Journal of Cancer Education

, Volume 28, Issue 2, pp 367-374

First online:

Pap Screening Goals and Perceptions of Pain among Black, Latina, and Arab Women: Steps Toward Breaking down Psychological Barriers

  • Julie W. GaussAffiliated withCollege of Osteopathic Medicine, Michigan State University
  • , Athur MabisoAffiliated withDevelopment Strategy and Governance Division, International Food Policy Research Institute
  • , Karen Patricia WilliamsAffiliated withObstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University Email author 

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Understanding women’s psychological barriers to getting Papanicolaou (Pap) screening has potential to impact cancer disparities. This study examined pain perceptions of Pap testing among black, Latina, and Arab women and goal setting to receive Pap tests. Data on 420 women, in a longitudinal study, were analyzed using Chi-square tests of differences and generalized linear mixed models. At baseline, 30.3 % of black and 35.5 % of Latina women perceived Pap tests to be very painful compared to 24.2 % of Arab women. Perceptions of pain influenced goal settings, such as scheduling a first ever Pap test (odds ratio = 0.58, 95 % confidence interval 0.14–0.94). Immediately following the intervention, women’s perception that Pap tests are very painful significantly declined (P value <0.001) with Arab and black women registering the greatest improvements (20.3 and 17.3 % reduction, respectively, compared to 8.4 % for Latina). Having the perception that the Pap test is very painful significantly reduces the likelihood of black, Latina, and Arab women setting the goal to schedule their first ever Pap test. Latina women are the least likely to improve their perception that the Pap test is very painful, though national statistics show they have the highest rates of morbidity and mortality from cervical cancer. These findings are instructive for designing tailored interventions to break down psychological barriers to Pap screening among underserved women.


Cervical cancer screening Pap test Perceptions of pain Cancer disparities Race Ethnicity