Top Five Reasons for Opting Out of Pap Tests

32267_article_fullFor years women have been presented with only one side of the story when it comes to pap tests to screen for cervical cancer. The ways in which pap tests are presented have led many women to believe that they are harmless, necessary, and life saving. This type of messaging has been so well promoted that women usually don’t think to ask any questions when it comes to pap tests. Unfortunately there is another side to the story that reveals there is significant potential for harm as a result of pap testing. Increased access to information, recommendations to increase the age to begin pap smears, recommendations to lengthen the interval between pap smears, and the discovery of alternative and better methods to screen for cervical cancer have recently encouraged women to start asking questions. As a result, women are uncovering the facts and the potential for harm that can result from screening. In other words, some women are discovering that there are many good reasons that support the choice to opt out of Pap tests.  Here are the top five:

1.  The harms of pap tests exceed the potential benefits by a significant margin. Despite intensive screening in countries such as the United States, there is no corresponding reduction in mortality from the disease in comparison to countries that screen far less often (Habbema, Inge, & Brown, 2012). However, there is evidence of morbidity caused by  pap testing (McCormick, 1989). According to Raffle, et al. (1995), in a study of women after a screening round in Bristol, England: “over 15,000 healthy women are being incorrectly told that they are ‘at risk'; over 5,500 women are being investigated, with many also treated, for a disease that would never have troubled them, and are being left with problems that include lasting worries about cancer, difficulties in obtaining life insurance, and worries concerning the effect of their treatment on their subsequent reproductive ability” (p. 1472).

2.  Pap testing programs are not based on scientific evidence that validates their effectiveness. No randomized controlled trials have ever been done to substantiate the oft repeated refrain that pap testing can save lives. Pap test propaganda rarely reveals the facts; such as the fact that in developed countries cervical cancer is a rare type of cancer. Unfortunately, the people in control of research funding are often the same people who benefit from the substantial business that pap testing generates, and therefore it is unlikely there will ever be studies done that could shed light on the facts: “If somebody suggested in 2003 we [should] introduce cervical cytology, no randomized trial would ever show it was worthwhile” admits Dr. Anne Szarewski, clinical consultant for Cancer Research UK.

3.  Pap tests increase a woman’s risk of exposure to HPV infection. Research reveals that vaginal specula can harbor HPV16.  HPV16 is a type of HPV that is associated with most premalignant and malignant disease of the cervix.  In one study, 29 specula after use on different women were examined post-cleaning.  In four cases, HPV16 DNA was detected.  The authors of the study concluded that “HPV infected cells can be found on instruments inserted into the vagina of women with HPV infection, and if these instruments are not cleaned and sterilized properly they will be a potential source of infection for subsequent patients” (McCance, Campion, Baram, & Singer, 1986, p. 817).  In addition, HPV DNA has been found on surgical gloves, biopsy forceps, and cryoprobe tips.  Biopsy forceps and cryoprobe tips can harbor HPV even after sterilization (Watson, 2005).

4.  Pap testing exposes women to risk of psychological harm.  There is a great deal of anecdotal evidence that reveals the extent of the psychological harm caused by pap tests.  Women’s comments reveal many different aspects of the psychological damage, such as this one by FerretGirl01 on Psychological Harms of Pelvic Exams: I have a terrible fear of the OB/GYN mainly because my very first pelvic exam was so traumatic. I was a virgin and it hurt so much that I cried. And even after I told the doctor to stop, she kept trying to collect the sample after telling me she would stop any time. I felt violated…scared…and I hurt so bad I had to take pain relievers. I was bleeding when I got home and discovered my “cherry” had been popped because the doctor was too rough and rushed with the exam. That made me terrified of ever getting one again . . via Fear of Gynecological Exam – Women’s Health – MedHelp.  The psychological harm can include trauma, fear, dehumanization, loss of control, invalidation, distrust, and despair. Pap tests can have a significantly negative impact on women’s lives, and yet this issue remains largely unaddressed and/or unacknowledged by the medical community.

5.  For women who wish to screen for cervical cancer, the HPV test is more accurate. Research is revealing that HPV testing is able to detect cellular changes at an earlier stage, thus allowing women who wish to screen to go for much longer intervals between tests.  In addition, self-testing is possible with HPV testing.

References
Habbema, D.,  Inge, M.,  & Brown, M. (2012). Cervical cancer screening in the United States and the Netherlands: A tale of two countries. The Milbank Quarterly, 90(1).
McCance, D. J., Campion, M. J., Baram, A., & Singer, A. (1986). Risk of transmission of human papillomavirus by vaginal specula. The Lancet, Oct. 4.
McCormick, J. S. (1989). Cervical smears: A questionable practice? The Lancet, July 22.
Raffle, A., Alden, B., MacKenzie, E. (1995). Detection rates for abnormal cervical smears: What are we screening for? The Lancet.
Watson, R.  (2005). Human papillomavirus: Confronting the epidemic – a urologist’s perspective.  Reviews in Urology, 7(3).

About forwomenseyesonly

Hi. My name is Sue and I am interested in promoting holistic and respectful health care.
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81 Responses to Top Five Reasons for Opting Out of Pap Tests

  1. Alex says:

    I’ve got to ask: why isn’t “Self Defense” first on that list? I mean even IF this wasn’t something that was imposed & IF it was a means to an end, I’d think that a problematic methodology would be a point in the first place. Maybe “sexual dissonance” is the correct term for things being an issue on that level?

    Just thought I’d add all that, since it tends to be a bit hard to put that type of things into words & “distress” seems like it’s more for when someone is trying to impose things. I know someone might argue “Well, that’s not a “sexual situation” because it’s medical,” but the term just denotes the nature of affront. It’s not the same thing as a punch in the face, which is not the same thing as stealing cash (interestingly, if a husband punched his wife, it’s deemed an attack despite that being a “matrimonial situation”).

    You could very easily make the point that this is like saying “It’s not a lethal threat if someone in a hospital tries to kill you with a scalpel, because it’s a medical situation.” You could add in “& I have a non-antagonistic association with that.”

  2. Karen says:

    Excellent post! What about the human rights angle, if I can have a recommendation?

    • Alex says:

      Thank you!

      Yeah, the end of the list could be capped-off with “And this is all a human rights violation, by being a breach of bodily autonomy & inviolability.” Something to that effect would make sense, especially since this is a broad effort toward a whole group in a society. A more psychological method of doing things compared to other human rights violations, but still an affront.

      Look at them getting coercive with birth control: this is coercive iatrogenic assault AND reproductive endangerment. It may or may not result in all the various ramifications that can be generated from the risks & inaccuracies of this situation- but coercing, deceiving, and otherwise imposing these situations on people is launching the possibility. It doesn’t matter what specific way they do all that, but given the mechanics it compounds an already present issue.

  3. BethK says:

    It appears that my concern about non-sterilized equipment, nonsterile supplies such as gloves and lubricant are well founded.

    If they can pass on HPV-16 this way, what ELSE can be passed on during a pelvic exam and or pap test? The standard answer when a woman comes down with some disease or infection which cannot be explained is, “You might have gotten it from someone YEARS ago and it’s been dormant all this time” or sometimes “Can you be SURE that your partner isn’t cheating?”. Dangers from a medical examination were minimized, or people given the idea that they were zero.

    • Beth,

      I share the same concern as you. Many women falsely assume that everything is always sterile in the doctor’s office.

      Misty

      • Diane says:

        This. Hospitals and doctors’ offices can be absolutely filthy.

        My mother was recently in the ICU in a “good” hospital. I witnessed nurses leaving her IV lines and ports on the floor and rolling IV carts over the tubing.

    • Moo says:

      I agree with all points of the article.

      Dental offices never given me too much reason to worry about cross contamination. Read their standard (American dental association)(http://www.ada.org/sections/professionalResources/pdfs/cdc_sterilization.pdf

      Whatever goes into your mouth at the dentist is clean. Even the chair is cleaned. At the doctors office what is clean or even sterile? You complain and they might say “well is your partner’s penis sterile? and you put that in your vagina”. Appalling there is no standards for gyno or family practice offices and few for colposcopy clinics.

      The excuse of “you may have got the infection (HPV) years ago and it was dormant until now” is really wrong. I have yet to find one single article or research study that is actual proof (not theory) that HPV infection to cancer is “dormant” and undetected for decades by Pap tests or HPV tests. A study would have to prove that a woman had exactly the same strain and it was reactivated and not a new infection. I could find several that proved that equipment had HPV contamination.

      “can you be sure your partner was not cheating?” Oh yeah. Tell me that and then ask me some screening questions about domestic abuse, I would rather that they cleaned their office furniture, their sink and used sterile equipment. Not wet the unsterile speculum in a dirty hand washing sink where they threw the last used speculum.

      Since I have five really good reasons why bother with cervical cancer screening at all? Where is my home HPV test Health Canada?

  4. Linda says:

    And even after I told the doctor to stop, she kept trying to collect the sample after telling me she would stop any time.
    I wonder if anyone here has ever encountered a doctor who kept that “I will stop at any time” promise?
    From my experience, this promise is often and easily given, and is NEVER kept. It is just a simple lie to make us agree to be tortured and humiliated, to save on pain management, and to circumvent the fact that most doctors have no appropriate skills or desires to be gentle and careful. It also means that we are treated like little children: a bit of lie, and anything can be done to us. So insulting!

