From the article: Pap Smear Guidelines - Recommendations for Cervical Cancer Screening
Lots of women are railing against the changes in cancer screening guidelines, saying that they want to keep getting screened the old way. They think more screening must be better and are unwilling to believe that doctor may know best. What about you? Will you follow the new screening guidelines if your doctor asks you to? What will you do if your physician wants to stick with the old guidelines but you think the new ones are the right way to go? Use this space to talk about how you make your health care decisions.
NOTE: To answer anonymously, log out of your account and post as a guest. Share Your Reasons
NOTE: To answer anonymously, log out of your account and post as a guest. Share Your Reasons
Programs should be in OUR best interests
- There is no greater proof in Australia that our outdated screening program is for the benefit of doctors and profits, than to compare our 26+ pap test program to the Netherlands or Finland. The latter have 5 to 7 pap test programs, 5 yearly from 30 to 50 or 60 and the Dutch are already using the Delphi Screener, the self-sample HPV device. The Dutch will shortly move to 5 hrHPV primary triage HPV tests offered at 30, 35, 40, 50 and 60 and only those positive and "at risk" from this rare cancer will be offered a 5 yearly pap test. Those negative and monogamous or no longer sexually active can forget testing or test infrequently for HPV - others negative but sexually active with more than one partner can follow the HPV schedule. This will GREATLY reduce testing and harmful over-treatment. This program is also more likely to pick up these rare cases, including adenocarcinoma, usually missed by pap tests. So while our doctors count their $$$, women are being harmed & dying unnecessarily.
- —Guest Elizabeth (Aust)
Patients Need Choice
- I am currently being told (ORDERED) to get a stereotactic breast biopsy after a routine screening mammogram. I am trying to get a second opinion but am being bossed around and bullied. I don't fear cancer. I fear harm from the "test" that I didn't even ask for nor want. I feel like moving to Europe where the doctors are not so "test happy" as American doctors. It all boils down to $$ women, so be sure to question ANY order for a test on your body, particularly 'female oriented" testing such as paps and mammograms. All testing carries risk - infection, radiation exposure, and other downsides. We need to stop worshipping the test mentality and get off the fear train.
- —Guest Wants Informed Consent
Please read this asap!
- Can I recommend a recent lecture by Prof Michael Baum at UCL entitled, "Breast cancer screening; the inconvenient truths"? It's highly informative and although runs for around 35 minutes it could save you a lot of grief. The new NHS breast screening brochure (UK) has been soundly criticized - once again it fails to inform women of risk and benefits. I agree with Prof Baum...a double standard exists - most accept the facts surrounding prostate screening and men have been promptly informed of the ACTUAL risks and benefits - they also have a choice about screening - while resistance continues in our cancer screening - to giving us truthful information and a say in whether we screen or not. It really is disappointing that women could be treated so poorly, for so long, by so many... The risks are greater for American women as coercion is the norm in your "healthcare" - many of you are testing in your 30's and yearly! http://medphyzz.blogspot.com/2011/01/professor-michael-baum-on-breast.html
- —Guest Elizabeth (Aust)
Increasing concern about mammograms
- Just thought some of you might be interested to hear that Prof Baum, UK cancer surgeon, is calling for the UK breast screening program to be shut down, too many women are being harmed through false positives and over-diagnosis. Also, Gilbert Welch is releasing a book called, "Over-diagnosing - making people sick in pursuit of health" in January 2011 - it includes a lot of information on mammograms and prostate screening. If you search Prof Baum and halting the breast screen program, the article should appear, it won't link for some reason. Good luck everyone!
