Why Don't Women Know When They Should Visit the Gynaecologist?

While it's not the most fun doctor appointment to make, going to the gynecologist for regular checkups is super important for your health. The stirrups and boob-squeezing are a necessary evil, in the interest of staying healthy and cancer-free as a woman. But do you know how often you should be making those appointments to be screened for cervical and breast cancer, and do you know at what age you should start making them?

A new survey by Planned Parenthood, carried out with the help of NORC at the University of Chicago, checked in to see how much women in the United States really know about the care and keeping of their reproductive health. As the survey found, a vast majority of women ​think ​they know how often they should be screened (73 percent said they knew how often they should be screened for cervical cancer, and 84 percent said they knew how often they should be screened for breast cancer) — but very few women actually knew the correct answer. Only 9 percent of the women surveyed about frequency of cervical cancer screenings were correct, and a slightly higher 10 percent of women surveyed about frequency of breast cancer screenings got the answer right.

Or, to put it simply, there's a stark knowledge gap between what women think they know and what is factually correct when it comes to their own health care.

Before you get all riled up about shaming, this isn't to say that women are dumb. Actually, women are very smart! Having misunderstandings about when to visit the gynecologist is just a dangerous symptom of living in a world where reproductive health-care access is routinely limited, and where teen girls are given piss-poor information about their own bodies in public school. So then what's the issue here? Why aren't women getting these answers right?

As Raegan McDonald-Mosley, chief medical officer of Planned Parenthood, told Cosmopolitan.com, there are plenty of "whys" behind the results of the survey. One problem is that guidelines for these screenings change sometimes. "I think some of the confusion may come from the fact that recommendations for breast and cervical cancer screenings have changed over time, as we've progressed in our understanding of how screenings are most helpful to detecting potential problems," McDonlad-Mosley said. She added that there's also a "lack of consensus" among the major groups that issue these recommendations (like the American Cancer Society and the American College of Obstetricians and Gynecologists​). "Frankly, it is confusing," she said.

One of those confusing new recommendations re: how often women should be having annual pelvic exams came recently, just earlier this year, from the U.S. Preventative Services Task Force. But ACOG didn't update its guidelines on annual pelvic exams just yet, and there was a bunch of initial confusion over what part of the annual gyno exam (which, yes, is still recommended) women would actually be able to skip. In reporting the story, I found I didn't actually know what the pelvic exam part of the gyno visit was — it's all, as McDonald-Mosley said, very confusing.

General wishy-washiness of serious government organizations aside, there are other factors that enter in when it comes to women's lack of knowledge about their own health care. One of the big findings of the Planned Parenthood survey is how much race affects the frequency at which women are being screened routinely for cervical and breast cancer. Among white women surveyed, a full 81 percent said they'd been screened for cervical cancer in their lifetime. But that percentage was much lower among black and Hispanic women, at only 64 percent. Why the huge difference?

"We know that many people of color in this country disproportionately experience greater barriers to regular health care and face greater obstacles to accessing health-care services than white people," McDonald-Mosley said. "Because of these barriers to regular preventive care, Latinas and African American women, for example, have higher cervical cancer rates and are more likely to die of the disease.​" As the survey reveals, this has real effects on why women of color told Planned Parenthood they weren't being screened. It's basically a huge, never-ending cycle of systemic racism that keeps women out of exam rooms. When asked why they weren't having regular cervical cancer screenings, black and Hispanic women disproportionately responded that they were scared of either the test itself or the test results. While only 14 percent of white women said they were scared of the test results, and that's what kept them from going to be screened, 40 percent of black women and 38 percent of Hispanic women said the same thing — it's fully triple the percentage of white women. And it makes sense, even if it makes sense in a terrible way: the women who are disproportionately getting sick and dying from cervical cancer (because they experience greater barriers to being screened) are the ones who report being scared of the test results and are therefore less likely to be tested at all.

Of course there are other barriers, like cost of the procedure and the distance a woman has to drive in order to get to a clinic for the procedure — two things that affect women of color (who tend to be paid less or work jobs with less flexibility). But again, it goes deeper than that. "I also think the repercussions for inconsistent recommendations may be different for women of color, who already have a higher distrust of the medical system," McDonald-Mosley said. "This country has a history of experimentation on and marginalization of communities of color, which means these communities have a higher level of distrust of the health-care system, especially when it comes to sexual and reproductive health care."

What can women do to help other women? Knowing how often you should be screened is a start, as well as talking about cervical and breast cancer screening with other women. Make sure your friends know the correct answers — as the Planned Parenthood survey found, that's not something very many women are discussing. "We hope more people will talk with their loved ones — mothers, siblings, aunts, cousins, partners and friends — about the importance of getting screened for breast and cervical cancer, about catching potential problems as early as possible," McDonald-Mosley said. "One way to start is to just ask when the last time they had a check-up was — and if they aren't going in for screenings, ask what's preventing them. Yes, anxiety around going to the doctor is real and mistrust of the medical system is real — my hope is that we can help our loved ones through that anxiety by talking about how important it is to catch health issues before they become serious.​"

And just to be clear, so you'll know in the future, the correct answer to how often a woman should be screened for cervical cancer is every three years, if you're between the ages of 21 and 29. If you're 30 to 64, the current recommendation is every three to five years. For breast cancer, you should start having checks every one to three years (depending on family health history) at age 21 — at age 40, you start adding in mammograms.