    • Alex says:

      A promise someone doesn’t intend to keep is easy to make.

      Speaking of being treated like children, apparently this sometimes gets aimed at children. There was a case in Stroudsburg, Pennsylvania where they ambushed 59 11-year-old girls with pelvic exams. This was in 1997, but they are more “we’ll do whatever we want” now than they were back then & anything of this nature tends to be deemed innocent as long as it’s done in a complex way or is “in the pursuit of a goal” (even if something WERE a means to an end, that doesn’t mean the components of that methodology cease to exist in their own right).

      I’ve heard of this being made a requisite for school, but I don’t know if that’s actually a requisite of the school (apparently, doctors decide to add that into the back-to-school physical sometimes).

      • bethkz says:

        Another word for making a promise one does not intend to keep is LIE. Failing to stop when told invalidates consent.

        On the girls in Stroudsburg, PA, I looked up the articles again. The alarming thing was how the case was allowed to proceed, and what was absent. The fact that the girls said, “NO!” was not mentioned, nor any sort of thing about bodily autonomy. Constitutional protections for “persons” is not limited to adults: Minors also have protections against unreasonable searches and seizures. A genital/pelvic exam on an asymptomatic 11-year-old is not even recommended by any medical organization. What WAS part of that case was that the girls’ parents were not informed nor did they give consent for their girls’ “examinations”. No parent can give consent to have someone else fondle their girls’ (or boy’s) genitals: That would be considered sexual abuse, and everyone involved would go to prison. But, you put “doctor” and “medical” in the equation, and somehow it’s right and proper??? Even when it violates accepted medical practice? I fail to see how it’s different.

        I found a similar case in 2005 at a kindergarten where the school nurse did “visual examinations” of the children’s genitals. Looking for genital warts and the like… nevermind that most genital warts are not on the external genitalia. It was “okay” though. The parent’s did sign a consent form. It was buried in the other forms they had to sign to get their kids into kindergarten.

        Moreover, this completely dissolves any assurances that the girls have that they can say “NO” to an uncomfortable, sexual touch, that if their “NO” is not accepted, that the person(s) who did it would be prosecuted for rape/sexual assault/sexual assault on a minor. This left the girls ripe for any non-medical sexual preditor to have his way with them as well.

        Beth

  5. Elizabeth (Aust) says:

    Another great article.
    Also, the pap test is unacceptable to some women. I’m pleased the invasiveness of the test prompted me to do my own research all those years ago, if a blood test had been available or self-testing the pressure might have gotten to me. I shudder to think where it would have ended, more than three-quarters of women who screen end up referred for colposcopy and at least a biopsy, many also, face “treatments”.
    Of course, once informed the lies and pressure have no impact at all.

  6. OverItAll says:

    Google “http://www.figo.org global guidance for cervical cancer”, tons of info.

    My 5 reasons: unreliable screening tool (high false-positives, “treatment” causes permanent damage, etc), dishonest doctors (incentive payments, no info given), too rare cancer (kidney cancer rates are the same/higher but no screening), no informed choice (withholding unrelatd birth control pills especially when bcp are being used for period problems)and my legs only open for my husband. Sorry for typos, on phone. :) I saw someone post about invasive/noninvasive: noninvasive is any procedure via natural opening (colonoscopy using anus) and invasive is any procedure via man-made hole (csection, laparoscopy).

    • Linda says:

      It may be the cause of the problem too: the medical community thinks that “invasive” is only when they cut us open. For the patients, on the other hand, bing raped by tools can amount to “invasive” as well.

      That’s how we ended up with pap-propaganda brochures assuring us that pap-smears are non-invasive, easy, painless, walk-in-the-park tests; and with women who bleed, cry, have to take painkillers, develop depression and start having problems in their intimate life after those “non-invasive” pap-smears.

      • OverItAll says:

        I agree completely. Another problem is that gynecology is taught to EVERYONE at medical school including psychology students. Gyn is BIG business. Women are easy to trick into consenting to anything, just use their emotions (“what will your husband/kids do without you?”) and misinform/lie to them. More women need to wake up and inform themselves. If you need to “zone out” to get through something, you shouldn’t be doing it

  7. Alex says:

    Well said about the “zoning out” thing.

    What do you mean about psychology students? That shrinks don’t get to be shrinks if they don’t give someone a pelvic exam? Are these people to double as doctors in that field or to just “play doctor” on someone & say it’s therapy?

    [I DO remember that at least one woman on here was a psychiatrist or something along those lines, so I don’t mean to be overly broad with my assumptions- but there is a bit of a reputation with head-shrinkers & I could see a common trait between the two existing.]

    • Karen says:

      OverItAll- do you mean psychiatry or psychology?

      • ADM (Canada) says:

        It would be Psychiatry as Psychiatrists are medical Dr’s.

      • Karen says:

        I was thinking the same, but you never know with America, it also makes no sense that obgyns are primary care doctors, however outlandish misogynist institutional practices seems, it does not mean they can’t be real

      • Karen says:

        Also I remembered how Mary Daly wrote a lot about obgyns and psychiatrists,and also therapists, Freud, Jung etc. in Gyn/Ecology, she has been criticised a lot, alongside with second wave feminism, but she said such truths… I am not an essentialist myself at all, but I think she has been misinterpreted a lot, and the transphone Brennan was her student, which does not help the case, but she had the guts to critique the Western mind/body doctors alongside other partiarchal practices such as chinese footbinding and african FGM.

    • OverItAll says:

      They’re similar enough to bunch together, in my opinion. For a psychologist to be a Dr it simply requires a PhD. For a psychiatrist to be a Dr it’s Med school and psych. Gynecology is taught to everyone at medical, to become an obgyn requires 2-4 years extra for obstetrics (in order to do baby care, ultrasounds, csections, etc). Sorry for confusion, i lump all the mental health in one group which is wrong i know. Freud and his ‘penis envy’s theory.

      I found an interesting PDF, I haven’t read it completely yet but I found it interesting that it said women should have paps but men should be informed of all risks/benefits and give informed consent before prostate screening AND only screen if they have risk factors. Go ahead and tell me women are equals in the medical field. http://www.cancer.org//Research/CancerFactsStatistics/2013-cancer-prevention-early-detection.pdf

      • ADM (Canada) says:

        They are not all similar. There is a huge difference between medical school and graduate level school in the Psychology field. Getting your MA or PhD in Psychology is not medical school in any way and a PhD in Psychology is not a Medical Doctor. A PhD in Psychology gives you title of Psychologists and they cannot diagnose or prescribe medication much less perform a physical exam. The field of psychology has progressed far beyond Freud and his penis envy theory to the use of researched and validated forms of therapy.

      • Chrissy (UK) says:

        My guess is men are more likely to sue, particularly if the treatment renders them impotent. I believe this is the driving force behind giving men informed consent. Women are more likely to believe they have been ‘saved ‘even if they end up with permanent damage to their bodies after treatment.

        The medical profession are simply covering their own backs.

  8. Adawells says:

    The misinformation about the pap test prevails:

    http://www.parliament.uk/business/committees/committees-a-z/commons-select/backbench-business-committee/news/debate-on-cervical-cancer-screening-tests-and-the-case-of-sophie-jones/

    There is going to be a debate about this in the UK parliament on 1st May, as 320,000 have signed a petition to allow under 25’s to have pap tests on demand. Let’s hope it forces our health authority to own up about the limitations of this test and the damage it does to women.

  9. Kate (UK) says:

    As if we need a ‘debate’ carried out by a bunch of stuffed shirts who probably don’t even know what a smear test is!
    Remember, there was a review into lowering the age back down to 20 after Jade Goody died? Did the NHS own up to what a rubbish test this really is back then? Nope.
    As we all know, allowing teenagers to have a pap test any time they have ‘women’s problems’ would be a disaster. Great for the pro-pap brigade, with all the ‘pre-cancers’ they’ll find. Even though many of them will have had the vaccine which is alleged to prevent cancer.

    These campaigners really don’t see the big picture, do they? Aside from issues with the pap test itself, extending the screening program is going to cost a fortune – the NHS is struggling to survive as it is, where on earth do these pap happy cretins think the funding is going to come from?

    • Alex says:

      I wonder if there’s the same response if someone dies in surgery that they got from an inaccurate diagnosis? What about for a miscarriage caused as a side-effect of years & years of testing?

      I’m curious: Do the women in the U.K. tend toward being self-determined medically or are they servile? I know this is talking in general terms, but I was noticing that British people seem to be more able to think that medical actions can be antagonistic- instead of thinking that reality, effectively, takes a coffee break for medical personnel. It really doesn’t seem that way with Americans (although a lot gets bottled-up in America, so it’s hard to know what someone’s assesments are actually like).

      • Kate (UK) says:

        I don’t think British women are any more self-determined than women in the US, really. The female population here is just subservient as American women when it comes to the usual ‘women’s health’ nonsense, IMO. It’s just that we’re subjected to less of it. I’m sure that, had the powers-that-be decreed decades ago that women ‘needed’ annual well-woman exams most of the women here would have bought into that.
        I think, though, that over the past few decades, there has been a huge shift towards ‘preventative’ medicine (which often does more harm than good) within the NHS and some people are starting to understand that this obsession with ‘preventing’ disease is diverting precious resources away from the people who need the most help.
        But when it comes to paps and mammos, most British women (present company excepted!) are just as ill-informed as women in the US. Just look at the furore surrounding Sophie Jones – the ignorance of these campaigners is staggering.