- —Guest Elizabeth (Aust)
We need lots more information
- The last poster is right... I saw a chart that showed the pros and cons of annual, biannual, 3 or 5 yearly pap testing. The benefits of the first 2 were only slightly better than 3 or 5 yearly testing, but the number of false positives rose sharply with annual and biannual testing. Testing women under 25 also showed no change in the tiny death rate, but very high rates of false positives and excess procedures. I thought at the time it's a shame women aren't given that chart and allowed to consider a) whether they want to test - has any woman ever been asked? My husband is asked by his Dr, the attitude appears to be completely different with men. I have around 4 friends that don't have testing anymore, largely because of traumatic experiences caused by annual and early screening. When you look at more moderate programs and certainly the Dutch one that allows self-testing, this test doesn't cause as much damage and the impact on the lives of healthy women is lessened. That's a good thing
- —Guest Janis
We should be able to tailor screening
- I think it should be possible to tailor screening to individual risk but that doesn't happen. Currently doctors make all screening decisions and only a few women are able to make their own decisions. My sister is a lawyer and opposed to screening FOR HERSELF, she has done lots of research and thinks doctors have been dishonest with women. After looking at risk and benefits and her research and speaking to a pathologist friend she has always stayed out of screening. She doesn't get pressured by doctors because she knows her rights. She has told me many times that I have every right to make my own decisions about screening, when, if and how often, but I often get intimidated in medical settings. For the rest of us, doctors make our screening decisions. Strictly speaking they should be responsible for any harm that occurs because we haven't really consented to the test particularly if it's required for BC. My sister gets BC with a blood pressure test, no other exam. Lucky her.
- —Guest Jessica
Our doctors were always wrong
- "They think more screening must be better and are unwilling to believe that doctor may know best" They only think that way because doctors have been telling us that for decades. When you find out the earlier recommendations were recklessly excessive and only now are changes being made, doctors can hardly complain that women are scared, confused & angry. Perhaps it might have been better to treat women like adults, give us the pluses and minuses and allow us a choice about testing - including how often and when to start and stop. Doctors gang up and practically force women to test every year from teens, and now they turn around and say, "Ummm, harmful, screen less"... None of this is new, if you look at Europe you'll see we always had excessive testing that caused high levels of intervention. My own mother has had around 40 paps. In many countries she would have had none as she's low risk and definitely no more than 5. Naturally, like every other woman her age, she's had treatment.
- —Guest Stop over-testing!
Look closely at your doctors advice
- That's not the Q, Elizabeth. Dr's are continuing to overtest women and that means sending too many women for distressing biopsies and LEEP. Women need to start refusing the excess or you risk your reproductive heath. Dr's are the greatest threat to our health, their pig-headed refusal to adopt evidence based recommendations and respect informed consent means healthy women are injured and will live with that damage forever. My sister is unable to have children as her cervix has been virtually destroyed by multiple aggressive treatments for mildly abnormal tests. She has endured 8 years of trying, tragic for us as all we can do is offer support. We need to find a way to force doctors to back off and behave professionally by putting our health and interests ahead of their own. It worries me what is being done to women in the name of medicine. If your Dr doesn't respect your opinion or is following the old excessive schedule, change doctors - your health depends on it!
- —Guest Claire
You can't trust doctors anymore
- Heck no... I've been watching with horror all the research into the harms of mammograms for about 10 years now and not much of it is mentioned by doctors or appears in the media. It scares the hell out of me that they don't tell women about the risks of these tests. Some research suggests mammograms cause cancer. Take a look at this study from about 8 years ago, this research is not new. I don't trust doctors and unless I'm ill, I'll stay as far away from them as possible. My health depends on it! http://jnci.oxfordjournals.org/cgi/content/full/95/20/1508
- —Guest Maggie
My health, not public health objectives
- I'm disillusioned with all of the tests and exams that we're pressured to have from an early age. The medical world is very slow to change and exams that are now known to be of little value or may even be harmful are still marketed to women. If the exams are of doubtful value, who benefits from them? Doctors. I think many American doctors depend on the income from the annual gyn exam. This is one exam I never started after becoming aware of its dubious value when I was studying in London. I also don't care for the attitude that all "responsible" women agree to every screening test without question. Once again, our doctors over-recommend....for their benefit. Over-screening equals a lot of income, but is not going to help you and is not in the best interests of your body. I insist on an honest overview of the test and I read up on the cancer. Is it a real threat to MY life? Is this test beneficial or are the risks of over-diagnosis too great? A good Dr will help you with these question
- —Guest Maggie
Educate and protect yourself
- These guidelines are general in nature. I prefer to deal with MY health. Am I high risk for anything? Dr's don't like women making their own decisions and would prefer us to file into day procedure like lemmings. I may be a woman, but I'm not a lemming. Having discovered 20 years ago that there are two sides to the screening story and women only hear one side, I embarked on a complete review of all the research and spoke to an epidemiologist working at the University. That information has shaped my healthcare and protected my healthy body from excessive biopsies, scans, ultrasounds, surgery and other procedures, all of which can harm you. I feel in control of my health, few women can say that. My Dr initially refused me the Pill and I arranged to go back after hours and took my research. I've been getting the Pill with no exams for 20 years. (apart from blood pressure checks, which ARE necessary when you're on the Pill) Women need to be very careful - don't be docile & trusting!
