What Doctors Don’t Want You to Know About Pap Tests and Pelvic Exams

You might have wondered why doctors are so persistent when it comes to your pap test and pelvic exam.  You might also have wondered why doctors don’t give you information and offer you a choice in the matter.  Here is some information about pap tests and pelvic exams that doctors rarely tell you:

Pap Tests – Undisclosed Information:  Pap tests detect abnormal cells on your cervix.  What doctors don’t tell you is that the results from a pap smear are often inaccurate (between 10 and 60% of pap smears are inaccurate) and will show a false positive for abnormal cells if you have recently had intercourse, taken a bath, used a tampon, or any number of such things.  An abnormal pap smear does not necessarily mean you have cervical cancer, or that you are even at risk of cervical cancer.   ehealthmd.com/content/how-accurate-are-pap-smear-results

Cervical Cancer – Undisclosed Information:  Doctors also don’t want you to know how rare cervical cancer is.  Your odds of getting cervical cancer are 1 in 13,699 (in developed countries).  Your odds of dying in a motor vehicle accident each year are 1 in 6,535.  In other words, you are more than twice as likely to die in a car accident than you are of getting cervical cancer.  Also, the odds of getting cervical cancer are even lower if you are a young to middle aged woman. http://www.statcan.gc.ca/pub/82-003-x/2012001/article/11616/tbl/tbla-eng.htm

Extra Fees – Undisclosed Information:  Doctors are able to charge extra fees for pap smears.  Doctors don’t want you to know that they are making more money from your visit every time you agree to a pap test.  http://www.pbs.org/wgbh/pages/frontline/shows/doctor/care/capitation.html

Bimanual Exams – Undisclosed Information:  Doctors perform a bimanual exam (insertion of fingers into the vagina) along with the speculum exam.  What doctors don’t want you to know is that there is no data to support the relevance of the bimanual exam.  Studies have shown that no abnormalities have ever been accurately detected by inserting fingers into a woman’s vagina. jwh.2010.2349 (application/pdf Object

Pleasure – Undisclosed Information:  Some doctors enjoy performing pelvic exams.  But do not take my word for this – read for yourself a male doctor’s point of view on pelvic exams: https://forwomenseyesonly.wordpress.com/2012/09/09/the-other-side-of-the-speculum-a-male-doctors-point-of-view/

Further Tests – Undisclosed Information:  Many women who receive a false positive pap smear result are sent for further and more invasive testing.  This leads to further income for medical professionals, but this is also where further damage to the cervix can occur from colposcopies and unnecessary biopsies; resulting in risk of heavy bleeding, infection, irreparable cervical mutilation, unnecessary hysterectomies, and difficulties with pregnancy and giving birth as the following evidence shows:

Based on solid evidence, regular screening with the Pap test leads to additional diagnostic procedures (e.g., colposcopy) and treatment for low-grade squamous intraepithelial lesions (LSIL), with long-term consequences for fertility and pregnancy. These harms are greatest for younger women, who have a higher prevalence of LSIL, lesions that often regress without treatment. Harms are also increased in younger women because they have a higher rate of false-positive results. Magnitude of Effect: Additional diagnostic procedures were performed in 50% of women undergoing regular Pap testing . . . The number with impaired fertility and pregnancy complications is unknown.  http://www.cancer.gov/cancertopics/pdq/screening/cervical/HealthProfessional/page1/AllPages#Section_133

So, as you can see, there are many good reasons why your doctor doesn’t want to offer you information and a choice regarding pelvic exams and pap tests.  Do your research, protect your healthy mind and body.


  1. While some of your information is acurate, your post leaves the impression that paps and pelvic exams are unnecessary. Cervical cancer is the 2nd leading cause of death in women worldwide. And though routine testing has largely eliminated that risk in the U.S., 3710 American women died in 2006 from cervical cancer. When caught early, cervical cancer is easily cured. When caught late it is terminal — there is no cure and painful horrific death is only a matter of time. I have seen women in their 20s dying of cervical cancer. Paps should begin at age 21 regardless of presence, absence or type of sexual activity. Please do not personally or encourage your readers to neglect their exams!

    • Dear Dr Pate, you are telling . . . after . . .
      1. Crevical cancer is not the 2nd leading cause of death in women worldwide. Not even 20th! Never was, never will be.
      2. Pap testing did not “largely eliminate” cervical cancer. It’s a hype used to coerce women into pap smears. There is less than 1% difference in chance of getting cervical cancer between women who pap-smear all their lives and women who never do pap tests.
      3. Pap smears are not just unnecessary, they are harmful. 77% of women end with butchered cervixes after biopsies and “treatments” for cancer that only 0.68% will get.
      4. You urge women they “should begin at age 21 regardless of presence, absence or type of sexual activity”, which is an outright . . .! A person who never had sexual activity doesn’t have HPV. No HPV = no cervical cancer. You either should go back to school and learn the facts properly, or stop with the deliberate . . .