      • Karen says:

        Kate- I am struggling to understand it too, how come so clueless people go and take up on themselves to “raise awareness”?

  10. Amelia says:

    I just got informed that because I haven’t had a pap smear in the last couple of years I’ll have to receive one from my campus health services for them to okay my birth control to be refilled. I don’t know what to do. I don’t want the examine but I need my medicine. I’ve looked into buying online but I worry about fraud. Is anyone aware of a reason I can say no and still get my prescription?

    • BethK says:

      The only test required in order to get hormonal birth control prescribed is a blood pressure test. Pap tests are not required per any current medical guidelines, and pelvic exams are very nonspecific about detecting abnormalities.

      Unfortunately, your experience is quite typical – to hold birth control hostage for the pelvic exam and pap smear.
      See http://www.motherjones.com/politics/2012/04/doctors-holding-birth-control-hostage

      For a possible temporary reprieve, Planned Parenthood has a program to get women temporary birth control pills until they can get a pelvic examination, or some clinics, I understand, use current guidelines – blood pressure only, and recommend pelvic examinations on a schedule.

    • Alex says:

      Off the bat, I’m pretty sure it’s illegal. I don’t know where you are, but in America it is (and I remember hunting something down for someone with a similar problem in Canada that blanketed this situation). In England, I think you just have to sign a waiver. Leaving your phone on record in your jacket or purse would work for proving they said “You don’t get this without that.” There’s even a whole slew of little gizmos that’ll do that (watches, pens, etc…).

      Being coerced into this situation is an iatrogenic attack. Actually, I think the whole situation would read out as “coercive iatrogenic sexual assualt and reproductive endangerment.” The properties of a situation don’t change by designation (just like if a doctor were to poison someone with a needle, it’s still murder), so since this is an interface with a sexual area as a product of someone else’s decision-making (specifically, a penetrative one) & it doesn’t work as advertised (there are numerous risks & inaccuracies that are not mentioned but ARE afforded- this adds a dimension of fraud to the situation).

      If they start mouthing off about their policies, don’t worry about it. They don’t have “medical attack” open to them, whether as an individual situation or as part of a pattern. Same deal with them talking about their liabilities- they ARE liable for what DO. Violating you in an unconventional way as a means of self-defense against groundless potential lawsuits is not LESS of a liability. Sometimes just mentioning the term “iatrogenic attack” is enough to end an argument- it’s a word that comes up suprisingly rarely, but it’s a good one to know (not that someone needs to be able to articulate something in order to have a grasp of it).

      Just curious, how is the campus involved? I wouldn’t figure a college would have anything to do with your birth control situation, but I’ve been suprised by them numerous times. Apparently, a small-framed girl was deemed anorexic by a college (Yale) & they threatened to kick her out if she didn’t get treatment (BY THEM, if I’m not mistaken). They backed down, last I heard.

  11. Elizabeth (Aust) says:

    Amelia,
    Your question highlights the shocking abuse of women by the medical profession, all cancer screening is elective, it can never be required for anything. I assume you’re American, there is a helpful article by an American doctor that you might find helpful, if you email this doctor he may be prepared to speak to your doctor, he’s made that offer to other women.
    The pap test, routine pelvic and breast exams have NOTHING to do with birth control, the only medical requirement is your medical history and a blood pressure test. (The pap test is an elective screening test, the other two routine exams are not recommended at all in many countries, they carry risk (unnecessary surgery, excess biopsies etc) for no benefit or no proven benefit)
    Some women here buy their pills online, I’m sure someone will respond to your post.
    Also, some branches of PP offer a genuine HOPE scheme where you can get pills without the need for an exam, but stay alert, some will still try to pressure you.

    You may be interested to know that ACOG have said the Pill should be available over-the-counter, no doubt because all of these unnecessary medical barriers lead to bad outcomes for women. Birth control should be freely available, the alternative carries a lot of risk to our health and lives…abortions, unplanned pregnancies, miscarriages, ectopic pregnancies, dysfunctional sex life, anxiety etc.

    http://www.managingcontraception.com/newsevents/dr-bob/pelvic-exam-necessary-for-contraception-rx/

    https://www.arhp.org/Publications-and-Resources/Quick-Reference-Guide-for-Clinicians/choosing/Initiation-Hormonal-Contraceptives

    You could write or email your doctor mentioning these facts and if they still refuse to prescribe without the excess, report them to the relevant medical authority and change your doctor, also, let the doctor know why you’re changing. As more women walk and profits fall, these doctors will soon change their “requirements”.
    I’ve read a few accounts from US women that suggests a lot of doctors try-it-on and when challenged many cave and provide the script. One young woman asked her Aunt, who was also an attorney, to send a letter, the script was ready to be collected a short time later.
    Good luck and welcome to the forum.

  12. ADM (Canada) says:

    Hi Amelia, pap smears are an optional screening test and are not a requirement for the safe use of birth control. All that is required for birth control is a health history and taking your blood pressure. I do believe that such information is available on the ACOG website and the World Health Organization. It can be difficult to be assertive in the Dr’s exam room but tell the Dr that you know that the pap test is not a requirement for birth control and that you have made the informed decision to not screen and that withholding of the pills is coercion which takes away from your informed consent. Any intimate exam that takes places due to coercion such as withholding birth control for the pap test is technically a sexual assault. If the Dr refuses to renew your prescription without a pap test make a complaint with the office and with the medical board. The Dr is acting unethically and often if they are challenged they give in. Many Dr’s receive incentive payments for reaching screening targets for the pap and withholding birth control is an easy way for them to meet their target.

  13. vickibee says:

    I am so glad that I found this board.

    Let me preface this by saying that I am empathetic to each and every woman who has explained their stories, be it of coercion, assault or simply unethical practice.

    I have always been reluctant to these exams but as a teenager I stuck through them because I didn’t know better. In my twenties now, and employed, I have a totally different outlook. I think that it is atrocious to even consider that women should simply follow through a procedure “for their health” or because “everyone does it”. Every person is responsible for their own bodies, and frankly, if no one wants to police people if they opt to have tattoos, piercings, eat fast food so why should they enforce pelvic exams/pap smears?

    I have had 3 in my life, and never will again. I work for a college that governs family physicians across Canada, more specifically in a department that does license renewal based on a credit system. I work directly in approval of published articles for content of our renewal program. Lately all I see is controversy with OB/GYNs and women’s rights.

    Studies have shown directly that self administered vaginal swabs were just as (actually more effective) ,provided instructions were given to a patient, swabs administered by a clinician. These swabs pertain to detecting the human papilloma virus which as I’m sure you know is the leading cause of cervical cancer and is estimated to cause between 93-100% of cases. Self administered swabs are less invasive, are not a breach of privacy, and they allow women to receive screening with the same efficacy should they wish to do so. Though there is resistance from ACOG and other governing health associations due to the fact (particularly in the US) that it diminishes revenue, eliminates the need for a medical doctor in these situations as a nurse is more than qualified to accept specimens.

    Major changes were made in Canada about screening, yet I still wait anxiously for this screening to become totally optional. There is yet a place I can visit without being asked when my last pap was, and frankly it sickens me. I can opt to have a lung biopsy, so why shouldn’t I be able to opt to screen myself for the potential (I wish I could italicize that word) of maybe developing cervical cancer. (Which by the way for women with few sexual partners, who don’t smoke and have no history of cancer, is like 1 in 2 million) As of yet, I only go to walk-in clinics if I have an issue to address for fear of needing to remove my clothes for a test that is estimated to be between 10-20% ineffective.

    Any other ladies here also refuse breast exams and any other pelvic exams?

    I refuse all.

    If anyone has tips about controlling anger and anxiety about simply thinking about this, please share because it really makes my skin crawl and my blood boil.

    If anyone wants to review this, you may find it through this link below. I believe the latter requires a subscription, though perhaps some of you may already have it.

    http://www.ncbi.nlm.nih.gov/pubmed/12794216 or http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1744681/pdf/v079p00251.pdf

    http://www.ncbi.nlm.nih.gov/pubmed/12935387

    • ADM (Canada) says:

      Great post and welcome. Thank you for providing that stat of 1 in 2 million. Looking at the risk factors that would be my chances of getting CC. I’m still waiting for the day when it doesn’t feel like my head is going to explode when I’m asked about my last pap test. The focus on this rare cancer both fascinates and frustrates me. I just do not get it. As you know there are far greater threats to women’s health than CC. Most importantly heart disease which is the number one killer.

      • vickibee says:

        Thanks for the warm welcome.

