How to Address Patient Hesitancy Around Cervical Cancer Screening With Ada Stewart, MD

Patient hesitancy remains a barrier to timely cervical cancer screening, even when guidelines are clearly communicated. Anxiety around Pap smears—including discomfort with the exam and fear of results—can discourage women from keeping up with recommended screening schedules. Primary care physicians are in a unique position to address these concerns directly during routine visits, ensuring patients are informed, supported, and comfortable throughout the process.

In this video interview with Patient Care Online, Ada Stewart, MD, a board-certified family physician, discusses practical strategies clinicians can use to reduce patient anxiety during screening exams. From incorporating shared decision-making to simple in-office adjustments such as using a smaller speculum, playing background music, or offering staff support, Dr Stewart highlights ways to make cervical cancer screening a more patient-centered experience.

The following transcript has been lightly edited for style and flow.

Ada Stewart, MD: Yes. It’s really important that, as a primary care clinician and family physician, I inform my patients and make sure that all decisions are shared between myself and them. I talk about the guidelines, the recommendations, and the limitations of the tests we perform. I also make sure to assess their comfort level with the Pap smear and address any concerns.

If it’s about pain with the speculum exam, I try to use the smallest available speculum. Sometimes I’ll have music playing in the background. I may even have one of my staff hold the patient’s hand. It’s all about shared decision-making—making sure the patient is well informed about what the guidelines say, what’s best for them, and what limitations may occur—while ensuring they are comfortable with the exam itself.