First they came for the mammogram...now the Pap Smear?

[Horse with no Name]

Is it NOT enough that the cancer rates in women have significantly dropped?
Now, we are wanting to reduce mammograms to women after the age of 50 and decrease the number of pap smears a woman receives.
Excuse me...but let me be graphic.
Putting a q-tip in a cervix once a year is NOT that traumatic...no more traumatic than sex.
So what is the deal here?
Are we decreasing the cost of healthcare on the backs of women???By decreasing THEIR healthcare needs? And if there aren't annual pap smears...then you can bet your ass the insurance agencies will quit paying for "annual" exams. There is always a cause and effect here.
I have NOT seen one iota about decreasing the PSA's on men...nor would I want to, but you want to talk about unnecessary surgery???
Take a look on your own at the stats on prostate surgery and how many that have PSA's do not have carcinoma.

This infuriates me.:mad:
http://abcnews.go.com/GMA/HealthyLiving/guidelines-ditch-annual-pap-smears/story?id=9131632
>>>Snip
The group announced today that women should start getting cervical cancer screenings at age 21 instead of 18, and that women could wait longer between the screenings -- regardless of when a woman starts having sex.

Women in their 20s with normal Pap smear results now should get screenings every two years instead of every year, and women in their 30s can wait three years between screenings, according to the new ACOG guidelines.

After a week of uproar over the controversial recommendations for less mammogram screenings for women, doctors say they will have to wait and see how the public reacts to the new pap smear guidelines.

[hedgehog]

1. You need to read past the headlines. The reason to delay the PAP

smears is that in younger women, any anomalous findings tend to resolve themselves with no further interference. The problem is that once an anomalous finding is found, the pressure is on to take care of it with a little minor surgery. the consequence may be a premature delivery later on due to a scarred cervix.

[gateley]

3. Are we sure that's correct? I'm sorry, but too often lately I lately assume I'm being

lied to by those "experts".

[Horse with no Name]

6. You are being lied to.

The cervical cancer AND the breast cancer rates have decreased with these guidelines.
Now, they want to take a gambit and relax them.
If they are wrong...then many women will suffer.

[hedgehog]

9. Don't forget, those are the same experts that told everyone to get

mammograms and PAP smears. If you believed them then, why don't you want to believe them now when they've looked at the data and come to a new conclusion?

[Horse with no Name]

11. They aren't the SAME people

who had the wellness of women at heart.
They have been replaced, like everything else, with corporate whores who want to save a buck...and I just about bet every last one of them are members of the AMA.

[Horse with no Name]

5. Actually I did read past the headlines

And I STILL don't agree with it.
It is a FACT that cervical cancer has decreased dramatically since annual pap smears.
That is an untarnished, unvarnished truth.
Reducing the guidelines puts women at risk.
When they find the cervical cancer rates soaring...then they will revise them.
How many women will suffer?

[gateley]

2. It leaves me breathless that they are willing to take risks with womens' health

just for m.o.n.e.y.

I can't understand why we're not out with our pitchforks -- this is so insulting and so wrong! We don't care about you, we care about costs. :grr:

[Horse with no Name]

12. Yet like everything on DU these days

this gets unrecc's and has apologists.
Go figure.:crazy:

[Rosa Luxemburg]

4. PAP smears can be done at 18 and at every year. HPV is rife.

HPV is a problem.

[Phoebe Loosinhouse]

7. I saw an ad last night on TV for some wellness center that suggested Pap smears as Christmas gifts!

I shit you not.

[tammywammy]

25. If you don't have insurance, that's a good gift

Well a whole physical not just the pap. :)

[hedgehog]

8. Remember a year or so back when women were told to skip the hormone replacement therapy

for menopause? Was that done to save money? No, it was done because research showed that HRT was causing significant numbers of breast cancers.

Years ago, getting a chest X-ray was a routine part of a lot of physicals. It was stopped, not to save money but because the threat of undiagnosed TB had dropped and there was a recognition that there is no 100% safe dose of radiation.

As far as decreasing PSAs done on men, you haven't been paying attention. There is considerable debate taking place suggesting that after a given age, say 75 or 80, there is no point to doing a PSA because even if the man develops cancer at that age, the cancer is going to grow so slowly that something else will kill the man first. Is this ageism?

