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white shirt day: why do eligible australian women forgo regular pap tests?


If you see plenty of women wearing white shirts today, it’s because it’s White Shirt Day. White Shirt Day was launched by OCRF in 2011 (with help from Witchery, and madison editor Lizzie Renkert), in order for all Australians to show their support for women suffering from ovarian cancer.

And why? One woman dies of ovarian cancer every ten hours. There is no early detection test and no cure. A pap smear does not diagnose this disease.

It’s heartbreaking.

But do you know what I find more heartbreaking?

90% of cervical cancers can be prevented if detected early. Yet a study by the Cancer Institute of NSW recently revealed only 57.5% of eligible women get a pap test (also referred to as a pap smear). While ovarian cancer doesn’t have an early detection test, cervical cancer does, and an alarming amount of women — almost half — are failing  to use it.

And why aren’t so many of us having them? Is it because we’re “busy”? Are we scared of getting cancer (because, obviously not knowing will stop it in its tracks)? Is it because we think it’s awful and painful? Are some women confused about if they need one?

I can set the latter mostly straight. If you are between the ages of 18-69, and if you have ever had sex, you need a pap test. It’s as simple as that. If you’ve had sex only once, you need one. If you’ve always used a condom, you need one. If you haven’t had sex for two decades, you need one. If you’ve had the HPV vaccine, you need one. If you’ve only had sex with the one partner and you’re also their one and only, you need one. There are no caveats or justifications. Say it with me: if you are between 18-69, and have ever had sex, you need a pap test.

To be honest, I place getting a pap smear shortly behind getting a root canal. There are plenty of people who say they find pap smears easy and painless, but I’m not one of them. I’ve spoken to my closest friends about their experience — some of them, like me, find the experience painful. Others find it vaguely uncomfortable. Others say they don’t feel a thing. Others say they find it awkward. Others say they get nervous about the results.

If you haven’t had a pap smear before, I can’t tell you what it will feel like for you.  But I can tell you this: for  obvious reasons, pap tests can make you feel very vulnerable, so it’s important to see someone you trust, and who makes you feel comfortable. Please remember that you can get your pap smears done by someone who isn’t your usual GP, and that you are completely in your rights to ask for a female doctor.

I also think that if we’re not one of those lucky people who claim to find a pap test no less awkward or uncomfortable than a spray tan, that we should give ourselves the day.  Take the day off from uni/work/the kids. Have your appointment in the morning, and then go buy yourself something pretty or get your hair done, and then go drink some wine. Or go home to a stack of your favourite movies and a bunch of chocolate. Do things that will make you happy.

And also, as women we need to do this:

We need to share our experiences, even if they aren’t great. We need to recommend doctors. We need to remind and encourage each other to make appointments. We need to take a deep breath, pull ourselves together, and remind ourselves that it’s only once every two years.

So, today, when you see a sea of white shirts in support of those who have ovarian cancer, think about how many people are wishing there was an early detection test. And then ask yourself, would you use it?

Because, right now, we have an early detection test for cervical cancer covered by Medicare, and so many of us are ignoring it.

Please read here  and here and here for some FAQ on Pap Tests. 

If you would like to talk to someone about a pap smear, or schedule one, but don’t know where to start, contact your local Family Planning Office. They are there to give you information, listen to your concerns, and can also do the test. Typing in ‘family planning’ with your state in Google, should bring up a list of nearby services.

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2 thoughts on “white shirt day: why do eligible australian women forgo regular pap tests?

  1. I would highly recommend all females have their pap smear. As a young mum I had mine
    attended in Sydney, was told it was fine. In the meantime we moved to the country and via my husbands workplace was tracked down to go and have a repeat pap smear attended as the slides had been reread and an abnormality had been found. Off to the local GP and two more pap smears later ( when he was finally convinced) I was sent to a specialist. He diagnosed CIN 2 level Ca fortunately only requiring diathermy of the cervix and a hospital admission overnight. Since that time until about 4 years ago I went every year because the thing that scared me most was that I had no symptoms and I relied on the fact that the technicians would read the slides correctly. Had I waited 2 years which was the recommended time lapse between pap smears my level could have been higher. I was informed CIN 2 is closer to CIN 3 than to CIN 1. Thankfully I have not had anymore issues with Ca cervix; I hate having pap smears but I hate waxing too. Waxing isn’t a diagnostic tool but I do it and more regularly.
    Now I am older I fear Ovarian cancer because there is no detection test yet but the symptoms could indicate any number of other issues. So to all those young women out there who do not have their regular Pap smears please do.

