Papanicoloau smear uptake among substance-using mothers in Western Australia

Abstract

Background: Papanicoloau (Pap) smear screening has helped to reduce cervical cancer rates significantly through the detection of premalignant cells ( Bray et al, 2005 ). Uptake among women who use alcohol and other drugs (AOD) is known to be low ( Chau et al, 2002 ) so they are at increased risk of being under-represented in the adequately screened population. AOD-using women experience disproportionately increased morbidity and mortality from cervical dysplasia and cancer ( Nogara et al, 2013 ). Pregnancy may provide the midwife an opportunity to offer this vital screening test. Objective: The audit investigated Pap smear uptake and results among AOD-using pregnant women. Setting: Pregnant women cared for by an obstetric AOD service based in a tertiary hospital in Perth, Western Australia, were eligible for inclusion in the study. Results: Across a period of 12 months, 333 childbearing-aged AOD-addicted women were audited: 142 had a Pap smear in the previous 3 years; 80 had not had a Pap smear in the previous 3 years; 80 declined a Pap smear; and 31 were either illegible or no record was available. Conclusion: This audit emphasises the importance of Pap smears being offered and followed up among the population of AOD-using pregnant mothers. Encouraging early booking and access to early antenatal care with midwives who are proficient in Pap smear collection is essential in order to provide optimal care.