A few years back, the obvious treatment for breast cancer was to irradiate the entire body t o kill any scattered cancer cells, then do a bone marrow transplant to restore the immune system. It was a very expensive procedure, but by golly, it made sense so it was done. the only problem was that when the results were finally examined, it turned out that what everyone knew from common sense just wasn't so. Full body irradiation followed by bone marrow transplant did not save lives, it just made women miserable for the time they had left.

[Horse with no Name]

10. We disagree

They stopped the HRT because the WHI showed IMMEDIATE evidence of the risk.
They stopped the annual CXR's because the studies showed exposure to radiation caused cancer.

However, the cervical cancer rates AND the breast cancer rates have dropped SIGNIFICANTLY because of the annual screens.
This is a FACT.
Women's cancer rates are DOWN because of these tests.

I am REALLY sorry if paps "might" interfere with childbirth. However, childbirth is a choice, cancer is not.
If women want to decrease the risk on their own and NOT obtain the tests--then fine.
However, I don't agree IN LIGHT OF GOOD AND POSITIVE statistics in the efficacy of the pap smear, that ACOG take a gamble with WOMEN'S lives to possibly preserve a pregnancy(and prevent a lawsuit to the ob/gyns). I just don't.

[hedgehog]

16. Here's some interesting reading from 2002 -

The assumption is that early detection leads to cures. There is a growing uneasiness with this assumption. What if fewer women are dying not because of early detection but because of better treatment?


HEre's what Dr. Susan Love has to say on the issue:

"Screening is better at finding slow cancers at an “early stage” than fast growing ones. I wish that mammography screening of all women starting at age 40 was the answer to reducing deaths in young women of all races, but at this point the data does not support that conclusion. Using guidelines that are not supported by research is not going to give us the outcome we so desperately want—and end to this disease."

http://blog.dslrf.org/?p=123http://blog.dslrf.org/?p=123

[Thickasabrick]

19. Thank you for all that great info in your posts. What do you think

about the studies of women where tumors were found to have basically just disappeared. I'm not sure how they knew that - maybe traces or something. If they had had screenings in the interim they would have been subjected to radical surgeries that would have been unnecessary had they waited. They still don't know why some women's tumors/cancer just go away but it's kind of nice to think that happens - especially to women who couldn't afford to be screened anyway.

[hedgehog]

23. I haven't seen those studies so I can't judge. Who knows? My mother just

had a mastectomy at age 82. It would have been wonderful if someone could have told her she had a slow growing tumor that she could live with. Her surgeon and her oncologist did a good job with the information they have today. I'll never blame them for pushing surgery, but I won't be surprised if 5 or 10 years from now they will just go for chemo with a patient in the same situation. The point is that this is an area that we are learning more about every day. (By "we" I mean the people who are doing all the work!) We can't stop here and say we have the best means of spotting and curing breast cancer or cervical cancer because we don't.



I'm sure some people were upset 150 years ago when doctors stopped using purges and bleeding patients. "The doctor bled my Aunt Emma and she recovered fine!"

The medical establishment makes mistakes. Just this morning there was an article in the paper stating that heart by-pass patient do better if a heart-lung machine is used during surgery. That's a result of research. Other research is suggesting that maybe medicine is better than a by-pass for some patients. The only way forward is to keep testing what we think we know using the scientific method and being willing to accept the results.

[Thickasabrick]

27. Oh - hope your Mom is ok! Here is an article that touches on what

I mentioned earlier. It's not that old and I thought it was fascinating!

http://www.nytimes.com/2009/10/27/health/27canc.html?scp=1&sq=breast%20cancer%20tumors%20disappear&st=cse

[Nikki Stone1]

13. I'm with you, Horse with No Name. I almost believe that too many

women are surviving and that somehow has to be "corrected."

[hedgehog]

31. Wait - are you advancing the proposition that somewhere "they "

decided that an increased number of random females must die each year? Exactly who would benefit from this?

[PVnRT]

14. These are guidelines, not laws

Same thing with the mammograms. It is an acknowledgment that false positives are a problem, and decreasing frequency does not necessarily mean more cancers are going to be missed.

Oh, and if you don't like agendas, how about all those doctors that make money for every test they put you through?

