Cervical Screening/Examinations/Smears

 Increasingly health professionals are beginning to appreciate that attending smear, and other health screening, can be difficult for many patients who have had prior experience of abuse.

Being able to understand ‘what happens’ when you attend for a smear, and how to perhaps reduce the level of anxiety can make the difference (for many) on whether to attend or not.  We give thanks to the GINA project (sister organisation of RSVP Birmingham) for giving us permission to upload the following document on CIS’ters website. The document was created, within GINA, by individuals with lived experience – and we do encourage you to read it, and if not already – please, book a smear.

Cervical Screening Support from the GINA Project

Jo's Trust - Cervical Screening After Sexual Violence

The above link is a helpful page to do with this difficult issue in partnership with Rape Crisis, it also includes quotes from survivors of sexual violence.

The National Association for People Abused in Childhood - NAPAC 

The results revealed in a study undertaken by NAPAC highlighted that only 49 percent of women who were abused as children underwent cervical screening compared to 79 percent of the general population.

NAPAC researchers sought survivors to complete a survey on their website. The survey included closed questions on demographic characteristics and cervical screening attendance. Open ended questions included discussed barriers to screening. A content analysis was used to decipher the responses.

"One way of coping with the trauma of sexual abuse is to control or avoid the triggers of trauma responses," researchers wrote. "Intimate gynaecological examinations can be particularly stressful for women who have been abused because of the parallels with the abuse situation, for example, perceived loss of control, the power disparity and the physical sensation of the examination."

Though the fear of reliving the feelings of shame, guilt, self-blame and feeling unclean, contaminated or dirty may inhibit victims of sexual abuse from undergoing cervical cancer screenings, it is imperative they do. Women who have been sexually abused are more likely to develop cervical lesions in addition to participating in risky behaviour such as drug or alcohol abuse.

NAPAC advice provided to survivors included:

• The survivor having time and space to talk about their fears and anxieties of having the test.
• A friend or supporter being present during the test.
• The smear taker having an understanding and insight into the issues of childhood abuse and the legacy of issues that adult survivors can face.
• A discussion of words/responses which would trigger anxiety or flashbacks for a survivor and finding alternative 'safe' words to replace these. For example, many smear takers would tell the woman to try to relax during the test. The word 'relax' is often used by abusers and can be very frightening for survivors. An alternative is to agree a word in advance to use in discussions with the patient.
• A private and comfortable environment for undressing and for the smear test to be taken.
• A clear signal agreed beforehand for the woman to be able to halt the test if she needs to at any stage.