Pap Smear Readability on Google: An Analysis of Online Articles Regarding One of the Most Routine Medical Screening Tests

Background: The Papanicolaou smear (Pap smear, Pap test) is one of the most routine screening tests performed in medicine. The development and widespread use of this test has brought a considerable decrease in the incidence of cervical cancer. Unfortunately, this disease process continues to convey significant morbidity and mortality. These persistent phenomena may be the result of inadequate compliance with routine Pap smear screening, in which limited education is thought to play a role, particularly among ethnic minority groups. Methods: A Google search using the phrase “pap smear” was performed and the first fourteen web addresses were analyzed using four standardized readability indices: the Flesh-Kinkaid Grade Level, the Simple Measure of Gobbledygook, the Gunning Fog Index and the Automated Readability Index. The average grade level readability was then compared to the American Medical Association recommendation that health care information should be written at a 5th or 6th-grade reading level (i.e., ages 10-12 years). Results: The average grade-level readability values of the fourteen analyzed sites using the four aforementioned indices were 8.9, 8.8, 11.9, and 8.4, respectively. The mean readability of all four indices was 9.5. Conclusion: The grade-level readability of commonly accessed internet information regarding Pap smears is above the recommendation of the American Medical Association. Health care providers and website authors should be cognizant of this, as it may impact compliance. This is particularly important given that this routine healthcare test is recommended for nearly fifty percent of the world’s population at various points throughout their lifetime