        I feel like these pressured screens for CC seriously deter women from wanting to get screened for other diseases, be it respiratory, cardiovascular or renal. The annual physical has come into question because seldom do they screen women for highly probable threats of disease or cancer for some of the aforementioned branches. I feel like it should go without question that each and every test made available to a person be optional, and have the risks and benefits explained prior to even considering the test. Information is our greatest tool, and deciding whether or not our individual benefits outweigh our risks is simply how decisions should be made. In the situation of women who are under 30, monogamous or have had few sexual partners, use protection, are non-smokers, the risk of CC is seriously non-existant. That being said demographics change with age, but that’s why a woman should be empowered with the knowledge to make her own choice. Canada recently increased the screening age to 25 (though many are still being talked into it if they are above the age of 21) though studies still show the likelihood of women getting CC is still so slim that the risks barely equate the benefits in a numerical sense; and if you wanted to associate a marginal value to how traumatizing, dehumanizing and the emotional stress caused by such an exam could cause you, the decision could be black and white. And age alone doesn’t mean you are at risk for cervical cancer, it simply means that it so happens to become apparent in women of that age group. Age does not equal risk for cervical cancer, how a woman lives her life does. And even if she did live on the wild side, if she didn’t want a test, so be it.

        Women have a say with whom they choose to engage in intimacy with, and they most certainly should be give 100% informed consent if they so wished to be screened. I have a sister in law who is a die hard supporter of the Pap. Yet when I speak with her she has no real idea of how CC comes into effect, who is at risk, or what the risks are to screening. She has been driven into fear that she will die of CC, and so she toughs it up and goes every year. This to me not only makes me sad for her but it puts the lack of information provided to her for the last 15 years in perspective. This goes for all women as they are made to fear this evil that is so insignificant in reality yet made to be a huge, dangerous disease that is out to get every woman. Driving is more dangerous, and so is crossing the street, and yet people do it every day.

        I hope to one day be able to have a regular appointment where threat of a looming CC screen is no longer there.

    • adawells says:

      Thank you for an excellent post, and a warm welcome to this group. I very much enjoyed reading your post and hope you’ll contribute many more.

  14. Elizabeth (Aust) says:

    Hi Vicki, welcome.
    Actually if you look at countries with evidence based programs like The Netherlands and Finland they don’t screen anyone under 30, why? Not one country in the world has shown a benefit pap testing those under 30, the same rare cases occur whether you screen or not (very young women usually get an even rarer form of cc called an adenocarcinoma, this type of cc is usually missed by pap testing so these young women are likely to get a false negative) Young Finnish and Dutch women are simply advised to see a doctor with any unusual and persistent symptoms, not for a pap test, but a proper investigation.
    We give women bad medical advice right through life, screen too early, too often, for too long, unnecessarily, inappropriately etc. It produces poor outcomes, but great profits for vested interests. With every effort made to mislead women and keep them ignorant of the evidence, the program has been free to keep abusing women for decades and keep the profits flowing to vested interests. Censorship and propaganda has been a big part of these programs.

    Also, pap testing those under 30 leads to the most over-investigation/excess biopsies and over-treatment of any age group. This is not new evidence, the Finnish program of 7 pap tests, 5 yearly from 30 to 60 started in the 1960s. So IMO, we’ve knowingly harmed women for decades, continuing to ignore the evidence and hide the damage.
    We also, know that HPV testing is NOT a good idea before age 30. About 40% will test positive when almost all will simply clear the virus within a year or two. By age 30 about 5% are HPV+, these are the only women who should be offered a 5 yearly pap test. (the new Dutch program)

    Assessing risk is easier than considering the number of sexual partners, whether you smoke etc. it comes down to one fact: are you aged 30 to 60 and HPV+?
    If not, forget about it and get on with your life.

    This is the information they’ll hide for as long as possible. A program like the new Dutch program would be unwelcome in many countries, it allows women to self-test, no testing at all until age 30 and only about 5% of women will be having pap tests, FAR fewer will be having biopsies etc. (fewer premature babies, miscarriages, high risk pregnancies etc.)
    That’s a lot of money down the drain, here in Australia approx. 77% of women have something “done” to their cervix thanks to serious over-screening and early screening – to screen for a cancer that carries a 0.65% lifetime risk…rare and always, rare. Heads should roll.

    I’ve never had a pap test and my doctor does not mention them, she knows why I’ve declined them for decades, end of story. I’ve also, never had a routine breast or pelvic exam or rectal or recto-vaginal or any of the other harmful stuff they sell to American and Canadian women. (and German and some other countries)
    In many cases in these countries (and some doctors here would still be guilty) there is no consent at all because they tell women, “No Pill without a pap test”, this negates all consent and IMO, amounts to an assault. Some mislead women and say a pap test is a clinical requirement for the Pill, it’s not, a screening test can never be “required” for anything, it’s always elective by it’s very nature.
    I’ve also, declined mammograms and doubt I’ll ever have a colonoscopy.

    It has horrified me for years so many are comfortable treating women this way, may even think it’s preferable. We can hardly say women are equal citizens when they are treated so badly, like mere bodies forced/led into submission for the benefit of others.

    Our program is likely to be changed, but we’ll stay with excess, ensure day procedure is still full of women, and lots of young women, having unnecessary and potentially damaging “treatments” and biopsies. You have to wonder about a program to screen for a rare cancer that results in more than three-quarters of those screening having something “done” to their cervix. The poor cervix is there for a reason, but is now about medical and business opportunities.

    There is very little research, but it would be interesting to know how many women with a damaged cervix go on to lose a baby, require a cervical cerclage, have a high risk pregnancy, end up with cervical stenosis etc.
    I think there is a reason there is so little research into this area: no one will fund it, certainly not the Govt, it might threaten the program and leave them open to legal action. This program is extremely sensitive to criticism for a reason too, they have a LOT to hide.

    • BethK says:

      When I did the numbers for US women – the country for which I HAVE the population and the number who had CC in 2009 (last year for which there is data), I got a lifetime risk of 0.0065% for the average woman in the US. It’s more rare than kidney cancer, much more rare than being killed by a lightening strike, and so much more rare than everyday activities that it would be laughable if it weren’t so sad.

      It’s sad that the frenzy for druming up fear and requiring this screening, to the exclusion of other tests for more likely things, or even treatment for symptoms a woman goes to the doctor for, delays treatment for those immediate concerns, and even keeps some women away from seeking medical attention. It delays treatment for the immediate concern by a couple of visits, by which time the problem has cleared up or become an urgent condition.

      There’s no thought to evidence-based concepts like “number needed to treat”, or the cost of all of this screening and more testing of false-positives (77% of the population) to find one case of actual cancer. Then, they talk about “overutilization of services” in the next breath they talk about the “need” for all of these paps. The cost is phenomenal!

      • Elizabeth (Aust) says:

        Except it was readily accepted that prostate screening would harm too many men for every life saved, the risks exceeded any benefit.
        No program is in place and I doubt it ever will be, when it’s mentioned lots of urologists and others come out strongly advising against a program. So real information came out quickly and GPs focus on informed consent. (no secret payments for reaching targets)
        Women were not so lucky, no RCTs and a program was rushed into place, the result…well, we all know the answer to that. A program that must screen 80% regularly to be viable means it can’t work with informed consent, but they went ahead anyway. Easy, let’s lie, mislead, coerce, pressure, ambush in consults, scare…disgraceful. That is not ethical cancer screening.
        One minus for men, mixed messages, some men’s healthcare groups promote prostate screening when none is recommended here, that gives some GPs a headache, but fortunately, they can be honest with men without having to dance around official misinformation and push for a screening target.

    • adawells says:

      Terrific work on the Demos website, Elizabeth! I noted that the Jo’s Cervical Trust website is recommending to their devotees that they go and check out Ms Slater’s sermon. Wonder how long they will be advertising this on their home page!

  15. vickibee says:

    Came across this specific article at work today. This article was published in 2001, and yet changes for self-screening have yet to occur in Canada. This article demonstrates that in a sample of random women at a 95% confidence interval, that self-screening was deemed EQUAL to samples collected from a pap smear in terms of efficacy. This was also favored (obviously) by women and were they given the option women would surely decline a pap.

    http://cebp.aacrjournals.org/content/10/2/95.full.pdf+html

    “As human papillomavirus (HPV) becomes accepted as the central cause of cervical cancer, longitudinal studies are shifting focus away from causality to a more detailed investigation of the natural history of HPV infections. These studies commonly require repeated samples for HPV testing over several years, usually collected during a pelvic exam, which is inconvenient to the participants and costly to the study. To alleviate the inconvenience and cost of repeated clinic visits, it has been proposed that women collect cervicovaginal cells themselves, hopefully increasing participation in the natural history studies. We evaluated the technical feasibility of self-collection of cervicovaginal cells using a Dacron swab for HPV DNA detection. We compared the self-collected swab sample and two clinician-administered swab samples (one from the endocervix and another from the ectocervix) from a total of 268 women participating in a case-control study of adenocarcinoma and squamous cell carcinomas of the uterine cervix (111 cases and 157 controls). HPV DNA was detected and genotyped using an L1 consensus PCR assay. The overall agreement between the clinician- and self-collected swabs was excellent [88.1%; kappa = 0.73 (95% confidence interval (CI), 0.61-0.85)]. The correlation was highest between the two clinician-administered swabs [kappa = 0.81 (95% CI, 0.69-0.93)] but was still excellent when comparing either clinician-administered swab to the self-administered sample [kappa = 0.75 (95% CI, 0.63-0.87) and 0.67 (95% CI, 0.55-0.79) for ectocervix and endocervix, respectively]. The type-specific agreement between samples was higher for high-risk, or cancer-associated, HPV genotypes than for low risk, noncancer-associated HPV genotypes when comparing the self-administered swab sample to the clinician-administered swab sample (kappa = 0.78 for high-risk versus 0.66 for low-risk HPV infections, t = -1.45, P = 0.15). The decrease in agreement for low risk types was largely attributable to an increased detection of these types in the self-administered sample (McNemar’s chi2 = 6.25, P = 0.01 for clinician- versus self-administered swab comparisons). The agreement did not vary significantly by age, menopausal status, case status, or clinic center. We have demonstrated that a self-collected Dacron swab sample of cervicovaginal cells is a technically feasible alternative to clinician-administered cervical cell collection in natural history studies of HPV and cervical cancer.”

