When the Data Does Not Match the Story:
Do Trauma and Addictions Issues Really Characterize Poor Cervical Cancer Screening Uptake Among Manitoba First Nation Women Living On-Reserve?
By Brenda Elias1, Madelyn Hall1, Say P. Hong1, Erich V. Kliewer1,2,3
1University of Manitoba
3British Columbia Cancer Agency
Aboriginal women in Canada have higher rates of cervical cancer than non-Aboriginal women, and they are less likely to have regular cervical cancer screening (Pap smear). Some studies have suggested a link between traumatic life experiences such as childhood abuse and being less likely to have a Pap smear, while others have found that Aboriginal women face more barriers in accessing health care services. Some older First Nations women have said that they feel excluded by cervical cancer screening programs, and that those with a history of trauma, addiction, or mental health challenges are less likely to have regular Pap smears.
For this study, the authors used data from the 2002/2003 wave of the Manitoba First Nations Regional Longitudinal Health Survey, which looked at the health status of First Nations living on-reserve in several communities throughout Manitoba. The authors used this data to see if there was a connection between traumatic life experiences, addiction, and/or mental health concerns and lower rates of Pap smear testing. They found that women with a history of suicidal thoughts or attempts and women who used more than one addictive substance were in fact more—not less—likely to have had a recent Pap smear. One possible explanation is that these women are more likely to be in regular contact with health care services, increasing their access to cervical cancer screening programs.
Because of the large proportion of women in the study who reported substance abuse, which puts them at higher risk for cervical cancer, and the low Pap smear testing rates among Aboriginal women overall, the authors stressed the need for more culturally appropriate, gender-sensitive health care services for First Nations women.