Originally Posted by CountMeAmused
We know HPV has to be present for cervical dysplasia.
How does a monogamous women in a 15 year marriage who has tested neg-Pap for 20 years / neg HPV DNA for 5 and has had unprotected sex only with her husband, contract HPV?
How does it make sense to continue pap smears at all (nevermind 3 year recommendation or 5 year with HPV DNA)?
And where are the home HPV DNA kits since self-collection has the same false negative rates as clinical collection (looking at you FDA...)?
The elephant in the room seems to be the notion of a unreported infidelity by husband or a lie by wife. But that's insulting and is a risk best assessed and managed personally.
The PAP smear guidelines still seem ridiculous and the industry's attitude is akin to a state mandated inspection program (vs. a service provided to meet demand).
You are spot on, CMA, most programs are not evidence based...most women are having unnecessary pap testing and many face excess biopsies and potentially harmful over-treatment. Take a look at the new Dutch program to be implemented shortly...women will be offered 5 hrHPV primary triage tests at ages 30,35,40,50 and 60 and only the roughly 5% who are HPV positive and at risk will be offered a 5 yearly pap test. Most women are HPV negative, about 95% of women aged 30 and older, they can only be worried and harmed by pap testing. Under the new Dutch program the HPV negative women will be offered the HPV primary testing program or they can test themselves with the Delphi Screener. Those HPV negative and confidently monogamous or no longer sexually active can forget further testing.
Many countries will never see evidence based testing, IMO, population pap testing and the enormous over-treatment it generates means huge profits...excess suits many, but is a lousy deal for women. Population pap testing misses too many of these rare cancers, condemns huge numbers to excess biopsies, potentially harmful over-treatment and a lifetime of unnecessary pap testing and it wastes a fortune...it also shows a deep disrespect for the bodily privacy of women, as well as a cavalier disregard for our health and legal rights. I made an informed decision not to test decades ago...if I were concerned about this rare cancer, and I'm not, I wouldn't even consider a pap test before establishing I was HPV positive and at risk...there is no point pap testing and doing biopsies etc on HPV negative women...it certainly is not in the interests of women.
I can't mention other websites as it apparently breaches the rules here, but if you search unnecessary pap smears, you'll find forums with many posts from women concerned about the misinformation and complete absence of informed consent in women's cancer screening and many tragic posts from women harmed by this testing.