[Horse with no Name]

15. Bullshit.

Once the guidelines are adopted...the insurance companies follow suit and then deny coverage.

[PVnRT]

21. Adopted by who?

No one "adopts" these guidelines. They're issued in a report, and that's it.

Have you bothered actually reading the reports that have been generated, or do you just go by media outlets trying to drum up some controversy to sell papers and ad space?

[Horse with no Name]

22. YOu are the one who is misinformed

Sadly uninformed.

[Hannah Bell]

26. bullshit yourself. they're adopted by practice groups & advisory boards,

& the expert recs are used to determine standard practice.

if the "experts" say 21 & every other year, that's all insurance will pay for.

[hedgehog]

30. But if the "experts" are right, why would anyone want more than standard

practice?

For a woman with no genetic markers, why not a PAP smear and mammogram very six months? every other month? Clearly there's a point of diminishing returns, where the risk from the procedure outweighs any added benefit. "Experts" used to think annual testing was worth while; now the numbers don't bear that out.

[Hannah Bell]

36. i've not seen any body of research demonstrating increased survival with fewer paps.

i've seen the opposite; more coverage = fewer deaths.

[gateley]

18. Who pays the doctors to have the PTs tested? nt

[PVnRT]

20. Uh....do you really have no idea how American health care works?

It's called "fee for service." More services, more fees, whether directly from the patient or from the insurance company.

[hedgehog]

17. BTW - any woman reading this thread should sign up with the Army of Love -

http://www.armyofwomen.org/

You put in your name and e-mail and you'll receive notice of researchers looking for particular groups - say left handed women who breast fed for 3 1/2 months. If you match the criteria and you're willing to participate, your name is given to the the researcher.

Here is an actual sample from the site:

roject Title Sleep, Circadian Hormonal Dysregulation and Breast Cancer Survival

Researcher David Spiegel, MD , Stanford School of Medicine

Study Summary Too much stress and not enough sleep are two things that many women know all too well. But, could they be linked to breast cancer? That is what a group of researchers at Stanford University want to find out. They are studying the effect that stress and sleep-related hormones may have on the immune system and cancer progression.

Who Can Participate? You can join the Stress and Breast Cancer study if you match ALL of these MAIN categories:

•You are a woman between 45 and 75

•You have been diagnosed with metastatic or recurrent breast cancer at somepoint during your life

•You live in Northern California (willing to travel to Stanford University and live no more than a one-hour time zone away from California)

•You are able to travel to Stanford University and stay overnight in the hospital

•You have not had another cancer in the past 10 years other than breast cancer, skin cancer, or in situ cancer of the cervix

The research staff will ask you additional questions to be sure that this study is the right fit for you.

What Does Participation Involve? If you join the Stress and Breast Cancer study, you will be asked to answer questions about your medical history and health-related behaviors. You will also participate in a
2-week at-home sleep data collection, which includes keeping a sleep log, wearing a watch-like device that will assess your activity and sleep, and two nights of more detailed sleep recording. Finally, you will be asked to stay at Stanford Hospital for 28 hours where your sleep will be assessed, and you will be asked to provide blood samples through an IV, saliva samples, and complete a psychological assessment including interviews and questionnaires.

Where? Stanford School of Medicine Department of Psychiatry and Behavioral Sciences

[tammywammy]

24. Didn't they start talking about reducing the niumber of paps years ago?

I could have sworn I read this years ago, moving to every other year instead of every year.

[ohheckyeah]

28. Yes. At one time it was suggested that every 2

- 3 years for some groups of women. It was about 8-9 years ago.

[dflprincess]

29. But I think that was after having 2 or 3 annual pap smears that were normal (n/t)

[tammywammy]

32. Ahh that makes sense

I don't believe they should be started later than 18. I knew I had read this suggestion before, that was after I had a biopsy and was having my paps every 6 months for a while. I'm a pro. LOL! ;)

[ohheckyeah]

35. Yes, I think you are correct. n/t

[REP]

33. I believe it's every 3 years, unless you've had an abnormal pap or cancer; then it's annually

I've had cervical cancer, so I get one every year (better than the every 3 month schedule I was one for the first five years!).

[tammywammy]

34. I've had a biopsy and did the 3 month/6 month regiment for a while

I'm an annual pap-er too.