7 Responses to “Angela Raffle on the problems with screening”

  1. Elizabeth (Aust) May 13, 2011 at 12:16 am #

    It’s a shame most women will never see these articles – most require an expensive subscription fee or a trip to the Library.
    I couldn’t get to this article, but I’ll find a way…
    Women so rarely receive honest information, we have to search for the truth and find a doctor who’ll respect our decision not to screen. (if that’s our decision) A double standard is at work – men get risk information and they have a say in whether they screen or not – all very respectful. Men matter – they can make their own decisions in life, their dignity and bodily autonomy matter as well.
    Women get puff, spin, skewed stats, scare campaigns and an order to screen – we’re even called names if we choose not to test. (non-compliant, uneducated, immature etc) All highly disrespectful. The rectal exam was unacceptable to men, so they got the PSA test (I know it’s also unreliable), women are told to get “used” to these invasive exams. The cervical specific antigen blood test (patented in the States in around 2003) is apparently very reliable and I’m told has been blocked by those with a vested interest in pap testing. (it generates millions with massive over-treatment)
    It seems strange to me that after so many decades we STILL have nothing better than the pap test. Personally, I have no idea why we’re obsessed with this rare cancer – there are far greater risks to our lives that are virtually ignored….heart disease, mental health – almost every other disease is shoved behind this rare cancer – it makes no sense. People also get very angry and defensive if you dare to criticize cervical screening – attack is the best form of defense – IMO, it is their way of protecting the program and vested interests and keeping women ignorant is vitally important to their success. Censorship is common in womens’ cancer screening. I also regard the “information and awareness” campaigns as nothing more than propaganda. Why mention rates of cervical cancer in Africa? The suggestion that we have less cancer than Africa “because” of screening is nonsense – it was always a rare cancer here and in natural decline. African women have unique risk factors and even in those countries, AIDS and infectious disease or starvation are far more likely to take your life.
    Yet year after year that same argument is made to women and not one doctor corrects them. We get unsupported statistics and statements and are expected to just accept them – we don’t deserve proof – “do as you’re told, you’re a woman”.

    The AMA (in Australia) is currently scolding young women for failing to screen – yet they must know women under 30 don’t benefit from testing, but suffer great harm with huge numbers of false positives. No one says anything and these young women are coerced to their detriment. Some say the continued screening of young women is part of an experiment to see if there are fewer lesions in women vaccinated with Gardasil – would they have an issue risking womens’ health as part of an undisclosed experiment? Of course not…the message has always been the same – the Govt and doctors make decisions and accept risk for us, we’re mere bodies.
    Our program was supposed to be changed to 3 yearly from age 25, but we’re still waiting…
    It is so acceptable to treat women like third class citizens or idiots that the Govt even feels comfortable paying doctors behind our backs to achieve screening targets. Hardly surprising some women are subjected to harassment, intimidation, threats and disrespectful/unethical conduct.
    One doctor in NZ is even paying women $10 if they’ll agree to a pap test – informed consent for women is a joke!
    Some doctors will even send a nurse to your home or send you an appointment time for a test you didn’t ask for….
    Screening has been turned into an unwritten law for women.

    I totally reject this thinking – I made an informed decision many years ago not to have cervical screening and more recently rejected mammograms. I made my decisions on the basis of information that is not made available to women.
    The treatment of women has shaken my faith and trust in the medical profession – not much has changed – a lot of talk, but nothing has changed in the consult room. In Australia women are very over-screened resulting in 77% of women being referred at some stage for biopsies to cover a 0.65% lifetime risk of cervical cancer – most women would not know that – Papscreen do not mention false positives in their brochures, but mention false negatives which are not common – but mentioning the latter serves to scare women into regular testing.
    Opportunistic screening is also encouraged by Papscreen – ambushing women in unrelated consults.
    The screening target is rising to 65% of eligible patients in August this year (2011) in response to the fall in the number of women screening…panic is setting in – have to feed that expensive screening machine!
    The distress and harm caused by these screening programs concerns me greatly…but I’m part of a very small club.
    Womens’ cancer screening is about politics, vested interests, control, profits and power – it has very little to do with our health.

