Ameliorated Pap Tests and Cervical Cancer Screening Participation

3-year cervical cancer screening participation

Defined as attending a Pap test at any clinic before the end of the 3rd subsequent year following study entry

1-year cervical cancer screening participation

Defined as attending a Pap test at any clinic before the end of the next year following study entry

5-minute recalled pain intensity on a 1-5 numeric scale and a 0-10 visual analog scale

Recalled pain intensity at 5 minutes after the Pap smear test with evaluation by a 1-5 numeric scale and a 0-10 visual analog scale.

3-month recalled pain intensity on a 1-5 numeric scale and a 0-10 visual analog scale

Recalled pain intensity at 3 months after the Pap smear test with evaluation by a 1-5 numeric scale and a 0-10 visual analog scale. To minimize potential propaganda for cervical cancer screening participation, the investigators choose the 3-month interval rather than 6-month or 1-year intervals for long-term pain recollection after Pap tests.

Real time pain during the Pap test using a 1-5 numeric scale

The participants will evaluate and record their pain every five seconds throughout the test with an application on a 1 to 5 numeric scale. The average pain, the maximal pain, and real-time pain at the beginning, first quarter, second quarter, third quarter, and the end of the regular course are compared between the two groups. The investigators will compare the average pain of each group's first and second half of the course's course. For participants receiving the modified Pap test, the investigators further compare the average pain, the maximal pain, and the last recorded real-time pain of the 15-second step with that of the regular course.

Patient-reported feedback at the end of the study

Patient-reported feedback at the health-service level drives revolutions and innovations. At the end of the study period (after the end of the third follow-up year in participants who do not undergo the 3-year cervical cancer screening after the study entry; or at least one month after the latest Pap test in participants who undergo the 3-year cervical cancer screening after the study entry), all participants will be asked to provide open-ended feedback for future qualitative research on Pap smear screening (detailed in subsequent research proposals). For instance, "Can you tell me more about your thoughts on Pap tests you have undergone these years?" or "What is your opinion on the future of Pap tests?".