title: Abnormal Pap test results and the rurality factor.
abstract: OBJECTIVE
  To review the published socio-cultural determinants that put women in rural areas at greater risk of having an abnormal Pap test result.
  
  
  METHODS
  Literature review.
  
  
  CONCLUSIONS
  An Australian woman is at increased risk of developing cervical dysplasia if she lives in a rural area, identifies as an Indigenous Australian or is from a non-English speaking country. Being aged over 50 years, increases the risk of cervical cancer but not cervical intra-epithelial neoplasia (CIN) 1, which peaks in the 20-24 year age group. Other connections with cervical dysplasia relate to a woman or her partner's sexual history, her nutritional status and possibly even her personality type. Smoking, social isolation, high negative life change events and having lived a 'troubled' life are all identified in the literature as increasing a woman's risk of having an abnormal Pap test result. Receiving an abnormal Pap test result often leads to feelings of fear, anxiety, guilt, shock, vulnerability, powerlessness, depression, shame and feeling dirty for the woman concerned. Compounding these negative feelings are social, practical and financial difficulties that have to be addressed. It is argued that social and medical models of health must complement each other to improve the well being of rural women experiencing an abnormal Pap result.
authors.affiliation: School of Clinical Sciences, Charles Sturt University, Wagga Wagga, New South Wales. edietsch@csu.edu.au
authors.forename: Elaine
authors.initials: E
authors.lastname: Dietsch
authors.forename: Heather
authors.initials: H
authors.lastname: Gibb
authors.forename: Karen
authors.initials: K
authors.lastname: Francis
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D005260:Female; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000458:organization & administration; D008875:Middle Aged; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000517:prevention & control; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology* / Q000517:prevention & control