    • Elizabeth (Aust) says:

      Vicki, self-testing has been an option for ages, they know many women hate speculum exams and would opt for self-testing. The fear is they’d lose control of the screening population (I call it the herd) and that might jeopardize the program.
      When you’re spending millions, you want to control the testing. So it’s not about reaching as many women as possible and providing them with options or the best test, it’s about getting numbers in for the test that best suits the program. (and it’s vested interests)
      They couldn’t care less about our bodily privacy, comfort, health or well-being.

      Women with these concerns are ridiculed and often left with nothing, they’d rather you go un-screened than give you an option. We see this when women are offered sedation before pap testing or offered counseling to “cope” with pap testing or pessaries for post menopausal women, heaven forbid they simply offer an HPV self-test kit. Almost all of these women would be HPV- and cannot benefit from pap testing. (but they don’t want us to know that!)

      They also, know they have a good chance of “capturing” non-compliant women at some stage, opportunistic testing (with your GP being rewarded with an extra payment for screening an overdue or un-screened woman), pre or post-natal testing, (a bad time to test women, but who cares? They can still count you, another cervix toward their target) women asking for the Pill or HRT etc.

      For decades women have said, “why is there nothing better, something non-invasive?” so they know many women hate the speculum exam, but they choose to ignore it or dismiss our concerns. Some even mislead women and say self-testing is not as reliable, that’s just not true, The Delphi Screener, for example, is easy to us (so I’m told) and very reliable.

      Tampap here was viewed as a major threat, was kept quiet, and locked behind a GPs script, needless to say not many women got their hands on it and then it disappeared completely. Also, it’s unhelpful to have better options if women are given misinformation, UK women have been told they still need pap tests even if they use Tampap and the result is HPV-. Not true. So the disgusting thing is they still want to sell you a self-test kit, but want you in for invasive testing as well, regardless of the self-test result, and knowing HPV- women can’t benefit from pap testing.
      Medical ethics…crickets chirping.

      They know if women had options and choices, few would agree to regular (and mostly unnecessary) speculum exams. Here IF we offer HPV primary testing, self-testing will only be offered to those who refuse the invasive test for 6 years. We’ll also, do HPV testing on those 25 to 29, 40% will test HPV+ (transient and harmless infections that would clear naturally) and they’ll probably be referred for immediate colposcopy and biopsy. I can only assume this was the trade-off with vested interests who’ll lose money with the axing of population pap testing. It means many young women will end up “treated”. We know HPV testing is not a good move before age 30.

      Also, they won’t release women from the program, those HPV- and no longer sexually active or confidently monogamous will still be expected to have an invasive HPV primary test every 5 years until an absurd 74.
      None of this is in our best interests or evidence based…the new Dutch program is the best program in the world, IMO, for those women who wish to test. (but they should freely offer HPV self-testing to all women)

      The document put together by the Health Council of the Netherlands (I linked under References and Education) also, expressed concern about the self-test option, many women might just wait until they were mailed a self-test kit as an overdue screener. (I think it goes out 3 months after the last reminder)
      So most of these programs see self-testing as a threat. To their credit though, the Dutch are doing some research and a trial to assess the feasibility of sending ALL women a self-test kit.
      I suspect word will spread quickly that self-testing is available, but many women here will probably fear waiting 6 years and won’t know they can order and pay for a reliable self-testing device online. (we may even get a scare campaign about their “reliability” if too many women opt for self-testing)

  16. Alex says:

    I just thought of something: When someone asks what your reasons are for not doing something, just saying “So that it doesn’t happen.” Works so well & it can apply to any subject.

    Makes a point of not being too susceptible to mind games- whatever specific methods are used (coercion, scare tactics, grading someone’s decisions, rushing people around so there’s no time to think, etc…), it’s still a question of whether this takes place or not. Cuts right to the core of the matter.

    Also, someone gets a real good look in the mirror. They’re trying to bring this, whatever “this” happens to be. I doubt that they’re unaware that they’re trying to wrangle someone into whatever it is, but it might point out THAT this is the case. At the very least, they’re seeing that you notice this & if they’ve got intentions, they might not think you’re a good mark.

    I think sometimes people just parrot whatever they’ve been told, but how are they going to argue aspects of the situation & not be aware of their existance? They’d be saying something isn’t there in contradiction to the situation that they are deliberately covering for. This is like someone putting a picture in front of a hole in the wall & then acting like they don’t know that hole is there. They’re factoring it into their actions, so they do know about it.

  17. Anita UK says:

    Hello all,

    I want to thank you all for your wise words and for your commitment to helping women realise the truth about cervical screening. I went for my first smear after being sent for at 25. It came back as abnormal and since then I have been on the merry go round of smears, colposcopy and biopsy.
    I have always refused “treatment” as it sounded barbaric, even though my family tried to used emotional blackmail on me to get me to agree to it.

    Thanks to you informed, assertive, intelligent women, I will now have no problem informing my GP that I will not be taking part in any more cervical screening as I will be armed with the facts about smear tests.

    • adawells says:

      Thank you for joining us on this website. I hope you find a great source of comfort and friendship in reading the posts and finding that women all over the world are feeling as you do about these screening programmes. Did you actually go through with any biopsies? What sort of resistance did you get from friends and medical people? They think women are brave to go through these procedures, but the really brave women are those who stand up, ask questions and decide for themselves.

      • Anita UK says:

        Thank you for your kind reply. It is reassuring to find out that I’m not the only one who has a problem with this testing.

        I have had a few punch biopsies but have refused any further treatment. I instinctively felt that something was off about the whole thing. I stumbled upon the 10 000 lost Blogcritic’s comments, which have helped me enormously in deciding that enough is enough.

        I completely agree with you that it is the women who ask questions and decide for themselves who are really brave. It takes a strong person to trust their own judgement when everybody around them is telling them they are wrong. I wish I had trusted my own judgement from the start and refused to participate.

    • Elizabeth (Aust) says:

      Anita, welcome, I’m pleased you now have the information you need to make an informed decision about screening.
      I’m just sorry you had to go through so much to get to this point, a merry-go-round of pap tests, colposcopy and biopsies sounds like a nightmare to me. It often takes a bad experience though to motivate women to go looking for real information.
      So many of us just accept what’s been said over and over for decades, “all women must or should screen”.
      I disagree, the decision to screen or not rests with one person, the individual woman.

      The shocking thing is…your experience was avoidable, if you’d been Dutch or Finnish you would have been protected from this program, they have evidence based programs, no screening before age 30. (that age restriction has been in place in Finland since the 1960s)
      We’ve known for a long time now that screening is of no benefit to those under 30 but that young women produce the most false positives, yet we keep testing young women.
      It’s BAD medicine that worries and harms lots of young women. (and now we know the only women with a small chance of benefiting from a 5 yearly pap test are the roughly 5% of women aged 30 to 60 who test HPV+)
      Thankfully, you refused a “treatment”, that was a smart decision.
      I’ve found GPs back off quickly when they’re confronted by an informed woman, they rely on our ignorance and that’s why real/balanced information has never been provided to women and why there is no respect for informed consent. (and even consent itself is often violated)
      They know they’d have no chance of getting 70% or 80% of women to screen if they provided women with a real choice and were required to contain informed consent. They must get that many women to screen to justify the millions wasted on screening…as I’ve said before, they’re trying to find a few needles in a huge haystack with a defective pitchfork.

      • Anita UK says:

        Elizabeth, thank you for your reply. I agree, doctors totally rely on women’s ignorance and compliance. After I had read about a possible link between dysplasia and the contraceptive pill, I stopped using it. When I mentioned this at my last colposcopy appointment, the doctor said it had nothing to do with the pill and tried to make me feel like an idiot. She was a very unpleasant woman who seemed to dislike having somebody question her instead of just believing what she said. She seemed desperate for me to have a LEEP done. I left that appointment knowing I was never going back.

        It makes me wonder why they want to do this to women. Is it all about money or do they want to control women, making them live in fear of their own bodies?

        I have read from your previous posts that you have never been for a smear. Were you put under pressure to have it done? Have you always felt so strongly about it all?

        That information about the Dutch and Finnish programme is very interesting, I will be sure to mention that when I go to inform my GP about my opting out.

        I’m glad I found this website. The females I know seem to think that without regular smear tests, you are sure to drop dead at any moment.

  18. Anita UK says:

    I have been made to feel like a risk taker by medical staff for not agreeing to a LEEP, but after watching a few videos of it being performed, I thought “no way am I having that done”. I feel terrible for the poor women who have been put through such awful procedures.

    • Moo says:

      Have you had any HPV test? Was it offered? Did you get any advice about nutrition or how to heal your cervix?

      • Anita UK says:

        Moo, thanks for your message. I had the HPV test, which came back positive, and I am a smoker, so I know that my risk of CC is higher than average. One positive that has come out of all this for me is I have become really interested in herbal medicine. I was given no advice by the medical staff concerning nutrition, I was told it was all down to my smoking and that I needed to have a LEEP which would cure the HPV.

