Screening & Prevention
Knowledge of Cervical Cancer among Migrant Farm Workers in the United States
Information provided by: PATH www.path.org
Improvements in Cervical Cancer Knowledge and Behavior
| Had heard of Pap smear (women) |
Had heard of Pap smear (men) |
Had heard of cervical cancer (women) | Had heard of cervical cancer (men) |
Had received Pap smear |
Of 316 Latino farmworkers surveyed in 1994, 65% of women and 74% of men had not heard of cervical cancer. Qualitative research showed that women enjoyed learning from and with other women, in groups or one-on-one. They seldom receive adequate information about Pap tests and cervical cancer at clinics, and they feel shy about asking health providers questions. Women feel less embarrassed in an informal gathering with other women. Of 11 women surveyed before an education session, 6 could not answer the question "What can you do to prevent cervical cancer?" When surveyed several weeks later, 5 of those 6 could answer correctly. Research with Farmworkers
One of the great challenges of conducting research with migrant farmworkers is that they work long, late hours and never know how long they will be in a given state or county. A hurricane or drought can change everything.
The project demonstrated that it is possible to conduct a study of farmworkers' health-related knowledge, attitudes, and behaviors using experimental and quasi-experimental study designs. We were concerned that, because we were working with a highly diverse and mobile population working different types of crops in different states, we might not be able to identify an appropriate control group. We succeeded in identifying two groups of single males working in orchards in western North Carolina and West Virginia and used one of the groups as a control group for the skin cancer study.
The control group design for the cervical cancer study worked less well because less emphasis was placed on its importance relative to the skin cancer study. We simply ran out of time to implement it as planned. For both studies, the pre- and post-test research design was difficult to implement at the large labor camp in Maryland where the main harvest season lasted only four to six weeks. The four other states generally had higher follow-up ratios from pre- to post-intervention.
For the skin cancer study, we used a 45-question survey which took 20-30 minutes to complete. We did this because: (1) we did not have access to enough demographic data on the farmworkers in the study areas; (2) very little was known about what farmworkers knew about cancer in general and skin cancer in particular; and (3) we wanted to see if we were talking to more or less the same people for the pre- to post-surveys and from one year to the next. We also felt it important to learn about farmworkers' interaction with the local health care providers. Despite the length of the questionnaire, very few farmworkers refused to be interviewed. During the last year of the study, we reduced the number of questions in the post-intervention survey by nearly half in order to make the process easier for the farmworkers and the health navigators.
It seemed that farmworkers had several reasons for participating in the study. Some were happy to be asked their opinion, some believed that by participating they could help other farmworkers, some wanted to learn how to protect themselves and their families. Almost all participants received a protective hat after completing the first interview; many received long-sleeved work shirts after the second. Health navigators gained their trust, helped them with many of their problems (whether health-related or not), came to interview them at the most convenient times, and respected them.
Cervical Cancer Key Messages
- Cervical cancer is preventable and curable!
- Any woman (who has not had her womb/uterus removed) can get cervical cancer.
- When it is most treatable, cervical cancer doesn't usually have symptoms a woman would notice.
- Early detection greatly increases a woman's chances of survival.
- Women should get a Pap test every 1 to 3 years, depending on the recommendation of their doctor.
- A Pap test is not (normally) painful.
- A few moments of embarrassment or discomfort while getting a Pap test can save a woman's life.
- A Pap test can detect a problem on the cervix before it becomes cervical cancer.
- A Pap test can also detect vaginal infection.
- Pap tests are available free to many women at health departments and migrant clinics.
- Of 48 countries, Mexico has the highest cervical cancer death rate. The United States ranks 35th, largely because most women in the United States get Pap tests regularly and have access to treatment.
- Cervical cancer caught early can be cured by surgery. Sometimes radiation is used.
- Your partner needs your support.
- Even if a male doctor does the exam, a female nurse or assistant is always present.
- Doctors are professionals whose job is to help you and your family.
- Your support can save your partner's life and keep your family together.
- Prevention (regular Pap tests) is less expensive (in time, money, grief, etc.) than cure or death.
