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As a Finnish woman, that list horrifies me....
You are all having far too many exams and smears and that can be very bad for your health.
Our doctors do not recommend routine pelvic exams in asymptomatic women at all, EVER.
They are of low to poor clinical value and can lead to more invasive and possibly, harmful testing.
You should be told they are optional and have the risks and limitations explained to you before agreeing to the exam.

You are all terribly over-screened for cervical cancer.
The risk of this cancer is low and near zero for a low risk women. Over-screening greatly increases the risks of over-treatment. American women have more pap smears and colposcopies and biopsies than any other women in the world. Biopsies carry risks to your mental and physical well-being.
Less is more with pap smears.
We have the lowest rates of cervical cancer in the world and just as importantly, send the smallest number of women for biopsies.
Sexually active women are offered screening from age 30...
Women under 30 are very likely to have abnormal pap smears and have unnecessary treatment. The cervix is changing over these years and this is perfectly normal, but may be labelled abnormal by a pathologist....the very rare case of cancer that occurs in a young woman is often an adenocarcinoma and pap smears are very bad at picking up these rare cancers. It means young women have lots of false positives and unnecessary treatment and can produce false negatives in the very rare case of cancer.
In fact, the pap smear is an unreliable test, full stop.
But in young women it does more harm, than good. The UK doesn't screen before 25 as they believe the risk/harm to benefit ratio would make it unethical to screen. The Netherlands is also, age 30.
From age 30, Finnish women are offered 5 yearly testing stopping at 50, 55 or 60...(depending on risk profile and past results)

I'm 51 years old and have never had a routine pelvic exam. I have a breast exam every 2 years (started at 45) and have declined mammograms. (concerned about the risks)
Low risk women may choose not to have cervical screening or have it infrequently.
No healthy woman has more than 5-7 tests in her lifetime. US woman can have 50-60 tests in her lifetime...that's shocking and explains your very high rates of over-treatment.
Your doctors have ignored the call for fewer smears and most still push annual screening KNOWING this causes unnecessary biopsies.
They recommend annual screening for women under 30 - this makes no sense at all, as these women have the lowest risk of cancer and the highest risk of over-treatment.
Screening for women not yet sexually active, is not recommended in any other country in the world.
Germany is the only other country that recommends yearly pelvic exams and annual smears. (as far as I could find)

You have to ask yourselves, why your doctors are disregarding very clear medical and scientific facts and research?

My American friends were very surprised to hear that other women don't live with this level of medical involvement in their lives.
Our doctors tell us the truth and don't try to scare us. We can then make the right decisions for our health and not act on fear and misinformation.
As an exchange student many years ago, I refused the US annual exams, following my Finnish doctor's advice. I saw the distress these exams caused my American friends and found it upsetting. I felt sorry that so many women were already afraid to even question the need for these invasive procedures. The use of stirrups also shocked me...like women are not entitled to any dignity. Stirrups are never used in a consult situation in my country and in fact, I could only find them in general use in the States. They are used in surgery and possibly during day procedure clinics in other countries.

There is some great discussion about these issues at a site hosted by an American doctor, Dr Joel Sherman...there are lots of great references and facts.
Protect your health and make informed decisions...good luck everyone!
Love your country and the people, but have MAJOR concerns about your doctors.
It seems to me this conduct is motivated by money, power, politics and defensive medicine and has nothing to do with your health.
Google, Dr Joel Sherman's Patient Privacy - see the women's heath issues thread.

November 7, 2009 - 8:49pm


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