  2. One thing women need is balanced information, not orders. I made an informed decision over thirty years ago not to have pap tests. After reviewing the evidence (and I had to search for it) it was an easy decision. My near zero risk of cervix cancer v 77% lifetime risk of referral for colposcopy/biopsy, (and huge numbers end up over-treated) almost all referrals are due to false positives. The risks were far too high for me.
    I think more women are working out the Australian program is excessive and way out of date, it greatly increases the risk of a false positive and potentially harmful over-treatment for zero additional benefit over an evidence based program. The Finns for example have offered women 6-7 pap tests, 5 yearly from 30 to 60 since the 1960s…they have the lowest rates of this rare cancer in the world (0.65% is the lifetime risk) and refer far fewer women for biopsies etc. (fewer false positives)
    The Dutch have the same program but will move with the evidence and shortly scrap their population pap testing program and offer instead 5 hrHPV primary triage tests at ages 30,35,40,50 and 60 (or women can self-test with the Delphi Screener) and only the roughly 5% who are HPV+ and at risk will be offered a 5 yearly pap test. Most women are HPV- and cannot benefit from pap testing, they should simply be offered a chance to re-test for HPV in 5 or 10 years (depending on age) to guard against a new infection. Those women HPV- who are no longer sexually active or confidently monogamous might choose to stop all further testing.
    This program will save more lives by preventing and detecting more cancer, including adenocarcinoma which is often missed by pap testing, and will spare the vast majority of women from a lifetime of unnecessary pap testing with the fairly high risk of over-treatment/excess biopsy. Damage to the cervix can lead to miscarriages, premature babies, c-sections etc
    No woman “needs” pap testing, just as no man “needs” prostate screening…all cancer screening is elective and legally and ethically requires our informed consent. It’s a personal choice and should be an informed decision.

    The example given of a woman in a lifetime mutually monogamous relationship “needing” pap tests…a woman with this risk profile has a near zero risk of cervix cancer and may consider the risks with pap testing too high.
    Women should be given all of the evidence and left to make up their own minds.

    Australian women are still being told they need 26 pap tests, 2 yearly from 18 to 70, this is bad medical advice, it is serious over-screening that sends risk way up for zero additional benefit. We “treat” more than 10 times the number of women than a country like Finland thanks to serious over-screening. Our program has always been excessive and has never followed the evidence.
    A review is finally underway, long overdue, hopefully, this program will be changed to finally adopt the evidence, putting women first. Our GPs receive target payments for pap testing, a potential conflict of interest that IMO, is inappropriate unless mentioned to women.
    More women are ordering HPV self-testing online or testing while overseas…then it’s possible to make an informed decision, HPV+ and you have a small chance of benefiting from a 5 yearly pap test, HPV- you cannot currently benefit from a pap test and might choose to test again in the future.

    The Delphi Screener is already being used by Dutch women and is also, available in Singapore and elsewhere. Delphi Bioscience can provide more information. HPV Today, Edition 24, sets out the new Dutch program.
    HPV testing is not recommended for those under 30 as approx. 40% would test positive, transient and harmless infections that will clear in a year or so, by age 30 only about 5% of women are HPV+…
    No country in the world has shown a benefit pap testing those under 30, the same very rare cases will occur whether you screen or not, but young women produce the most false positives which can lead to excess biopsies etc
    Women should demand real information on the risks and actual benefits of cancer screening and some respect for informed consent…and for those who wish to test, evidence based testing provides the best protection from this rare cancer and from the much higher risk of over-treatment.

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