Cover photo of Pap-A-Thon Toolkit

Pap-A-Thon Toolkit: Hosting a Women’s Community Health Event – Increasing Cervical Cancer Screening in Rural Tribal Communities


Cervical Cancer is the fourth most common cancer among women globally, with an estimated 570,000 new cases worldwide in 2018.

American Indian/Alaskan Native (AI/AN) women experience higher cervical cancer incidence compared to White women, specifically the Northern Plains, Alaska, Southern Plains, and Pacific Coast regions (Melknonian et al., 2019). At least 80% of cervical cancer incidence and mortality rates can be reduced by regular Pap tests (Sasieni, 2009). The top reasons for AI/ANs were overdue for their cervical cancer screening or Pap test are: never thinking about having it, not having any problems, never told by doctors to do so, putting it off, not knowing it is needed, and being unpleasant (Lin et al., 2016).

American Indians and Alaska Natives cite a number of barriers to cancer screening such as cultural reluctance to access Western medicine for non-acute health problems, transportation difficulties, lack of childcare, negative perception of health providers, long waits for appointments, poor patient-provider communication, provider time pressures and an underfunded health system (National Indian Council on Aging, Jan 2020).

AI/AN cultures have distinct practices for health, medicine, and healing. Cultural values and social norms about cervical cancer and screening should be considered when tailoring screening services for these populations (Lee et al., 2021). This tool-kit provides the framework for a planning, delivering and evaluating a cervical cancer screening event in your community. Women’s health events offer an opportunity to address your community members’ needs for health promotion, education and prevention (Dillon, 1997).

A locally planned Pap-a-Thon provides an opportunity for tribal heath clinics to dedicate time and attention to address cervical cancer screening for their clients in a culturally respective manner (Olsen, et al., 2013). When dedicating an event to cervical cancer screening it is important that the providers and health system staff address the physical, spiritual, mental and emotional needs of their respective clients.


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