      • Moo says:

        There are a few herbal things you can try such as green tea extract. It does kill HPV infected cells because it is used In a prescription cream for genital warts that is very expensive. Some women use herbal vaginal suppositories, tinctures on tampons or douches with herbal teas or hydrogen peroxide right on the bad areas.

        20% or more women who have keep have the dyslexia come back. It does not cure HPV it cuts off the tissue that is infected (they somewhat guess the are and cut off some around the border). Of course they get angry if you refuse a biopsy at a colposcopy. They make more money if you have them. If you get your own speculum you can put vinegar (yes that is what they use) and put it on your cervix. Any white areas are the HPV infection.

        To me either you have cancer or not. None of this pre-pre cancerous cell garbage. Take some good vitamins with vitamins B. Smoking is bad but I am sure you would quit if it was easy.

      • IMustBeSurrounded says:

        This is where I’m confused. They tell you that LEEP will “Cure” HPV – BUT if it lives in your bloodstream – how does shaving off part of your cervix “cure” it? Further, just because you are HPV positive – does it really mean you are on a crash course to get Cervical Cancer? I have a feeling I already know the answers to these questions – they are “It doesn’t” and “no” – and if those answers are right, these medical personnel are certainly more than eager to cart women in and out of unnecessary procedures.

  19. Alex says:

    Anita UK- There is a bit of a presumption of honesty & accuracy between people- not so much a deduction, but more like when you ask someone what time it is & they look at their watch. You presume it at least says whatever time they told you. It’s pretty weird to randomly lie out of nowhere like that, so usually this isn’t misplaced but some people try to use it against you.

    Look at when doctors say what you “will be having” or “this is what we’re going to do,” it’s presenting things as a fixed situation. It’s trying to convey the idea that there exists no capacity for reality to “unfurl” any other way. This is bullshit, since an action has to be engaged in order to occur. This tactic relies on that knee-jerk “trust.” Seeing them in a lesser light than other people seems like it would help.

    I don’t know if you actually need this advice, I just thought I’d mention it- seeing as you mentioned that you had been made to feel like a risk taker. Apparently, if wrong for a patient to be a risk taker, but it’s fine for a doctor (ex: “advising” all kinds of tests & procedures- regardless of risk, inaccuracies, or alternatives).

    • Anita UK says:

      Alex, thanks for your reply. I have had doctors say to me ” you will have the LEEP”. I just thought, “well, we’ll see about that, won’t we”. They seem to think that they own your body and that you have no say about what happens to it. At my last colposcopy around a year ago, I refused the biopsy and the doc seemed furious with me. She looked at me as if I had just spat at her!

      I’m not easily intimidated by doctors but I know a lot of women are afraid to stand up for themselves in these situations. I wish there was a way to point all these women in the direction of websites like this one, full of advice and FACTS about the true nature of these tests. This website and the 10 000 lost comments website have been a blessing for me.

      • Alex says:

        You’re welcome. It’s good that their bullshit doesn’t spook you.

        Not entirely sure how this would come about- but I truly think if they were attacked, this sort of behavior would be reduced. There isn’t enough presence of threat. It’s not like you can fire them, you’re most likely not in a position to effectively attack them, and you might very well have the problem of them being supported in their attacks by law enforcement personnel. I guess self-preservation has to be the incentive.

      • bethkz says:

        I’m not sure just how you would successfully attack them and this BS.

        I certainly would not advocate any sort of violence. It’s unlikely to be successful. It hasn’t worked even in areas where it’s commonplace. It certainly won’t have anything good happen in the US or other civilized, western democracies. If anything, the attacker will be seen as a kook or (if male) out to control women, and will dig the “imporance” of all of this in even deeper along with prison or the death penalty.

        As long as it is commonly held that women “have to” have all of this stuff, even with all of the science saying that it does no good or does harm, the argumentum ad popularum will keep it in place. As long as the doctor – even if he utterly disbelieves the crap about all of this necessity (one who reads what the science has to say) – has it expected of him/her to push these tests, they will continue.

        The utter and absolute dangers of something going wrong in a medical setting that leads to injury or death have been handled by mallpractice lawsuits. Many states now have limits on the amounts one can sue for – regardless of how eggredious the action was or how much harm it caused. The popular notion is that all malpractice cases are just someone out for money – or to get rich by suing a medical establishment.

        Note that the large corporate hospitals have teams of attorneys on their staffs! The corporations that run them have still more. Do you really think you, or even your lawmakers, can successfully fight these large teams of attorneys with a lot of money behind them?

        One can complain to such things as medical boards or health departments. My own experience with that has been less than stellar in any given instance.

        HOWEVER, if many people complain to medical boards and health departments about how they were harmed, about things which are clearly risks to the public health or public good, can show that certain institutions or practices are violations of laws and dangerous – something MAY eventually get done. OTOH, they may stop telling you exactly what went wrong. Yet, they have to so as to be able to sell the fear that something WORSE could be going wrong, an you need something else/more/different.

        The best tool is education. However, as individuals or even owners of large blogs, we do not have the multi-billion dollar budget that the advertisers of these tests and procedures and equipment have. It has gotten medical issues talked about a great deal, which may backfire in the long run. It will eventually get there – one-on-one, and as people know someone who had an “adverse effect” – injury, debility, disablement, or death – occur from a “routine” care. people willl stop wanting, accepting, or demanding it. Then, the science can take over, and show how these things are unneeded, harmful, or seldom beneficial.

      • Alex says:

        BethK: Well, if there was a gang that tended toward this sort of behavior, how would that get dealt with? Education would play a role: not falling into their traps & ideas for countermeasures, things like that- but I still think there needs to be real bodily risk for them, especially since they pose one themselves more & more frequently. I look at them in the same light as enemy troops (and even in an actual invading army, there are those that don’t really match the rest & try to stay out of the stuff they don’t agree with).

        Isn’t there all kinds of strife over chemical or biological weapons being used on the people in whatever countries? Don’t things get brought up about sanctioned abuses of the people- particularly with women? What about imprisonment for not wearing a headscarf & all that consists of? Plenty of times virginity testing is included in that or is imposed on it’s own. Sometimes this is even something done by a person’s own family! Does their being related or their being of the same gender make this any more non-existant? No, so it doesn’t make sense to see doctors pulling the same things as any different- whether they use the same tactics or not.

        As it is, the insurance companies tend to pay for their malpractice suits- the doctor might not even hear about it! It doesn’t necessarily stop anyone- they might just see it as a purchase. They might not get fired, either- since hospitals & such tend toward doing in-house investigations & seem to rubber stamp a conclusion that everything’s fine (that, or they’ll just keep telling them they shouldn’t do that- look at doctors that have a massive amount of complaints against them & are still there to cause problems). This things don’t hit them where they live.

        Another point is that other people don’t just get fired when they do something- even when it’s less than all this. Why should they have a situation where their occupation will take the bullet for them?

        Also, I don’t know how a man’s looking like he’s out to control women if he goes after doctors for being dictatorial with them. He’s not trying to manage her situations, he just takes issue when someone else is pushing her around. I don’t think it’s weird for him to take an interest in what happens to his family, at the very least. If this is the way that surrounding environment is, what reason does he have to presume they won’t try something else, as well? All of this applies to his children, too. It could even apply to him- it’s not like they’d only impose something on women & little kids.

      • bethkz says:

        + Alex: The education we need to do is that reality doesn’t change because of designations. There is functionally no difference between a doctor and nurse coercing a woman into letting them penetrate her vagina and/or anus than having a street gang coerce a woman into letting them penetrate her vagina and/or anus. What’s the difference between the doctor/nurse telling the woman that she’d die without it, and having the gang tell her she’ll die if she fights it? It’s aggravated sexual assault even if they don’t have a real gun, but something that just appears to be one! The cancer scares are just something that they can tell her is “deadly” when it’s extremely rare. As it stands, the gang members would be sent to prison. The doctor and nurse would not. What’s the difference? That the gang did it in a condemned house whereas the doctor/nurse did it ina well-lit medical office? That the doctor and nurse wore clean clothes while the gang probably did not?

        We’d have to educate the women – and sometimes men who are so coerced – that this really *is* sexual assault under a medical guise. We’d have to educate the juries and the attorneys and judges to. We’d need to have juries who didn’t have stars in their eyes when they saw the doctor’s medical license and/or the nurse’s nursing license. They’d have to look at the actual scientific studies on the matter, but that’s part of researching the cases.

        There are physicians who do “virginity checks” on girls who the (usually religious) parents don’t trust when she tells them that she didn’t have sex on her date. There are physicians who do virginity checks on children when their other parent suspects that their other parent, that parents partner or friend(s) had sex with the child, no matter what the child says. There is functionally no difference between this and what goes on in the middle east. There’s functionally and ethically no difference between the parents paying a doctor to do it and doing it themselves. If they did it themself, it would be sexual abuse. If they asked their neighbor to check their child’s virginity, that would be sexual abuse. If parents ask a doctor to do it, it is still sexual abuse of that child. It needs to be thought of that way when a medical person does it too.

