During the summer I had the privilege of working with charity Jo’s Cervical Cancer Trust. I was commissioned by Jo’s Trust to write two new resources for their website, looking at cervical screening support for survivors of sexual violence. While smear tests offer the best possible protection against cervical cancer, they’re also understandably traumatic for women with a history of violence and abuse.
The first of these new resources was therefore aimed at survivors themselves, offering practical tips and advice on how to cope with the screening appointment if you choose to attend. The second, longer resource looked at how healthcare professionals can better support these patients both practically and emotionally, with sympathy and understanding of the issues at stake.
These resources launched online at the end of August, to coincide with the publication of a survey on survivors’ experiences and attitudes towards cervical screening. I wrote about the survey results for both Patient and Refinery29, looking at survivors’ experiences, practical tips on preparing for a smear test, and signposting to the Jo’s Trust resources.
The Trauma Of Going For Your Smear Test As A Survivor Of Sexual Violence – for Refinery29:
When Julia was 12 years old, her mother, who was in her early 30s, died of ovarian cancer. The following year, Julia was raped.
Now 35, she is terrified of developing gynaecological cancer like her mum. But as a survivor of sexual violence, she’s also terrified that going for a smear test – the best protection against cervical cancer – will force her to relive the trauma of rape.
She’s not the only one. Research published today by Jo’s Cervical Cancer Trust, in partnership with Rape Crisis and My Body Back Project, found that nearly half of survivors don’t attend cervical screening tests as a direct result of their experience. Another quarter of the 131 survivors they surveyed said they’ve put off going for their test for the same reason, while only 15% regularly attend when they’re invited.
The potential ramifications are huge. One in five women aged 16-59 has experienced some form of sexual violence in her lifetime. If almost three-quarters of those women delay or avoid their smear test, it’s fair to assume they’re at an increased risk of developing cervical cancer. And many of them are painfully aware of this.
“I’m a radiographer working in a busy oncology hospital, and I’ve seen what happens when people don’t go to screening tests or ignore their symptoms,” says 40-year-old Kate, who was raped in 2013, just after having her smear test.
When her next screening invitation came, three years later, Kate says: “I felt sick. I genuinely believe cervical screening saves lives, and I wasn’t prepared to let [my attacker] jeopardise my health; that felt like another way for him to win. It was too important to not go, but I knew I would find it difficult in a way I never had before.”
Preparing for your smear test as a survivor of sexual violence – for Patient:
“I remember a viral tweet a few years ago that said: ‘If you don’t go for your smear test, you’re stupid. It takes minutes and it can save your life’,” recalls 41-year-old Sam*. “Everyone was retweeting it but it was so overly reductive that, as a survivor of sexual violence, it was difficult to read. I mean, sure, it does take minutes, and it’s usually fine, but I knew it wasn’t ever that simple.”
According to the World Health Organization (WHO), cervical cancer is one of the deadliest but most preventable types of cancer for women. The NHS cervical screening programme – which can detect abnormal, pre-cancerous cells – saves around 5,000 lives every year. But knowing all this doesn’t make the experience of going for your smear test any less traumatic or distressing for women like Sam.
In the UK, one in five women aged 16-59 have experienced some form of sexual violence – and many of these women avoid going for their smear test as a result. A report published by Jo’s Cervical Cancer Trust reveals that almost half of the survivors they surveyed had chosen not to attend cervical screening because of their history. Another quarter had put off their smear for the same reason – and that reason goes far beyond embarrassment or stupidity.
If you’re a survivor of sexual violence, the cervical screening procedure is understandably reminiscent of your past trauma: the position and penetration; the exposure and vulnerability; the lack of control; and often even the language used, like “open your legs”, or “it’ll be quicker if you relax”. But, despite the difficulties, remember that you are just as worthy of good, preventative healthcare as anybody else.
While going for a smear will probably never be a pleasant experience, there are things that both you and your healthcare professionals can do to make the screening process as painless and stress-free as humanly possible.
IF YOU NEED SUPPORT
Please note that I am NOT a psychologist or healthcare professional. Check out my resources page for details of organisations who might be able to help.
However, if you would like to get in touch about your own experiences, or a story that you’re keen to tell, please feel free to drop me an email.