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Readers Respond: Reasons women avoid Pap smears: Is it fair to require them for birth control?

Responses: 195


Updated October 14, 2010

Stop overdoing paps

I'm high risk for cervix cancer, I have all of the risk factors and had CIN 3 treated last year. Even with CIN 3 only about 30% of cases progress, but I felt that was too high and went for the treatment. I won't lie, the treatment was horrible and very painful. The problem with this testing is casting a huge net to drag all women into this imperfect testing and that's wrong and unfair. I can see why many women might not be concerned about a cancer that doesn't bother all that many women, some would say (including my Dr) that it's rare. When I see virgins, low risk women, women with no cervix (after hysterectomies for things other than cancer), elderly women, teenagers /young women and women being over-tested, it scares me. Women should be free to make their own call. When I see women with almost no chance of cancer having chunks of their cervix removed, it angers me. We're overdoing it and that's what all these women are upset about... We are seeing too many procedures for a rare canc
—Guest Jane C

You can't demand women have screening

I think we need to be very careful with the increasing demands made on us to have cancer screening. I've noticed those demands are made of women and not men. I saw a pleasant brochure the other day entitled, "Should I have prostate cancer screening - the pros and cons" and thought how lucky men are to be treated like grown ups. The fact that is always overlooked with our screening tests is our individuality. No one can say that this test is advisable for every woman because no one can say how I'd cope with the very invasive test, some find it painful or how I'd cope with biopsies and they are almost definitely going to happen with cervical screening. Also, our level of risk varies. It's arrogant in the extreme to demand I put my health on the line so a Dr can tick a box. Dr's care about numbers and profits, I care about my health and happiness. I've never had any sort of screening test and at 52 couldn't be healthier. My decisions were made after I gave the test a fair hearing.
—Guest Jackie P

Take control and be polite

I don't understand why more women don't take control of their health care. If you don't want screening, politely and firmly tell the doctor/NP you have made an educated decision. If they refuse you birth control, you remind them politely that these exams are not compulsory and BC can't be denied simply because a woman has made an educated decision. I'm anti-screening, the sheer numbers of women who get "abnormal paps" makes the test unacceptable to me. It's not a common cancer, not at all and I'm not a high risk woman. I don't feel these investigations are trivial. I've had many friends go through laser treatments, cone biopsies and other diagnostic checks. Always negative, oops...the test was wrong again. I doubt any other screening test would be allowed that produced such high numbers of excess investigations. I'm not sure why it's acceptable when it's our bodies being interfered with. Stand firm is my advice, doctors cannot by law refuse you BC, unless you're an unsuitable candidate
—Guest Marisa

Re Safe than Sorry.

Her response just shows how doctors seem to keep patients illinformed about these tests. Pap smears don't test for HPV Safe than sorry. You probably are infected because 80% of the population is. Having a clear pap test doesn't mean you don't have the virus.
—Guest Sue

Safe than Sorry!

I'm glad I've done it. It's a piece of mind; and knowing on a cellular level I'm healthy and safe is a good thing for me and my partner. Knowing whether or not I may have HPV (cancer) for example is supreme - not only for my health, but HPV (in other forms ie. warts) can be spread. The last thing I want on my conscience is that I may have given it. Even though visible signs may not be present, the strain may be and can pass on, creating issues for someone else. After all, I would not want my partner to give it to me, when a woman he may have slept in the past neglected a PAP - then he give it to me. Get checked out! Don't give it! Don't get it! Stop the spread!
—Guest B.J.L

Not all women want screening tests

I noticed American women spend a lot of time at the gynaecologist's office. I've never seen one. (I'm 37) No woman uses a gyn as her everyday Dr or sees one routinely. I only see a Dr when I have a health problem. I went recently to get injections because I'm travelling to China next month. I'm never pressured to have anything, not would I allow that to happen. If I wanted the Pill, I can get it easily, nothing invasive is needed. My partner and I use condoms, easy and no side effects. My Dr has raised pap smears in passing, but I'm anti-screening. All screening is a gamble, why expose myself to risk? I prefer to live the old fashioned way and wait for symptoms and deal with real problems, not imaginary ones and suffer treatment for fun. All screening has been oversold to women. Note: Doctors make money from testing! We have a right to our own feelings about cancer tests. Refusing the Pill is a serious thing, the risks of pregnancy are high whereas screening is a gamble.
—Guest Aimee, Brisbane

I regret not looking for answers earlier

Thank you for this place full of facts. My daughter had a conization and curette when she was 18 after she had to have a pap test exam before she could get BC pills. I was surprised she needed this treatment but I guess accepted that the doctors must know what they're doing. I'm ashamed I didn't protect my Dr or even advise her to get another opinion. When the guidelines changed recently and it said screening was not advised for women under 21, I quizzed my doctor. I wanted answers and made my way to a forum on the blogcritics site. Devastated beyond words, I read that doctors in England have known for a long time that pap tests are unsafe in women under 25. Many of our doctors are still testing young women and we as mothers can't sit idly by. My daughter has lots of scar tissue and will have problems if she wants children. The trauma of that procedure means she avoids Drs and doesn't want a relationship anymore or children. This is her way of protecting herself from further harm. Gina
—Guest These sites are SOOO important!!!