        The colposcopies, biopsies, and hysterectomies really should be looked at as FGM. Again, there is no difference between it being done in a medical setting by doctors and nurses than in a barber shop by a barber or group of women. Well… there is the thing about anesthesia being used when it’s in a medical setting – normally. Infections are a growing concern in hospitals, and while it is not as high as in a north African barber shop, it’s not zero. Consent is lacking in both cases. In North Africa, it may be force, or it is often coercion as the girls thinks this makes them “more modern” and “women” and “a man will want to marry them”. In the US and other western countries, the girls think this is “more modern” than their grandmothers who never had to deal with this stuff, or believing that it would somehow save her from certain death.

        We arrest, prosecute, and incarcerate people who penetrate others without valid consent. We arrest, prosecute, and incarcerate people who do virginity checks on their daughters. We arrest, prosecute, and convict those who mutilate women’s genitals without valid consent.

        The education has to be that this is without medical use, fraud and coercion are used, and consent is invalidated.

        I’m in another group, mainly men, who are extremely concerned about what happens to their wives, girlfriends, mothers, daughters, sisters, etc in doctor’s office – and how the men are kept in the dark about what these exams are, how they are wrongly prohibited entry into such examining rooms – as well as someone who has collected over 6,000 names of doctors who have been convicted of wrongdoing – most often sexual. A number of these men have to deal with others – of course the medical people, but sometimes their friends, neighbors, wives, mothers, daughters, etc telling them how “controlling” they are because they “won’t allow them to access women’s healthcare”. It’s nonsense: The women have been sold a bill of goods – as I admit to having been in the distant past before I started looking at REAL statistics. Some women change their minds, and some women attack the messenger telling or showing them this.

      • Alex says:

        Bethkz- Thanks (I’m presuming “+Alex” was a thumbs-up).

        I’m suprised there’s a group of men that are doing all that! I’m curious: What kinds of problems do they run into? If they’re keeping something from being imposed on women, how is that being controlling? When that something doesn’t even work as advertised, how is it blocking access to care?

        If they’re saying to them that they can’t come in, they could probably make the point that if they’re not trying to impose anything on the person they’re coming in with they’d have no problem with them coming in with them. If someone is saying that they want someone to come in with them & these people aren’t going to believe them, what’s going to happen when they refuse something? They’re not going to believe them?

        That’s something I’ve noticed: medical personnel seem to have a lot of trust issues & when they get incoming information, they don’t know if they should “give it their trust.” That or they figure that this information needs to be affirmed by them- they’ve got to check with themselves before it’s something they’ll “swallow.” They figure consent is outsourced to them- although what happens is what occurs & if they’re clashing with a refusal they obviously are aware of it, since they can’t aim against what they don’t know about. That’s why I tend to presume malice & that includes when they don’t have a vicious look on their face.

      • Elizabeth (Aust) says:

        Beth and Alex, I think it’s worse than the street gang because the medical profession is in a position of trust and have a duty of care. Medical professionals are in a unique position and can easily take advantage, so harsh penalties should apply for any breaches.
        How often does that happen? Most women don’t complain about criminal conduct or misconduct in a medical setting.
        Interesting, we call an assault in the consult room, medical misconduct, why not call it what it is? An assault, a criminal act.

        A perfect example: the young model who posted here, she was misled and pressured by a male doctor to have an unnecessary breast exam. She made a written complaint to the hospital and they investigated the matter.
        The model (sorry, I can’t recall her name) gave them her account, she was told the breast exam was compulsory and without it he couldn’t give her a medical clearance for an overseas modeling assignment. HE said he offered her a breast exam and she accepted the offer. The investigators noted it was inappropriate to offer a routine breast exam to a young woman. (or any woman, they’re not recommended in the UK)
        So he’s either a liar and molested the woman misusing his position of trust or he’s incompetent.
        He’s given a warning, end of story. He continues to practice as a doctor.

        Compare that to a man who grabs your breasts and fondles them in a park, he’d be arrested and charged with a criminal act, go to a hearing etc. He then has a record with the Police. No one would be happy with a, “we’ve given him a warning”.

        I find it amazing that doctors get away with a slap on the wrist when they misuse their position of trust and assault patients.
        On the evidence I think a jury would have convicted this man, doctor or not.

        We should not allow the medical profession to police their own, we know it doesn’t work, they simply protect these predators to go on and attack others. I imagine they take greater care choosing their next victim, but doubt someone with these tendencies stops and starts acting professionally.
        Personally, I wonder whether these “warnings” are designed to defuse the situation and hopefully, avoid Police involvement. So, protecting the doctor.

        When this sort of thing happens, women are better off going straight to the Police. A dermatologist here happily assaulted women until a woman left his consult room shocked and upset and headed straight to the Police. He was arrested, went to trial, was convicted and now sits in a prison cell. I wonder what would have happened if she’d complained to the Clinic or Medical Board…a warning. (sssh, be more careful next time)

    • bethkz says:

      This thread is getting so long that I’m getting confused about who or what I’m replying to.

      + Elizabeth
      Yes, it SHOULD be considered a more severe crime if a doctor does something than if a street gang does the exact same thing. They’re in a posiiton of trust with especially vulnerable people. It’s a similar situation if a teacher, coach, step-parent, or priest mollests a child vs a stranger in an alley. The teacher/scoutleader/parent is in a special position of trust – just as is the medical professional.

      These people should be given long prison sentences, not have warnings placed in their confidential personnel charts! Moreover, since they are in a position of trust over one’s health, if it causes any health problems, or delays getting treatment for an actual condition, that should come from the doctor’s pocketbook. Not from any insurance!

      +Alex
      The group I’m referring to is howhusbandsfeel on Yahoo. There are men who find out what is going on. It’s a male instinct to protect the women he’s got responsibility over – wife/girlfriend, mother, daughter, sister… Many times a new man finds his way into the group and tells a similar story: He’d known that there were these (mysterious) women’s exams and special women’s doctors. Women didn’t talk much about it. He presumed that they took blood tests and talked to women about their periods. Then (somehow) he found out what it actually was, and was outraged! Outraged because of how the women are being taken advantage of, outraged because of how another man is doing sexual things with his wife (or daughter, or mother). In the case of a wife/gf, he feels that it’s a violation of the monogamy he’s expecting from her. The wife doesn’t see it that way – as far as she’s concerned, this is necessary for her health, it’s not sexual, and her husband wants her to die. In many cases, the women won’t go to a female gyn when that’s offered as an alternative, because their gyn who has seen them for years and knows their condition can best treat them.

      An observation made by many of the women there is that male gyns are more gentle than female gyns or female nurse practitioners. Women DO seem unnecessarily rough – probably to be sure that no one thinks it’s sexual for her. Men are gentle because…. well…. seduction.

      Some of the men have commented on a sort of smirk on the doctors’ face when he looks at them when they’re in the room, and she’s having such an examination. It’s definitely a game!

      Another complaint from women who are there and the men is that when they try to go to the back with their spouse, they are told that “insurance regulations” won’t allow it. He’ll have to stay in the waiting room.

      BTW, I ran into that with a (female) dentist a couple of years ago. I went along with it: I’d had a toothache for weeks, and been trying to get in with any dentist. I started to write what happened, but let’s say disaster based on her trying to extract a lot of money for unwanted and unneeded care. It won’t happen again without a witness.

      Another book I’ll recommend is _Doc: The Rape of the Town of Lovell_ by Jack Olson. Based on a true story, it involves a town in northern Wyoming, near Yellowstone, where a doctor who practiced there for YEARS took advantage of all of the women in town, subjecting them to pelvic exams and outright rape at every appointment. These women were religious and VERY NAIVE. The young girls didn’t realize what had been happening until their wedding night, and then they were afraid to say anything – as were the older women.

      BTW, the doctor involved got out of prison a couple of years ago. He sued the state of Wyoming for his examination table to be returned! He was never going to practice medicine again, but wanted it… as a trophy????

  20. Elizabeth (Aust) says:

    “Is it all about money or do they want to control women, making them live in fear of their own bodies?”

    Hi Anita

    Once the program came down, women were doomed, because they knew they couldn’t make the program “work” (reduce the already small incidence and death rate) if they respected consent and informed consent. The medical profession apparently had no problem proceeding on that basis, in fact, they set to work to find ways to force women into testing…the call and recall system we see in the UK, which provides greater control over women. (they will probably introduce that sort of system here in a year or so) Coercion – the pap test “requirement” for the Pill or women being pressured or misled into testing during that consult. (to name just two examples)

    I think both of your points are valid and they feed off each other, if you can control women, you maximize profits. (they’d say coverage, “for our own good” sort of stuff) I believe the Pill remains on script to push, mislead and coerce women into pap testing. Cancer screening has nothing to do with the Pill, but this was an early strategy to force women into elective cancer screening and excess. (routine pelvic and breast exams) I consider these exams to be an assault, you cannot consent when you’ve been coerced or misled. The Pill has been proven safe over decades of use and barriers around the Pill can mean unplanned pregnancies, abortions etc. which carry risk, FAR more likely than a diagnosis of rare cervical cancer. (most women are HPV- anyway and not even at risk and cannot benefit from pap testing) Making women afraid of their bodies means they’re more likely to turn up and accept testing, hopefully, without asking too many questions or doing any independent research. That was always the aim, “just do it, like brushing your teeth”.

