Many Women Misunderstand Pap Tests

Many women do not know what a Pap test is, a new survey shows.

And a second study suggests that many teens do not consider oral sex to be sex.

“While Pap test screening has decreased the number of deaths from cervical cancer by 70 percent, misconceptions persist,” says researcher Raksha Joshi,MBA, of Monmouth Family Health Center in Aberdeen, N.J.

Previous research has shown that two-thirds of teens and young adults think the Pap test is the same as a pelvic exam, Joshi says.

In fact, the Pap test, also called a Pap smear, is most often performed as part of a routine gynecologic exam. Named for George Papanicolaou, the doctor who designed the test, the Pap test takes a sample of cells from the cervix; it can detect early abnormal cell changes that could lead to cervical cancer.

What Is a Pap Smear?

Pap Test Survey

For the new survey, presented at the annual meeting of the American College of Obstetricians and Gynecologists, the researchers asked 351 women seven basic questions about the Pap test.

A total of 192 of the women completed the questionnaire in English, while 159 completed it in Spanish.

Among the findings:

--Only about half of the English-speaking women and two-thirds of the Spanish speakers knew that the Pap test is not used to detect gonorrhea or chlamydia.

--About half of the women in both groups mistakenly thought that they would definitely have cancer if their doctor tells them their Pap test is not normal. In truth, an abnormal Pap test result is not uncommon because the cells of the cervix normally undergo constant change. But not all of these abnormal results indicate changes that are cancer or precancerous.

--Nearly half of women in both groups mistakenly thought they would need a hysterectomy if their Pap test is not normal.

--Only one-third of the Spanish speakers and two-thirds of the English speakers knew the test is performed to detect cancer of the cervix. Of those women who answered incorrectly, most thought the test was used to check for cancer of the uterus, Joshi says.

Women Want Annual Pap Smear Despite Guidelines

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The Youth Perspective

The second survey, of 1,050 teens and young adults, showed that nearly 60 percent had engaged in “hooking up” -- a phrase used to describe one-time sexual encounters that involve anything from kissing to intercourse.

But of the health care professionals surveyed, only 52 percent had ever heard of “hooking up,” says researcher Alexandria J. George, DO, of Lehigh Valley Hospital in Wescosville, Pa.

Of those who did hook up, half engaged in oral sex, she says.

What was disturbing, George says, is that “there is evidence the young people think oral sex is not sex.”

For example, one young woman who responded to the survey said she didn’t need protection from sexually transmitted diseases because she didn’t really have sex, she says.

“While syphilis rates are steady in the U.S., 14.7 percent of cases are now attributable to oral sex,” George says.

“Despite this, many doctors don’t ask about oral sex and many often fail to screen for syphilis,” she says.

“We need to take a more active role with our young patients, especially in recommending use of latex condoms, even plastic food wrap, when performing oral sex,” she says.

James Byrne, MD, chief of obstetrics services at Santa Clara Valley Medical Center in San Jose, Calif., says, “This is eye-opening information that really requires that ob-gyns question their patients about sexual activity, especially oral sex.” This also pertains to any primary care provider.

The common ingredient of both surveys is that “we can’t overestimate the value of basic communication. If doctors don’t ask you, you should ask them,” Byrne tells WebMD.

By Charlene Laino, reviewed by Louise Chang, MD

SOURCES: Raksha Joshi,MBA, MonmouthFamily Health Center, Aberdeen, N.J. Alexandria J. George, DO, Lehigh Valley Hospital, Wescosville, Pa. James Byrne, MD, chief of obstetrics services, Santa Clara Valley Medical Center, San Jose, Calif. American College of Obstetricians and Gynecologists Annual Meeting, Washington, D.C., May 6-10, 2006.