It's such a shame American woman don't look at the clinical evidence for themselves and medical practices around the world. All these articles pushing routine pelvic exams, breast exams and how to cope with them - I have a better idea and it's good for your health - reject these exams!
I've never had a routine bimanual pelvic, recto-vaginal, rectal or breast exam - none are evidence based - they're of poor clinical value in the absence of symptoms and expose you to risk. That's why so many American woman are constantly having procedures and biopsies and some are harmed by these unnecessary interventions. 1 in 3 of you will have had a hysterectomy by age 60 - a very high number!
Our doctors don't recommend these exams at any age and I'd refuse them if anyone ever suggested I have one.
I also rejected pap tests more than 25 years ago - the cancer is rare, my personal risk is near zero, but our screening program condemns 77% of women at some point to colposcopy and usually some sort of biopsy. That's HUGE over-detection and over-treatment for a cancer with a lifetime risk of 0.65% and only 0.45% (at most) benefit from testing. (0.20% get false negatives and may be disadvantaged by false reassurance and delay seeing a Dr for symptoms)
Some women are left with health problems after unnecessary procedures - cervical stenosis that may require surgery and can cause infections and/or endometriosis also, infertility and more c-sections OR cervical incompetence - miscarriages, high risk pregnancy requiring cervical cerclage and premature babies and of course, psych issues. Cone biopsies and LEEP carry the most risk to your body.
I'd urge every woman to examine her risk profile before agreeing to cervical smears. Women under 30 don't benefit, but produce very high rates of false positives - 1 in 3 will be abnormal, yet cancer is very rare in this age group. (and rare in all age groups) - see research by Angela Raffle linked to Dr Joel Sherman's medical privacy forum under women's privacy issues - in the side bar. Dr Raffle's research rocked the UK and made doctors squirm - "1000 women need regular smears for 35 years to save ONE woman from cervical cancer" BMJ: 2003 also see commentary at, "Why I'll never have another smear test" by Anna Saybourn (on line)
Richard DeMay, American pathologist, has also published an informative article, "Should we abandon pap smear testing" - also, online.
If you want to have pap tests, consider the Finnish program - 5 to 7 tests in total - 5 yearly from age 30 - they have the lowest rates of cc in the world and JUST as importantly, send the fewest women for colposcopy/biopsies - fewer false positives, but even so, it's such an unreliable test that even 35%-55% of Finnish women will be referred - almost all are false positives. With no screening your lifetime risk of cc is 0.65% and less than that if you're low risk. Using condoms with a partner of unknown HPV status reduces the risk of infection by 70%, perhaps higher with perfect use. That's a huge benefit to cover a very small risk.
Still the Finnish program is better than the States who send almost every screened woman for colposcopy/biopsies at some stage (95%) and in Australia it's 77%...the UK - 65%
"No country in the world has reported a decline in the incidence of or the mortality from cervical cancer in women under 30, irrespective of cervical screening. Many countries do not perform cervical screening on women under 30" Taken from "Cervical cancer screening" - pull-out guide for doctors in "Australian Doctor" 2006 by Assoc Prof Margaret Davy, Director, Gyn-oncology, Royal Adelaide Hospital and Dr Shorne, GP. (on line)
Cervical cancer is rare, always was and was in decline before screening started...don't over-do pap tests, if you choose to have them at all.
Women not sexually active don't need pap tests, you're accepting risk for no benefit - nor do women in lifetime mutually monogamous relationships and women who've had full hysterectomies for benign conditions - also, low risk women be careful with this testing, know the risks and make an informed decision about testing. ALL women should look at their risk profile and make their own decision about testing.
I recently also rejected mammograms - far too much risk with false positives and over-diagnosis also, the risks of testing concerned me - radiation and compression of delicate breast tissue. See: "The risks and benefits of mammograms" at the Nordic Cochrane Institute website.
Clinical breast exams are not recommended either - they don't help, but they cause biopsies.
You don't need to cope with all of these exams - they're either unnecessary and potentially harmful or optional - make up your own mind.