    I don’t believe this testing is about women’s healthcare or we wouldn’t be misusing the pap test to maximize risk and sending huge numbers off for unnecessary procedures and of course, we miss some real problems wading through all of the excess. There was always a better way for those who wanted to screen.

    “I have read from your previous posts that you have never been for a smear. Were you put under pressure to have it done? Have you always felt so strongly about it all?”

    I’ve always felt strongly, initially became very concerned when I saw so many Uni friends being forced to test to get the Pill and many ending up having some of their cervix removed, I could smell a rat, or a whole bunch of them actually…
    After doing my research (and this was pre-internet) fear fell away because I knew what was going on, I didn’t fear cervical cancer, but certainly feared cervical screening and where it so often led. Most women remained ignorant, hardly surprising, there was no real information available for women, in fact, anything informative IMO, was suppressed.
    Screening was DONE to women. (still is)

    I stayed away from doctors and fortunately, was healthy. I studied the Billings Method because I knew what would happen if I asked for the Pill, that was the consult that triggered abuse and still does in many countries. (and I’m sure still happens here with some unethical doctors)
    I saw a skin specialist in my late 20s but they don’t ask about pap tests. (not in this country anyway)
    I started to shop around for a doctor in my 30s, someone I could trust, someone respectful and ethical. (I had developed some mild asthma) My doctor and her practice have been great, pap testing has rarely been mentioned over the years, when it was, I calmly, politely and firmly explained why I don’t have pap tests, end of story, file marked.
    I recall a female doctor (at another surgery) asking me about pap tests, when I declined her parting shot was, “you SHOULD be having pap tests”. I made a mental note not to see her again.
    Now (at 56) I’d make a written complaint about that sort of unprofessional attitude, you do not TELL someone they should be having screening, that’s our call.

    I have to say MOST of the pressure came from all I saw going on around me, other women talking about their scares and biopsies, tears, humiliation etc. (most doctors were male back then which made this stuff worse for many women) Some women were quite aggressive about pap tests, “I think women must be sick in the head if they don’t have pap tests” came from one of my well-screened and “treated” friends. I said very little back then, but kept reading. Over the last 10 years though I’ve started to tell people I don’t screen and have never screened. I felt it was important, for too long the system has silenced us, so other non-screeners feel isolated and perhaps, afraid. Silence and censorship has protected these programs and the abuse.

    My posts were often deleted or edited and I was banned from a few websites for my “irresponsible posts” that might cost lives, but something has changed over the last 5 years, now most of my posts remain in place.
    I should say my interest in this subject went up a notch when my younger sister had an unnecessary cone biopsy. Widespread carnage to prevent a rare cancer. I still struggle to believe they get away with it, very few women ever take legal action, when huge numbers would have an open and shut case.
    Sorry, but if you’re reading this blog, you’ll know I’m long-winded, I think it’s partly a response to so many years of imposed silence on this subject. It’s also, great to vent. For a long time there was nowhere safe for women to vent, share real information and talk about their experiences. Now there is…
    It seems more likely at this stage that BlogCritics were pressured to shut down our discussion. If not, why haven’t the comments appeared on the new website?
    If you have nothing to hide, you wouldn’t be concerned about people sharing real information and experiences on cancer screening. For too long they’ve had it their way, that’s changing and about time!

  21. vickibee says:

    You ladies will love this. We all know that women under 30 have almost no risk to obtain cervical cancer, yet HPV is common in this age group and is most often cleared on its own. This is what Sunnybrook hospital in Toronto has now posted.

    Colposcopy Clinic

    We are home to a unique colposcopy unit where research and education in the prevention, early detection and treatment of cervical cancer takes place.

    Colposcopy is a procedure used to examine the vagina and cervix using a lighted magnifying instrument. It is performed by gynaecologists with specific training and incorporates a multidisciplinary approach to diagnosis and treatment.

    We accept referrals for women with abnormal pap smears or related problems, offering full diagnostic and therapeutic options. This clinic runs on Wednesday and Friday mornings between 9 a.m. and 12 p.m. and 1 p.m. and 3 p.m.

    We have a colposcopy clinic on the University of Toronto main campus, in the Koffler Centre Student Health Service located at 214 College St.

    The unit provides convenient on-campus colposcopy services to University of Toronto students. The university maintains state-of-the-art equipment in this unit, which is directed by Dr. Sara Taman. For more information, please phone the University Health Service at 416.978.8030.

    What the hell? Why would this be common place for university students? It actually makes me sick.

    • bethkz says:

      It makes no sense for women of traditional university age to be getting colposcopies. It would make sense, at least as much as it ever does, for older students – those who have returned to college after motherhood, a different career, wanting more education in the career she’s in, etc and for faculty and staff, who are very likely to be older than most of the students.

      This is still not commonplace for a majority of the students, nor should it be a draw to get students to enroll. As most universities that teach health care specialties (physicians, nurses, various sorts of medical technician), and the professors are under the same old “publish or perish” mandate, have hospitals connected with them, having the colposcopy clinic is sort of a side-effect of them having this teaching hospital, and will be for as long as this nonsense is in any way “standard of care”.

    • Alex says:

      Sounds like something that’ll be kept afloat with all kinds of coercive tactics & false information.

    • Kleigh US says:

      Its like they expect there will be alot of girls with abnormals. thats a red flag. and they probly try to force all the woman there to show for pap smears.

  22. Kleigh US says:

    Somthing else I want to tell yall. My friend went to a private collage and she came back saying that the school was telling girls that they needed to go on birth control bc there were so many woman at that school being raped. and of course they try to force paps with the pill. And they lined up all the woman for paps before they whould alow them to enter the school refusel whould mean they whould be sent home and they said it was bc they didnt want people comming in the campas and spreeding stds. idk if the guys got tested. that is so not right. I was so madd when she told me.

    • Alex says:

      So, it went “Oh, a lot of women get raped here so you need to go on the pill so you don’t get pregnant from that”? I wonder if any of these attackers would use their hands or an implement? Maybe they liked aggressive role-playing? Maybe they were mentioning these women getting backed into something penetrative?

      It’s possible that if they were to level charges of attempted coercive iatrogenic assault & reproductive endangerment, the school would admit them without any arranged probing. The women that this actually happened to could always level the same charges, just without the “attempted” part- it IS an instance of compulsion, after all. Where was this, anyway?

      It’s actually illegal for them to back women into these tests for birth control, so you might want to ask your friend to spread that around a bit. Also, the school doesn’t determine whether or not someone goes on birth control. Now that I mention it, what if one of these women wanted to get pregnant?

    • bethcz says:

      If there are THAT many girls raped at that school, I don’t think I would WANT to go there. Running for the exits and demanding return of any fees paid is much more reasonable. Effectively, they’ve informed these prospective students that they are not providing a safe environment, nor do they plan to. If they know they have a problem, they need to address the problem that exists – NUMEROUS rapes on campus, and they need to aid in the prosecution of the rapists. Not aid-and-abet them as some campuses seem to do by handling it in-house.

      The school cannot *tell* women that they have to go on the pill. Hormonal birth control is not effective or safe for all women, plus there are women who are pregnant, plan to get pregnant, or women for whom pregnancy is impossible.

      PAPs do not check for any STDs other than HPV. Do they plan on periodic checks throughout the school program for gonorrhea, syphilis, herpes, Hep B & C? Or, just when someone goes off campus – boys and administrators/instructors too?

      Something is really amiss here, and they’re all but asking for a host of lawsuits and even criminal prosecutions if they don’t do more to help ensure prosecution of rapists.

  23. Kleigh US says:

    well that was about 7 years ago and she felt forced to have the pap when she got there. she didnt question the no pap no pill and sice thin sadly like a robot repeats the acog recomendations for paps and tells me im taking a risk. she wont hear anything i have to say. i belive those girls were all raped the the forced pap smear.

  24. Kleigh US says:

    she left that school after a few monthes.

  25. Kleigh says:

    She said they took a swab for stds and another for a pap smear when they arived on campus. And birth control was pushed but not mandatory. She stoped taking it bc it made her bleed all the time.

  26. Kleigh US says:

    i dont see how a schhol could leagaly force students to screen for stds and have paps or be kiked out. i dont know if that was a try on but it worked. she said all the girls did it.

    • bethkz says:

      For one thing, STDs are not an immenent health threat, such as having the flu. It would fall under such things as medical right to privacy, and even the Americans with Disabilities Act. There are no “swabs” for most STDs: They are blood tests. Also, there’s a Title IX issue: If they required the women/girls to have paps and STD tests, or threatened to throw them out if they didn’t, and they did not require the men/boys to have them, this is discrimination on account of sex or gender.

  27. Kleigh US says:

    school lol

  28. Kleigh US says:

    It was a trade school of some kind but i cant remember the name. at the time i looked up the school and it said all students whould get health exams and pap smears. i dont know if anyone has chalanged it.

  29. Kleigh US says:

    yeah i know it seemed like they were saying people whould bring stds in the school auming collage kids are all having sex with each other. no stds are not like the flu were u can get it in the air. also schools in texas tried to force girls to have the hpv gab i didnt see how they could judtify that bc hpv is from sex you canyt get it from the air so how did that have any thing to do with going to school.

  30. Kleigh US says:

    in the us they do screen for stds with a swab and somtimes the same sample the pap smear is taken . even tho you can screen thru blood and pee. I think its a way to charge for a pelvic.

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