Income a factor in smear test results

POORER women are more likely to have abnormal smear test results than those who are better off, new figures reveal.

Well Woman has found that the rate of abnormal smear results requiring further investigation was higher among medical card holders. Figures published in Well Woman’s 2008 annual report show that over 10% of women who got an abnormal smear test result in the past six years were medical card holders who attended its clinic in Coolock, compared with 7% of all women screened at its Ballsbridge clinic.

Well Woman’s chief executive Alison Begas said it was critical women from the most at-risk groups were targeted in planning future delivery of CervicalCheck – the national cervical screening programme.

Ms Begas said the free screening programme must place extra emphasis on recruiting patients likely to have poorer health outcomes.

She said a number of factors might be responsible for increasing the likelihood of women having abnormal smear results.

The Human Papiloma Virus (HPV) that causes cervical cell abnormalities was more prevalent in women who are smokers and was also more prevalent across groups who experience first sexual intercourse at an early age, she explained.

“From our experience at Well Woman, both of these are factors across low income groups. Poorer immunity, resulting from poor diet, may also be a contributing factor to low resistance to HPV,” she said.

Since last September women aged between 25 and 60 have been able to avail of free smear testing, regardless of where they live, under the National Cervical Screening Programme. Women simply have to call to make an appointment.

Ms Begas said CervicalCheck was reviewing the future operation of the programme and was considering a pre-registration system for women seeking to have a smear, a move that Well Woman feared could create extra barriers to accessing the service.

“Streamlining the programme should not, in any way, make it more difficult for poorer women to avail of screening. While online registration might be a useful tool in managing screening demand from the general population of women, many poorer women do not have access to a computer,” she said.

A spokesperson for the National Cancer Screening service commented: “As with all screening programmes we will ensure we have a facility that all women can engage with in a user-friendly way.”

And, despite the range of contraceptive options available, Well Woman has found that the number of women seeking emergency contraception continues to increase. Last year, 4,200 women received emergency contraception from its three clinics.

Well Woman has also found that women opting for abortion are not just travelling to Britain for the procedure, but are travelling to other countries and especially to the Netherlands.

And the number of women seeking post-abortion counselling remains low, despite a high-profile campaign on such services by the Crisis Pregnancy Agency last year.