A smear test, or cervical screening, as it has been rebranded in the hope of making this most unfairly loathed of all tests sound a bit more appealing, hurts. So the lore goes, anyway. Of all the routine medical checks out there, it’s the one devised by “Dr Pap” in the 1940s, when cervical cancer was the biggest killer of women, that gets most, well, smeared. It is seen as being intrusive, offensive, scary, gross. Never mind the fact that cervical screening helps pick up changes to cells that could eventually lead to cancer. Never mind that they save thousands of lives every year. Smear tests are embarrassing.
These are the messages women continue to receive, whether openly, subliminally, through word of mouth, by default or negative association. While it’s true that most things are more fun than a smear test – and I say this as someone who has had abnormal smears and after the birth of my first baby, developed an unexpected, thankfully short-lived fear of speculums – the same could be said of many routine checks.
The impact of all this is a plummeting test rate. According to new data, cervical screening rates among all ages are at their lowest for two decades. Five million women in the UK are currently overdue for testing. The rates for young women are particularly concerning: only 65% of under-35s took up their latest screening invitation. This is a generation that grew up with the so-called body positivity movement, where “wellbeing” is cast as an exercise in self-care or a simple matter of will. Sorry, empowerment. But no hashtag has the power to make centuries of structural sexism and misogyny disappear. So, 72% of the young women said they had delayed a test or never went for screening because they felt embarrassed. Which means, to be ysterical about it, that women could actually die of embarrassment.
Smear tests happen to women’s bodies. And specifically to our cervixes, which are located in our vaginas, and most of us, one way or another, are taught from a young age to be embarrassed, frightened and ashamed of them. Our collective response to the simple, benevolent smear test – which, for the majority, lies, on a scale of one to childbirth, somewhere between tampon insertion and toe-stubbing – is a perfect encapsulation of the real discomfort being administered here. The deep, invasive pain caused by internalised misogyny.