A qualitative meta-synthesis of women’s critical experiences with the Pap smear for the development of a novel cervical cancer screening device

Objective: This qualitative study and systematic review examines womens critical experiences with the Pap smear in order to identify opportunities for the development and improvement of cervical cancer screening devices (e.g., Citobot, Pocket Colposcope, and others). Methods: Eighteen studies were assessed based on the Critical Appraisal Skills Program. Qualitative meta-synthesis was used to integrate the study Findings, and the experiences were classified into four categories: fear and embarrassment during the procedure, pain and discomfort from the speculum, distress about the Results, and barriers to health services. Critical experiences before, during, and after the test were analyzed. Results: Previous experiences comprised a lack of instruction and misinformation, administrative barriers in health services, and behaviors and perceptions associated with gender roles. During the Pap smear, women experienced fear, embarrassment, and pain, associated in particular with the inappropriate use of the speculum. Experiences after the test included delays in the delivery of Results, anxiety associated with a lack of understanding of the Results, delays in treatment, and consequences affecting sexual relationships and life as a couple. Conclusions: Technologies with the potential to replace the traditional speculum and allow immediate delivery of both cervical imaging and HPV testing would benefit significantly from addressing these critical experiences to increase the acceptability of pap smears for women.