Culture a barrier to Pap tests for Mexican women

NEW YORK (Reuters Health) - Women in Mexico often avoid being screened for cervical cancer due to lack of knowledge about the disease, a cultural tendency to look to other family members' health before their own, and other factors, including guilt and denial, a new study shows.

"Within the Mexican culture, women have always been the procurers and not the beneficiaries of health," Dr. Blanca E. Pelcastre Villafuerte of the Instituta Nacional de Salud Publica in Cuernavaca and her colleagues write in the medical journal Reproductive Health.

Cervical cancer is a leading cause of death among working-age Mexican women, Villafuerte and her colleagues note in their report, and they sought to better understand the role family, emotions and other social factors may play in women's failure to receive regular Pap smears -- which can detect cervical cancer in its very early, much more treatable stages.

Villafuerte and her team interviewed 130 women with cervical cancer; 200 friends and relatives of these women who were free from the disease, referred to as controls; and 20 husbands of women with cervical cancer.

Women with cervical cancer tended to feel the disease was completely their own responsibility, the researchers found, and blamed themselves while feeling guilty about not getting a Pap smear earlier. However, most of the cervical cancer patients interviewed said they thought they didn't need to get the screening test unless they had symptoms.

Women in both groups felt embarrassed about having their bodies seen during the examination, while husbands felt shame about their wives bodies being seen as well.

Patients also tended to deny the diagnosis, while having high hopes that they would be cured, the researchers found.

Villafuerte and her colleagues also found that having a close friend or relative with cervical cancer did not seem to encourage the women in the control group to get Pap tests.

Some women would get the screening test, but then not get the results, only returning for another test when their symptoms had worsened. Many women said that their daughters encouraged them to get the test.

Women with cervical cancer feared that their husbands or partners would abandon them after the disease was diagnosed, a fear that was often realized.

The beliefs recognized in the current study "are not easy to overcome or transform," but must be addressed when trying to design programs to improve women's health, the researchers conclude.

SOURCE: Reproductive Health, March 1, 2007.