Abnormal Pap test results and the rurality factor

Conclusion: An Australian woman is at increased risk of developing cervical dysplasia if she lives in a rural area, identifies as an Indigenous Australian or is from a non-English speaking country. Being aged over 50 years, increases the risk of cervical cancer but not cervical intra-epithelial neoplasia (CIN) 1, which peaks in the 20'24 year age group. Other connections with cervical dysplasia relate to a woman or her partner's sexual history, her nutritional status and possibly even her personality type. Smoking, social isolation, high negative life change events and having lived a 'troubled' life are all identified in the literature as increasing a woman's risk of having an abnormal Pap test result. Receiving an abnormal Pap test result often leads to feelings of fear, anxiety, guilt, shock, vulnerability, powerlessness, depression, shame and feeling dirty for the woman concerned. Compounding these negative feelings are social, practical and financial difficulties that have to be addressed. It is argued that social and medical models of health must complement each other to improve the well being of rural women experiencing an abnormal Pap result. What is already known: Innumerable studies have verified that cervical screening significantly reduces the incidence of cervical cancer and the Pap test is promoted as a tool to prevent cervical cancer. However, preventative strategies used in addition to cervical screening have rarely been considered in the literature. What this study adds: This review concludes that optimum health outcomes for rural women are realised when socio-cultural considerations are articulated with cervical screening programs. It suggests possible strategies for practitioners to use to use to help reduce the incidence and impact of cervical pathology for rural women.