I think your friend is quite entitled to make her own decisions about screening. Screening is not black and white - some people will choose screening and some won't - it is never right or wrong to screen.
We need to move away from bullying women to simply "do as they're told"...we're adults and quite capable of making our own informed decisions.
I believe informed consent is totally lacking in cervical and breast cancer screening even though it is a legal requirement for ALL cancer screening. (not just tests for men - didn't risk information for prostate screening come out quickly and doctors were advised to obtain informed consent?)
Sadly, women are still waiting....
Instead women get half the story and a scary or misleading story at that...
I doubt many women are giving informed consent for screening tests at the moment.
Pap smears - oversold to women and over-screening exposes you to risk for no additional benefit.
In the UK we're receiving the information that should have been released many years ago.
FACT: 1000 women need regular screening for 35 years to save ONE woman from cervical cancer. (Dr Angela Raffle - published in the BMJ)
This cancer would affect around 1% of women in an un-screened world.
Over-screening which is basically annual or biannual screening and testing women under 25 and even 30 causes harmful over-treatment. (and testing women not yet sexually active is irresponsible screening)
LEEP and cone biopsies carry risks...damage to the cervix leading to infertility, problems during pregnancy, miscarriages, pre-term delivery, more c-sections and premature babies.
When 99.35% (99% no benefit and 0.35% false negative)
of women derive no benefit from smears, why is there no informed consent? This is respected for men even though prostate cancer affects 200,000 men every year in the States and cervical 10,500.
I don't believe this test was ever suitable for mass screening and doctors knew screening for an uncommon cancer with an unreliable test was a long shot - 80% of women MUST screen to bring down the already small death toll to justify the money spent on screening programs.
In the UK, Australia and the UK doctors are paid to reach targets for cervical screening - an uncommon cancer - no targets apply for breast and prostate cancer screening. (FAR more common cancers)
I think many women would be appalled to find out the facts behind this testing.
As a low risk woman I have always declined screening.
I have also declined mammograms after researching the topic - that was more difficult as breast cancer is common. The Nordic Cochrane Institute paper, "The risks and benefits of mammograms" helped me.
(available online) and papers by Prof Michael Baum.
I have never permitted clinical breast exams either - there is no evidence they help at all, but they increase the risk of biopsies and some research suggests biopsies are a risk factor for cancer.
Also, the routine pelvic exams pushed at American and Canadian women are not evidence based - they are of low/poor clinical value and expose you to the risk of false positives and more diagnostic testing even surgery. Having a gyn as your primary physician is a very bad idea - you have the highest hysterectomy rates in the world - a horrifying 600,000 every year!
There are many articles in medical journals re routine pelvic exams and their true value (poor) and risks. (Heather Dixon)
The only exam required for the initiation and safe use of the Pill is the taking of a medical history and a blood pressure test.
I know many women suffer these exams and tests thinking they're doing the right and responsible thing...when in fact, the reverse is likely to be true.
Dr Joel Sherman's Medical Privacy under women's privacy issues has lots of great references - my stats come from Dr Richard DeMay's article (American pathologist), "Should we abandon pap smear testing" (available online) and articles by Dr Angela Raffle, Professor Michael Baum (UK breast cancer surgeon) and others.
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I think your friend is quite entitled to make her own decisions about screening. Screening is not black and white - some people will choose screening and some won't - it is never right or wrong to screen.
May 20, 2010 - 6:33amWe need to move away from bullying women to simply "do as they're told"...we're adults and quite capable of making our own informed decisions.
I believe informed consent is totally lacking in cervical and breast cancer screening even though it is a legal requirement for ALL cancer screening. (not just tests for men - didn't risk information for prostate screening come out quickly and doctors were advised to obtain informed consent?)
Sadly, women are still waiting....
Instead women get half the story and a scary or misleading story at that...
I doubt many women are giving informed consent for screening tests at the moment.
Pap smears - oversold to women and over-screening exposes you to risk for no additional benefit.
In the UK we're receiving the information that should have been released many years ago.
FACT: 1000 women need regular screening for 35 years to save ONE woman from cervical cancer. (Dr Angela Raffle - published in the BMJ)
This cancer would affect around 1% of women in an un-screened world.
Over-screening which is basically annual or biannual screening and testing women under 25 and even 30 causes harmful over-treatment. (and testing women not yet sexually active is irresponsible screening)
LEEP and cone biopsies carry risks...damage to the cervix leading to infertility, problems during pregnancy, miscarriages, pre-term delivery, more c-sections and premature babies.
When 99.35% (99% no benefit and 0.35% false negative)
of women derive no benefit from smears, why is there no informed consent? This is respected for men even though prostate cancer affects 200,000 men every year in the States and cervical 10,500.
I don't believe this test was ever suitable for mass screening and doctors knew screening for an uncommon cancer with an unreliable test was a long shot - 80% of women MUST screen to bring down the already small death toll to justify the money spent on screening programs.
In the UK, Australia and the UK doctors are paid to reach targets for cervical screening - an uncommon cancer - no targets apply for breast and prostate cancer screening. (FAR more common cancers)
I think many women would be appalled to find out the facts behind this testing.
As a low risk woman I have always declined screening.
I have also declined mammograms after researching the topic - that was more difficult as breast cancer is common. The Nordic Cochrane Institute paper, "The risks and benefits of mammograms" helped me.
(available online) and papers by Prof Michael Baum.
I have never permitted clinical breast exams either - there is no evidence they help at all, but they increase the risk of biopsies and some research suggests biopsies are a risk factor for cancer.
Also, the routine pelvic exams pushed at American and Canadian women are not evidence based - they are of low/poor clinical value and expose you to the risk of false positives and more diagnostic testing even surgery. Having a gyn as your primary physician is a very bad idea - you have the highest hysterectomy rates in the world - a horrifying 600,000 every year!
There are many articles in medical journals re routine pelvic exams and their true value (poor) and risks. (Heather Dixon)
The only exam required for the initiation and safe use of the Pill is the taking of a medical history and a blood pressure test.
I know many women suffer these exams and tests thinking they're doing the right and responsible thing...when in fact, the reverse is likely to be true.
Dr Joel Sherman's Medical Privacy under women's privacy issues has lots of great references - my stats come from Dr Richard DeMay's article (American pathologist), "Should we abandon pap smear testing" (available online) and articles by Dr Angela Raffle, Professor Michael Baum (UK breast cancer surgeon) and others.
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