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

Background: The Papanicolau smear (Pap smear, Pap test) is one of the most routine of all screening tests performed in medicine. Its advent and widespread use has brought a considerable decrease in the incidence of cervical cancer. Unfortunately, this malignancy continues to convey significant morbidity and mortality. Much of this is the result of inadequate compliance with routine Pap smear screening, in which limited education is thought to play a role, particularly among ethnic minorities. Methods: A Google search using the phrase “pap smears” was performed and the first fourteen Uniform Resource Locators were analyzed using four standardized readability indices: the Flesh-Kinkaid Grade Level, the SMOG index, the Gunning Fog Index and the Automated Readability Index. An average grade level readability was then obtained and compared to the AMA recommendation that health care information be written at a 5th or 6th grade reading level. Results: The average grade level readability of the fourteen analyzed sites using four aforementioned indices were 8.86, 8.82, 11.92 and 8.35, respectfully. The total average readability after considering all four indices was 9.49, three grade levels above what the AMA has recommended. Conclusion: The readability of commonly accessed internet information regarding Pap smears is above what is recommended by the AMA. Physicians should be cognizant of this, particularly given this is a routine healthcare test that should be undergone by nearly fifty percent of the world’s population at various points throughout their lifetime.