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It's such a shame American woman don't look at the clinical evidence for themselves and medical practices around the world. All these articles pushing routine pelvic exams, breast exams and how to cope with them - I have a better idea and it's good for your health - reject these exams!
I've never had a routine bimanual pelvic, recto-vaginal, rectal or breast exam - none are evidence based - they're of poor clinical value in the absence of symptoms and expose you to risk. That's why so many American woman are constantly having procedures and biopsies and some are harmed by these unnecessary interventions. 1 in 3 of you will have had a hysterectomy by age 60 - a very high number!
Our doctors don't recommend these exams at any age and I'd refuse them if anyone ever suggested I have one.
I also rejected pap tests more than 25 years ago - the cancer is rare, my personal risk is near zero, but our screening program condemns 77% of women at some point to colposcopy and usually some sort of biopsy. That's HUGE over-detection and over-treatment for a cancer with a lifetime risk of 0.65% and only 0.45% (at most) benefit from testing. (0.20% get false negatives and may be disadvantaged by false reassurance and delay seeing a Dr for symptoms)
Some women are left with health problems after unnecessary procedures - cervical stenosis that may require surgery and can cause infections and/or endometriosis also, infertility and more c-sections OR cervical incompetence - miscarriages, high risk pregnancy requiring cervical cerclage and premature babies and of course, psych issues. Cone biopsies and LEEP carry the most risk to your body.
I'd urge every woman to examine her risk profile before agreeing to cervical smears. Women under 30 don't benefit, but produce very high rates of false positives - 1 in 3 will be abnormal, yet cancer is very rare in this age group. (and rare in all age groups) - see research by Angela Raffle linked to Dr Joel Sherman's medical privacy forum under women's privacy issues - in the side bar. Dr Raffle's research rocked the UK and made doctors squirm - "1000 women need regular smears for 35 years to save ONE woman from cervical cancer" BMJ: 2003 also see commentary at, "Why I'll never have another smear test" by Anna Saybourn (on line)
February 7, 2011 - 2:03amRichard DeMay, American pathologist, has also published an informative article, "Should we abandon pap smear testing" - also, online.
If you want to have pap tests, consider the Finnish program - 5 to 7 tests in total - 5 yearly from age 30 - they have the lowest rates of cc in the world and JUST as importantly, send the fewest women for colposcopy/biopsies - fewer false positives, but even so, it's such an unreliable test that even 35%-55% of Finnish women will be referred - almost all are false positives. With no screening your lifetime risk of cc is 0.65% and less than that if you're low risk. Using condoms with a partner of unknown HPV status reduces the risk of infection by 70%, perhaps higher with perfect use. That's a huge benefit to cover a very small risk.
Still the Finnish program is better than the States who send almost every screened woman for colposcopy/biopsies at some stage (95%) and in Australia it's 77%...the UK - 65%
"No country in the world has reported a decline in the incidence of or the mortality from cervical cancer in women under 30, irrespective of cervical screening. Many countries do not perform cervical screening on women under 30" Taken from "Cervical cancer screening" - pull-out guide for doctors in "Australian Doctor" 2006 by Assoc Prof Margaret Davy, Director, Gyn-oncology, Royal Adelaide Hospital and Dr Shorne, GP. (on line)
Cervical cancer is rare, always was and was in decline before screening started...don't over-do pap tests, if you choose to have them at all.
Women not sexually active don't need pap tests, you're accepting risk for no benefit - nor do women in lifetime mutually monogamous relationships and women who've had full hysterectomies for benign conditions - also, low risk women be careful with this testing, know the risks and make an informed decision about testing. ALL women should look at their risk profile and make their own decision about testing.
I recently also rejected mammograms - far too much risk with false positives and over-diagnosis also, the risks of testing concerned me - radiation and compression of delicate breast tissue. See: "The risks and benefits of mammograms" at the Nordic Cochrane Institute website.
Clinical breast exams are not recommended either - they don't help, but they cause biopsies.
You don't need to cope with all of these exams - they're either unnecessary and potentially harmful or optional - make up your own mind.
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