  2. Elizabeth (Aust) May 13, 2011 at 1:09 am #

    I just wanted to add that I’ve read some of your excellent articles and have enormous respect for doctors brave enough to challenge the unfairness of the current screening programs. You’re a small, but highly valued group.
    We should all spare a thought too for poor American women who are basically locked out of all medical care if they refuse pap testing – no contraceptive pill, migraine medication or anything else.
    It also extends far beyond pap testing – women are also routinely coerced or seriously pressured to have annual well-woman exams from age 12 or 13 (ACOG recently called for girls as young as 12 to start annual visits to get “used” to these exams – horrifying!) These exams require the woman to get into stirrups, naked under a thin piece of paper or in a short gown and includes a full breast exam (not recommended by our doctors), a bimanual pelvic exam (not recommended in asymptomatic women), sometimes a recto-vaginal exam (not recommended) and often annual pap testing. (and often unnecessary STD testing) Even though ACOG have wound back pap testing, most women have been brainwashed into annual testing and many doctors still recommend it or women won’t “come in for their annual well-woman checks”. Some women can’t get the Pill unless they agree to not only screening, but over-screening. Some US doctors are speaking out – Dr Carolyn Westhoff, “Questioning the value of the routine pelvic exam” also, Dr Robert Hatcher from the Managing contraception site (search his name plus pelvic exam and birth control and it should appear) – also, “women after birth control get unneeded pelvic exams” WSJ…
    But nothing really changes…
    I consider this abuse….pure and simple. Also, virgins are included in the US guidelines from age 21
    On Blogcritics and Unnecessary pap smears there are thousands of posts from women who’ve been harmed by testing or concerned at the current coercive system and lack of respect for informed consent – many have felt silenced for decades.
    Every doctor who speaks out is making a valuable contribution – how did we get to this dreadful state? Some say medicine was always paternalistic and this is just more of the same.
    I find it shocking that so many American and Canadian women are locked out of all medical care because they refuse pap testing – many turn to internet cafes or make trips to Mexico.
    Denying women the Pill to force cancer screening (which is elective!) and refusing to treat “non-compliant” women means unplanned pregnancies, stress on relationships, abortions, miscarriages, lack of medical care, worry, fear etc, etc – how can this be justified to force an unreliable elective screening test for a rare cancer?
    After decades of research, why is the Pill still available by prescription only? Men can get Viagra everywhere..
    I believe it’s a way doctors can control, manipulate and even coerce women
    into screening and other things. The attitude seems to be that women can’t be trusted or lack the capacity to make their own healthcare decisions. I totally disagree….

  3. Eliz May 13, 2011 at 1:12 am #

    Sorry, not internet “cafes” – meant to say internet “pharmacies” that don’t require scripts for the Pill and other meds

  4. Margaret McCartney
    margaretmccartney May 13, 2011 at 9:15 pm #

    thank you, Elizabeth…..the entire pelvic-exam-as-a-check-up will, I believe, be looked back upon as one of the great travesties of modern medicine. The US has it far worse than the UK as far as non-evidence based interventions goes.
    Screening is the kind of stuff which is in the book, which I hope will be out late this year or early next. The irony is that many doctors feel that not offering well women check ups is risky – when in fact, the risk is the reverse. Well women risk becoming patients, with all the attendant risks, instead.

  5. Sue Cartlidge November 21, 2011 at 10:07 am #

    I have not had intercourse for about 10 years now. I am a widow, and only had 1 sexual partner – my husband. My last smear was negative. I am being bombarded by my GP nurse to have a smear test. Do I really need to go through this procedure? I had a hysterectomy in 1998 but I still have a cervix.

  6. Margaret McCartney
    margaretmccartney November 21, 2011 at 9:49 pm #

    dear Sue
    I can’t really offer personal medical advice. Can I suggest that you speak to a GP at the surgery and explain your dilemma and discuss the pros and cons?
    It’s a real shame that women aren’t offered balanced information and offered a choice of whether or not to have a smear. all best, mgt

  7. OverItAll April 1, 2012 at 10:46 am #

    Just a little background on me:
    Since I started my period at 12, I’ve had extremely painful periods that were so bad I stuck stuck in bed each month for 3 weeks (the week before, the week of and the week after my periods). By 19 I had had enough and started seeing an OBGYN. I had MONTHLY FULL pelvic exams for 12 months before putting my foot down and telling the TWELVE doctors to do something else. So, ON TOP of the continuing full pelvic exams, for another 12 months I also had 10 transvaginal AND 10 abdominal ultrasounds. I got sick of it and told them I wanted a laparoscopy, which I was denied. Instead they had me do a pelvic CT scan which I would later find out was a FULL body CT scan because they thought my pains were in my head, 2 of my doctors could FEEL my contractions. The CT scan showed I was born with 1 kidney and they told me I’d NEVER have kids, even with IVF.

    I moved to California last May in search of a decent doctor. 9 months later, I found out I’m pregnant. Today, I’m 14 weeks pregnant and stuck with a lousy doctor becuase my insurance refuses to cover my midwife, I chose her because my only in-network midwife is 2 hours away. So, I’m paying $2,000 more to do an intervention-free home birth than I would going to a hospital (assuming I don’t end up with a C-Section and we all know how wonderful the US is with that).

    After finding out about my 1 kidney, I vowed NEVER to see another OBGYN. However, due to my pregnancy, I’m forced to see an OB who is planning on inducing me by September 28 (2 days before my guess-date!) just to “get it out”. Um, I was told I’d never have a kid, so I’d let to stay pregnant as long as possible, unless absolutely necessary.

    It is because of articles like this one that I’ve decided I will NEVER have another GYN exam unless I feel something’s wrong with my body. If that means I have to have an unassisted home birth, then so be it. But at least I know my insides will be intact, unharmed and normal. I am a healthy 22 year old woman who has made an informed decision to opt out (of course, here in the States, that means ignoring those postcards from the doctor).

    I sincerely hope the women in other countries realize how great they have it. I go to an ear doctor for an infected ear and the first thing I see is “last pap smear test”.

    I’d die before I let anyone perform any of these unreliable SCREENING TOOLS on my unnecessarily, especially when they tell me nothing and just toss me a gown.