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Old 10-04-2012, 07:04 PM   #8
Join Date: May 2011
Location: Australia
Posts: 7
Eliz52 HB User
Re: What is the science behind Pap Smear screening guidelines?

Originally Posted by Titchou View Post
Frankly I don't see any untoward risks in having a Pap smear annually. I've had 3 or 4abnormal paps over the years and was not pressured to any treatment plan other than to come back in 6 months for another. I did and nothing showed up the second time. One time I am sure the abnormal result was from having sex the night before as I forgot about the gyno appt the next day. I do agree that women aren't told reasons a pap could be abnormal from such things as sex in the recent past and even so much as bubble bath the night before so that they can avoid them and have valid test results. But it behooves us all to ask more questions and demand more answers and alternatives.
We need to be participants in our healthcare - not bystanders.

None of this however, changes the fact that some cases of cervical cancer are not caused by the woman being HPV positive. To say they all are is to put women who have not been exposed to HPV and have cervical cancer in an untenable situation with their loved ones. And then there are those cases where HPV was transmitted by the mother to the child during birth. And that's a whole other story.
Even when a child is infected by the mother, that doesn't change a thing, HPV primary testing provides you with very important information, I'm at risk or not at risk, HPV positive or negative.
If you want to have unnecessary pap tests every year and don't mind dealing with false positives and the risk of potentially harmful over-treatment, that's your business, but women should be provided with honest information so they understand what they're agreeing to...the benefit with annual and 5 yearly pap tests is the same, but the more often you screen, the more false positives you produce, not surprised you've had a few already....the referral rate for colposcopy/biopsy with annual pap testing is very high, Dr Richard DeMay, the American pathologist, put it as high as 95% lifetime risk, and it would certainly be higher than the Australian referral rate of 77%... now this is for a cancer with a 0.65% lifetime risk.
Frankly though, any doctor promoting annual testing is IMO, either incompetent or unethical, he/she is taking a huge risk with the health of their patient for no additional benefit. You may not mind false positives, but many women find them terribly distressing, not to mention the huge number that end up being over-treated and having excess biopsies..some of whom end up with damage to the cervix and can then have issues - premature babies, miscarriages, infertility, the need for c-sections, cervical cerclage etc
Population pap testing is now outdated anyway, why would a HPV negative woman, most of us, want to spend a lifetime having unnecessary pap testing and the risk of over-treatment?
You may be accepting of annual pap testing because you're also having routine pelvic and breast exams, if so, you might want to consider the evidence there, neither is recommended in Australia, the UK and in many other countries. The routine pelvic exam is of poor clinical value and carries risk...your Dr Carolyn Westhoff partly blames this exam for your high hysterectomy rates, 1 in 3 will have one by age 60, and women losing healthy ovaries after false positive exams...routine breast exams don't bring down the death rate, but lead to excess biopsies.
The evidence is clear now that HPV negative women have nothing to fear from cc and that's why countries that do what's best for women adopt evidence based programs. Sadly, women's healthcare in the States (and to a lesser degree, Australia) is IMO, about harmful excess and huge profits for the medical profession. The Finns have the lowest rates of cc in the world and refer far fewer women, yet have had a 6-7 pap test program, 5 yearly from 30 to 60, since the 1960s...some older American women have had 40 pap tests, just absurd...and yet the States has more cc than Finland...excess just worries and harms women and makes billions for the medical profession.
Anyway, good luck to you, you'll need it with your annual pap testing, please be horrifies me to hear that some women are still having annual pap testing, these doctors really should be stopped, they know their patients cannot benefit from this excess and can only be worried and harmed.
Unfortunately, this forum does not permit links or references to other websites or I could post some references for you. Sadly, I believe many women have been misinformed over decades and are now afraid to move away from excess.
I've done a lot of reading on this subject over many years and I don't think a HPV negative women is at risk of cc...of course, she can get a new infection, but that's why women will be offered 5 hrHPV primary tests at 30,35,40,50 and 60 to cover that possibility, or they can test themselves, but women HPV negative and no longer sexually active may choose to stop all further testing and women who are confidently monogamous may do the same...up to them.
It's time women were included in the decision-making and that's only possible with access to real information. I had to do my own research, that shouldn't be necessary. Anyway, nice chatting to you.