'I felt too ashamed to attend smear test after abnormal results - I regret it'
Feelings of shame stopped Jenna Al-Ansari from following up on her abnormal smear test results - and now she regrets ever burying her head in the sand.
Smear tests are available to anyone in the UK with a cervix aged 25 to 64 - and yet, one in three do not take up their screening invite. Research by leading charity Jo's Cervical Cancer Trust in 2019 found that women from minority ethnic backgrounds are less likely to attend cervical screenings than white women.
In many conservative cultures, female sexuality is a taboo topic and discussions may be frowned upon or non-existent. A 2015 study found that ethnic minority women felt there was a lack of awareness about cervical cancer in their community. Fear, embarrassment and shame were also identified as barriers.
According to a Department for Health report in 2022, embarrassment was the most common reason for not booking or missing a screening appointment. As an Arab and Muslim woman, Jenna understands the negative connotations associated with smear tests and grew up associating them with being 'painful and shameful'.
Speaking to The Mirror during Cervical Cancer Prevention Week, she explained: "There is a stigma attached to it - universally and within different cultures. Everything I'd heard about smear tests was negative and no one ever discussed it with me directly growing up."
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Jenna, who is Arab and Muslim, internalised that she was being judged and felt isolated (Jenna Al-Ansari)
She says attending a smear test should not be secretive or embarrassing (stock photo) (Getty)Jenna, 33, from London, attended her first smear test at 25, but when her results came back with HPV and borderline cell changes, she was put off returning for three years. "HPV instantly made me feel as though I'd done something wrong - I associated it with an STI," she said. "Specifically as an Arab and Muslim woman, there is shame in our culture around sex and it added to that sense of isolation and embarrassment."
Jenna's fear of being judged contributed to her decision to ignore the advice to return. "My first smear test was also a really horrible experience. The nurse and team were from a similar ethnic background and I internalised the idea that they were judging me. It was painful and I felt really vulnerable," she explained. "In reality, it's an overstretched service, and looking back, I felt like the situation was bigger than it was."
When Jenna received her test results letter in the post, she instantly didn't want to follow up. "I buried my head in the sand for three years - and it would've been a lot longer than that. My partner had a sudden heart attack and it made me realise that I was taking my health for granted," she said. "I went on Jo's website and read stories and information before booking my smear test again.
"I told the nurse on arrival that I was very nervous. She could not have been more empathetic and kind. It didn't hurt at all. She told me that if it's hurting, something isn't right. You need to be vocal." Jenna's results came back and she had abnormal cells. She was invited to have a colposcopy, a procedure to closely examine the cervix for signs of disease. "I thought I had cancer immediately and bawled my eyes out. I had a meltdown," she said.
"I had so much guilt for missing my appointments. But again, Jo's website was so informative and explained that it was a pre-cancerous check. It ended up being a completely painless procedure and the doctor was brilliant." If left untreated, there is a risk that some abnormal cells can go on to develop into cervical cancer in the future. Jenna had the choice to undergo a procedure to remove them and she went ahead with it for peace of mind.
"Now they are gone and I have a routine smear every three years," she said. There are lots of reasons Jenna was put off her initial follow-up appointment, but cultural shame played a huge role. "It felt like a taboo topic and, as sexual health was never really spoken about at home, I didn't have any experiences to relate to," she said.
"The reality is that it isn't easy for everyone to talk, but if you do feel isolated and embarrassed, you can read all of the information online. It should be an open conversation and we need to make it as normal as discussing a GP appointment, rather than thinking it's so serious and secretive. If you are going to any of these appointments, tell someone and go for a cocktail or ice cream after. Don't live with your worries alone."
Find out how to get involved in Cervical Cancer Prevention Week, take part in the NHS campaign and book your free smear test now.
Do you have a cervical cancer story to share? Get in touch. Email [email protected].
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