- —Guest Marianna
I'd never follow YOUR guidelines
- I never follow your guidelines, they're all too much and land you in trouble. I think the changes for mammograms are way overdue. The risks with breast screening are real we do what we think is in our best interests, only to wind up worse off. I'm from Cornwall and always knew your smear test "recommendations" risked your health, I also knew mammograms at 40 and yearly was a bad idea. I doubt I'll have them at all. I was worried when I read your doctors recommend yearly pelvic and breast exams for healthy women with no symptoms. That's crazy and very likely to land you in day procedure. Most of this is about doctors interests, $$$$ and not our interests. I keep up with my reading from the UK. A lot of your excess is also doctors' preferring to hurt you (but hopefully not kill you) covering themselves from legal action - they'd rather risk your health doing 55 pap smears than adopt an evidence based schedule that protects you from cancer & unneeded procedures. Stop trusting Dr
- —Guest Donna
No, I want more information
- Dr's warn about prostate screening; it's inaccurate and sends healthy men off for biopsies after incorrect results and some end up impotent or incontinent. Doesn't that happen with cervical and breast screening as well? No one seems to care about that. I know cervical biopsies are very common and obstetricians are seeing the damage in alarming numbers of women. Yet doctors write off this damage as unimportant, even though cervical cancer is rare compared to breast and prostate cancer. Breast screening can lead to pointless surgery, chemo, biopsies & finds pseudo-disease. I didn't read about these things here, but my sister in London sent me some articles that appeared in the "Guardian" including a letter to that paper signed by a large number of very senior doctors warning the government to stop lying to women about screening. Basically screening has been oversold to us and risks played down or hidden. I've stopped screening and want full info, not spin, before I gamble with my health.
- —Guest Maggie
I want what I want
- I worry about all this screening. It doesn't help many people but turns lots of us into patients. I've noticed lots of women need that comforting "your results are normal" every year. Our grandmothers didn't need those assurances. Now no one has confidence in their health unless their biopsies and tests are normal. We feel like we should be doing "something" to prevent cancer, but we still drink and smoke, don't make time to exercise, carry too much weight. This lulls people into a false sense of security. I look at overall health and don't have screening. My Dr is disapproving, but in the end we have to do what's right for us. I want what I want, which is no screening at all. Increasingly that means I'm a "difficult" patient. I don't agree with behaving like a robot, I take ultimate responsibility for my health and life.
- —Guest Suzanna
I want to consider the new guidelines
- Actually this is an area in need of regulation. My doctor has now said unless I agree to annual screening (even though I only need 3 yearly screening) and an annual mammogram (even though we're now told we shouldn't have a mammogram until we're 50), I will no longer be able to get birth control from that clinic. I'm in a no-win situation. Do I agree to these tests even though we're now told these tests are not recommended and can cause harm? I guess the harm is from incorrect readings and results. It is a bit unfair to change guidelines when our doctors make up their own. When doctors control access to birth control, doesn't that mean we have do do what may be wrong and against our best interests, to get pills? I have called another nearby clinic but their rules are the same. We're going back to condoms until we can find a doctor who will permit me to do what is best for me and not blindly test regardless of need and risk.
- —Guest Chloe
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