research should be done on menstrual blood testing, and U.S. hospitals should offer at-home HPV tests as a more comfortable alternative for their patients. The Pap test has already saved countless lives, but expanding care options will save even more.


Written by: Eden Winniford — opinion@theaggie.org

Disclaimer: The views and opinions expressed by individual columnists belong to the columnists alone and do not necessarily indicate the views and opinions held by The California Aggie.




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