Refiguring pap smears and the Cervical Cancer Screening Scheme : a feminocentric study of women's identification with the scheme

Abstract

This is a nurse-feminist work based on a re-reading of the evidence and interviews with women on their experiences of the Pap smear (PS) procedure and the cervical cancer screening scheme. It was found that women's accounts contradict the Scheme's public health doctrine. Instead of PSs being a matter of simplicity and informed choice, the procedure is complex and practised as a 'necessary' procedure. Women are uncertain about their eligibility, the purpose and preventative qualities of PSs. Published information was found to substantiate these views. A concentration of mixed messages exist particularly around attempts to deflect from the venereal aetiology of cervical cancer. Furthermore, women's PS behaviours are influenced by both the Scheme's emphasis on 'good womanhood' and individuals' sexual experiences. Women associate the Scheme with a form of medical(ised) féminisation, and engage in both PS procurement and dissent. PSs have inherent and other perils for women in association with their exposure of intimate body areas to a PS service provider. Veterans of PSs are aware of these and use papping skills to enhance their capacity to retain self-composure. Contrary to what the Scheme advertises, women require mastery of papping skills to endure a PS. Questions are raised about the failure of the Scheme to correct misleading public health information particularly in relation to the emphasis on secondary screening, whilst tolerating an absence of primary prevention strategies. It is found that the fundamental incentive underpinning the Scheme is that of in vivo oncogenic research in which women unwittingly participate and fulfil the norms prescribed by the Scheme as 'good womanhood'. A genealogy of the Scheme is outlined. It is concluded that the Scheme is underpinned with values of a past era which are incompatible with contemporary values relating to research and to women.