Protection means being honest with women

In my ethics course, we looked at a paper that shows how women are mistaken about this cancer and the pap test. Because there is pressure to test and it's raised often, many women believe this cancer is very common. A survey was taken where women were shown a graph showing the incidence rates for 4 cancers - breast, cervix, lung and bowel, most OVER-ESTIMATED the risk of this cancer. Many thought cervix cancer was more common than bowel or lung. Not true. Women also OVER-ESTIMATED the value and accuracy of paps because the advice we get says paps are important, safe, reliable and will save your life. We don't hear about risks or number of lives saved per number of women tested. This means danger - women placing too much faith in paps, being overly worried by over-detection, ignoring symptoms & making bad decisions for their health. (allowing radical treatment, uninformed and over-testing) http://her.oxfordjournals.org/cgi/content/full/18/3/318 This is unfair and risks our health.
—Guest Jacqueline B

Doctors overuse this test

"our loose society and morals" Yes, high risk women should look at the benefits of having smears but need to let doctors know they won't allow them to overuse the test. I read in the newspaper that drs are still overusing the test and that risks our health. Even high risk women need to use this test sparingly. Low risk women are in a different group and really our chance of being helped is tiny but we all have to accept risk every time we have this test. I know a 17 year old girl who is about to have a conization. I know she'll be left injured and it is unnecessary. Her Dr should be forced to follow the new recommendations and not carry on doing these harmful things to young girls. Her chance of cancer is 1 in a million and the treatment is too aggressive for moderate dysplasia. By all accounts this test is unsafe before your mid 20's. I agree that women who have lots of risk factors probably should consider the test but like others have said never be refused BC and it's her choice.
—Guest Tina

not getting checkups

1. I'm post menopausal 2. Not sexual active 3. Waste of time and money for older women I think it is wise for sexually active women to get pap smears because our loose society and morals are so weak and the STD rate is only going to rise. Birth control does not totaly stop STDs. If not found early with screenings some STDs go unnoticed and can cause irreversable damage or death.

Time for women to sue...

I hear men got risk info and a choice about screening because men sued after being left incontinent and/or impotent after treatment for false positives. The current militant, harmful and dishonest system can be stopped by women who've been harmed - SUE - there is no informed consent in any country, one-sided government health sites, brochures and ads - even the fact most mention false negatives (which are not all that common) but not false positives (which are VERY COMMON). There is also rarely a clear idea of risk - they never say 1000 women need regular smears for 35 years to save one woman from cervical cancer, they say something fairly vague like "there has been a 70% reduction in cervical cancer since screening started"...ahhh, 70% of what? Open and shut cases and vast numbers of women would have solid cases against doctors and the govt. It is the only way we can stop this ugly and destructive machine. Hit them where it hurts - their bank balances!
—Guest Beth (UK)

We're not selling cars

This cancer is largely preventable, aside from false negatives, but so is bowel cancer as it starts with a polyp that becomes cancerous over the years. There is no real pressure to have bowel screening & doctor's don't refuse drugs UNTIL we have bowel screening - yet bowel cancer is COMMON and takes the lives of lots more people and bowel screening doesn't produce huge numbers of false positives. My feeling: in the chase to reduce the death rate from this fairly rare cancer, we've forgotten the basics, human and women's rights. If this cancer is reduced down to near zero, is that really a success if we've harmed the majority of women in the process? Many of these posts show the impact of this screening test being forced or pushed onto women. There IS dishonesty with this testing. I compared my pap smear brochure with the facts taken from 5 medical journal articles and it was like they were talking about 2 different things. How is that right/fair? Puff & spin 4 us, facts 4 men Drs
—Guest Megan

Sorry, this isn't what we intended...

Hi everyone, I was passionate about the Australian program once, but somewhere along the way things have gone wrong. This test was intended to be an offer to women, but because this is one of the rarer cancers, we were aware at the beginning that a large part of the population would have to be screened to have any affect on the death rate. Sadly, this meant tweaking the truth, exaggerating the risk of this cancer, pushing aside individual risk and choice and using GP's to "recruit" women and pay them for their trouble. We also did not tell women about false positives and excessive interventions (always unpleasant, but also sometimes leave women worse off) We did give info on false negatives because it was useful to get women to come back. I started to feel this program was wrong and not what it was intended to be; a choice for women. I've had nothing to do with the program for a few years now and as there is no honest info available, I won't recommend it to any woman.
—Guest GMcC

You don't know the facts!

I agree with most of these comments. My husband and I traveled to Helsinki recently for a wedding. Women talk about these things and I left that country really angry at the lies we're been told about this cancer and testing. Dr's scare-mongering! This test has been used against women and not in our better interests. In Finland there is an honesty that is totally lacking here, doctors are respectful and committed to THEIR PATIENT'S interests. Since returning I've dropped the annual gyn exam that does little more than cause humiliation, discomfort/pain and harms many of us. Smears are a thing of the past for me. Had I known the truth, I would never have agreed to them, they have been a burden for me. We get propaganda from self-interested groups, not the facts and free-will for women is non-existent. I'm sorry I've been trusting and ignorant. The harm hasn't been too great, many of my friends were not as lucky, a few have had issues with miscarriages and prem babies after biopsies.
—Guest Rosalynne

Educate and protect yourself

I don't understand how BC got tied up with cancer screening. Our doctors certainly don't require it, but they do seriously pressure women. I find it amazing that a refusal means a waiver is produced for the woman's signature. She is also told the risk she's taking not having screening YET never told of the uncommon nature of this cancer OR the risks OF testing. All one-sided and designed to scare women into testing. No greater fuss is made about anything, but money is a powerful incentive for doctors. I've always known this concern was about bank account balances and not cancer. My husband didn't want prostate cancer screening and no waiver was produced even though that cancer is very common, but doctors don't get money for testing and hitting targets. No money = no pressure = doctors couldn't care less. More women need to stop being docile ignorant lambs - get online, get the facts and take charge. At least test sensibly, if you want to test at all. Storm in a teacup if you ask me.
—Guest Joan

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Reasons women avoid Pap smears: Is it fair to require them for birth control?

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