New research has found 72 per cent of women who once experienced sexual violence will either put off or never attend a potentially life-saving cervical screening test because of their trauma.
That’s three out of every four survivors.
It’s a heartbreaking statistic to absorb.
But for the Australians who work in this field, it is sadly “not surprising at all”.
While the survey was conducted in the UK by Jo’s Cervical Cancer Trust, health experts have told Mamamia the figures on our shores would be very similar.
And considering about one in five Australian women has experienced some form of sexual violence since the age of 15, that makes a lot of us whose lives are being put at risk. It means sexual abusers are managing to take away a woman’s physical health – or life, even – years after an attack.
“Cervical screening is an inevitably intimate and invasive process and for some survivors it can trigger memories or even flashbacks to the sexual violence or abuse they’ve experienced,” Rape Crisis England & Wales spokeswoman Katie Russell said.
“The thought or reality of going for a test can cause some survivors to fear they’re not in full control of their body or situation and this can make them reluctant to access this vital health service.”
Australian Cervical Cancer Foundation chief executive Joe Tooma told Mamamia he found the results "worrying".
"It is absolutely devastating, and you can really sympathise with how they feel about it. Their trust has been broken," Mr Tooma said.
"I totally understand that if you have been assaulted or had a horrific event like that happen to you, then you'd be reluctant to undergo a very intimate examination."
But he warned that by not going, women were "hugely increasing their risk of dying from cervical cancer. It's a really important issue".
While it's believed cervical cancer could be effectively eliminated in Australia within 40 years, thanks to the national HPV immunisation program which began a decade ago, in 2018 it remains a devastating illness.
It is the 14th most commonly diagnosed cancer among females, according to government figures. This year, it's estimated there will be 930 new cases and 258 deaths.
So what can sexual assault survivors do to empower themselves?
Mr Tooma said women could use the checklist the Australian Cervical Cancer Foundation created after consultations with doctors, psychologists, nurses and women in the community.
He said the document was "very simple but practical", designed to hand patients control of the situation and ensure healthcare providers were thinking compassionately about how women were feeling.
There are steps women can take to improve the procedure, such as bringing a friend or relative with them, asking for privacy when undressing, asking the practitioner to stop at any point or requesting to insert the device themselves.
"Women think it's out of their hands, but they need to be aware they have they every right to be treated the way they feel comfortable, they can take matters into their own hands," Mr Tooma said.
He also suggested sexual abuse survivors find a doctor or women's health clinic they felt secure in before going ahead with the test.
In the UK survey, a third of respondents said they would benefit from having a card to show their doctor or nurse to explain their experience without having to vocalise it.
It's something Carolyn Worth, of Australia's Centre Against Sexual Assault, described as a "great idea", and she encouraged women to do this if they felt it would help.
Ms Worth urged survivors to be open with their medical professionals, as they could put them in charge of the process.
"None of us like going for screening tests so you automatically have this built-in resistance," she said, adding that when you've experienced sexual assault, "you have a lot of reasons to want to avoid it".
"(But) it's very dangerous not to go for regular check-ups," she said.
Ms Worth said this problem didn't exist just with cervical screening tests. Maternity care, contraceptive devices, birth and even dental procedures could all be triggering for survivors.
Mr Tooma hoped that simply by talking about the hidden problem, more women would realise they were not alone.
"If you know other women have had similar experiences and they talk about how they go through it, that helps. At the moment women are at risk of a life-threatening cancer because they can't put themselves through the check."
If this article brings up any issues for you, or if you just feel like you need to speak to someone, please call 1800 RESPECT (1800 737 732) – the national sexual assault, domestic and family violence counselling service.
From December last year, Australia switched from the Pap smear test to the new Cervical Screening Test. For more information on the procedure, click here.
Do you have an experience you'd like to share? You can contact Sophie Aubrey on [email protected], or you can message her on Twitter.