OVER time, the proportion of women who had the necessary preventative health screenings and checks — Pap smears and breast checks, for example — has trended upward, with one-half of women reporting a routine gynaecological exam in their lifetime, the 2021 Reproductive Health Survey, Jamaica is showing.

Routine gynaecological examinations include urinalysis, breast, physical and pelvic exams, and Pap smear, and with cancer of the breast and cervix the leading malignancies resulting in the premature death of Jamaican women, screening for these conditions are important strategies for female survival, the study authors noted.

The study showed that screening for cervical cancer with a Pap smear was reported by two-thirds of females, at least once.

“As guidelines re frequency of Pap smears vary by age and other risk factors, compliance can be improved by educating females about the requirement and the benefit of Pap smears,” the authors noted.

The study showed that half of females 15-49 years (51.8 per cent) have had a routine gynaecological exam in their lifetime, especially females from the Kingston Metropolitan Area (KMA) (56.0 per cent); and other urban centres (OUCs), (53.0 per cent); compared to those from rural areas (48.7 per cent). The likelihood of having had a routine gynaecological exam increased with age from just 10.4 per cent among females 15-19 years to 62.5 per cent among those 30-34 years, reaching a high of 74.6 per cent of females 45-49 years. Prevalence was higher among more educated females (62.4 per cent) and those in a union (visiting, 53.2 per cent; common-law, 59.8 per cent; married, 73.8per cent). Of the females who had done a gynaecological exam in their lifetime, over one third (38.2 per cent) had an exam in the last 12 months; and 26.3 per cent within 12 to 23 months; while 21.3 per cent last had a gynaecological exam three plus years before the interview (20.3 per cent); or the last three years of being interviewed (19.9 per cent). Another 28.1 per cent had their last Pap smear more than three years ago (before the interview).

Meanwhile, approximately two-thirds (67.2 per cent) of females 15-49 years had ever done a Pap test, and this was higher among sexually experienced women (75.6 per cent). Pap smears were also more common among KMA residents (72.8 per cent) than those living in OUCs (65.6 per cent); or rural areas (65.4 per cent). The likelihood of having had a Pap smear increased with age and was practically universal among women 35 years and older — 35-39 (92.2 per cent); 40-44 (93.2 per cent). Females in a union were more likely to have done a Pap smear, especially if they were married (94.9 per cent); however, prevalence was lower among females in common-law unions (83.4 per cent) or visiting relationships (72.0 per cent). Among females who had ever been screened for cervical cancer, seven of 10 (71.9 per cent) did so within the recommended three-year period; within 12 months, 31.6 per cent; and 12-23 months, 20.3 per cent; or the last three years of being interviewed, 19.9 per cent. Another 28.1 per cent had their last Pap smear more than three years ago.

A Pap smear is a common screening method to detect changes or abnormalities in the cervix that can result in cervical cancer. It is advised that a Pap smear test be done at least every three years for females who are sexually active or who are at least 18 years old. In 2022, the Jamaica Cancer Society reported that cervical cancer was the fourth most prevalent cancer in the population and the second most diagnosed cancer among females.

It was estimated that approximately two hundred Jamaican females die annually from cervical cancer. It was further highlighted that, compared to females from other Caribbean islands, the incidence of cervical cancer was twice as high among Jamaican females.

During the survey, females who had done a cervical cancer screening were asked about the test results and if they had received them. They were also asked if they required follow-up treatment after the test. Most of those who did a Pap smear did not need follow-up treatment (90.0 per cent), while only 5.6 per cent required treatment based on the Pap smear test results.

The survey indicates that approximately one-third of females aged 15-49 in Jamaica had never done a Pap smear. These females were asked to provide reasons for never doing a Pap smear. The results show that 24.7 per cent of females said they have never done a Pap smear because they ‘never thought of it’, while 15.1 per cent said it was because they had ‘no gynaecological problems’. A further 13.2 per cent said it was because they ‘did not have a partner or weren’t sexually active’, while 9.4 per cent said it was because they had ‘never heard of a Pap smear’.

“Considering that a Pap smear is a form of cervical cancer screening, these results suggest that there is room for more public education campaigns to increase awareness among females about the usefulness of the tests,” the authors noted.

The recently released 2021 survey, which looks at the fertility, contraception, and reproductive health of women and men aged 15 to 49 years, was conducted by Statistical Institute of Jamaica on behalf of the National Family Planning Board. It covers fertility; contraceptive use, knowledge, attitude and practice; reproductive health; maternal and newborn care; infant and child mortality; sexually transmitted infections including HIV/AIDS; gender-based violence; and the reproductive health of respondents 15-49 years. The data also generated indicators on Jamaica’s progress towards achieving Sustainable Development Goal (SDG) 3 on good health and well-being, including SDG 3.7.1 on contraceptive use, and estimates for SDG 5 on gender equality. The information gleaned is used in determining programme implementation and other vital issues specific to how the country deals with matters relating to reproductive health.

There were 5,008 participants — 3,224 females and 1,784 males.