      • To the editor of this blog: I don’t mind you editing my comments if you prefer certain words to be removed for your peace of mind. It’s a great blog, and I’m happy with the way you are managing it.

      • Antonmedical, cervical cancer incidence rates have also greatly declined in India since the 50s. Yet, the majority of these women have NO access to paps or any treatments. The general trend tends to prove that our bodies are killing any abnormalities. Facts win!

      • I also found that while having colonostopies, if their instruments aren’t steralized well, can cause hpv

    • James, I was just browsing through your blog and learned that you are against routine circumcision, you call it “infant genital mutilation” and you apologise to your son for having done that to him.
      Unless you fully advise women of the high risks and limited benefits of pap tests and make sure they understand that screening is a choice and if they choose to screen, you offer them to follow the Dutch program (5 hrHPV primary triage tests), unless you do all of that, you will have to apologise to all of your patients who endured treatments at the end of your career for having mutilated their genitalia for nothing.

      Why did you allow your son to be circumcised? “We didn’t understand the risks. We didn’t understand the permanent damage that we were condoning. We did not understand the history of circumcision in the U.S. nor its root in puritanical aims to deter masturbation. We were simply uninformed and did not understand the gravity of our decision to circumcise our son.”
      Women in the US (and apparently doctors too) don’t know of the risks that come with (over-)screening. You, as an OB/GYN resident, really have the opportunity to educate yourself and make a difference…

    • {Sneeze} oh pardon me, while I’m perfectly healthy in every way shape and form somehow I am highly allergic to bulls***.
      “Cervical cancer is the 2nd leading cause of death in women worldwide.” LOL WOW. I bet obesity, heart disease, and car accidents fall close behind right? I know ALOT of women and not one has cerivcal cancer. In fact, not very many were aware of it until Gard-n’fail. “I have seen women in their 20s dying of cervical cancer.” Interesting, where do you live? Would love to know so I can far far away. SOO glad I am not into conventional medicine. Have never seen an obgyn, ever. I think I will continue to never see you now. Good day.

  2. It’s amazing to me how few doctors respect informed consent for women, the use of the word “should” is very concerning and highlights a major problem with the medical profession and their attitudes to female patients.
    The routine pelvic exam is NOT recommended in Australia, the UK and in many other countries for good reason, it is of poor clinical value and exposes the woman to risk, even unnecessary surgery. Dr Carolyn Westhoff, an American ob-gyn, partly blames this exam for their high hysterectomy rates and the number of unnecessary oophorectomies. Beware of the routine pelvic exam. (several articles online)

    Only one person can decide a screening test is “necessary”…the individual man OR WOMAN. I doubt a doctor would appreciate being told he should or must have a prostate exam, all cancer screening is elective and legally and ethically requires informed consent. There are benefits with some screening tests, but also, there is RISK and only the individual can decide whether the benefits outweigh the risks.
    I made an informed decision about 30 years ago not to participate in cervical screening, my risk of cervical cancer is near zero while the risks with testing are high, very high in Australia (and the States) with serious over-screening. The lifetime risk of referral for colposcopy and usually some sort of biopsy is a whopping 77% for a cancer with a 0.65% lifetime risk. Of course, this information is never released to women, you have to do your own research. I also recently rejected breast screening due to the significant risk of over-diagnosis for little or no benefit. (the Nordic Cochrane Institute have produced an excellent summary of the evidence to assist women to make an informed decision, “The risks and benefits of mammograms” is at their website.)

    There are no randomized trials for pap testing so we’ll never know for sure whether anyone has been helped, stomach cancer has dropped significantly over the decades with no screening at all…IF women have been helped, the numbers are fairly small, if you take out false negatives and consider natural decline, (this cancer was always rare and in natural decline before testing started) fewer than 0.45% could possibly be helped…and of course, no one considers the HUGE over-treatment rates, especially in Australia and the States. We know many of these women then have damage to the cervix that can mean infertility, high risk pregnancies, premature babies, miscarriages etc

    Cervical cancer is more common in Africa (unique risk factors) and the undeveloped world, but this cancer has always been rare in countries like Australia, the UK and the States. To compare cervical cancer rates in Africa and Australia is misleading and inappropriate.

    Women in their 20’s dying from cervical cancer – this will happen whether you screen or not. Over decades of testing not one country has shown a benefit pap testing those under 30#..but all have evidence of risk/harm, these women produce the most false positives.
    (#See: “Cervical cancer screening” by Assoc Professor Margaret Davy and Dr Shorne, Australian Doctor, July 2006.)
    These very rare cases are usually an adenocarcinoma… (the pap test often misses this even rarer type of cc) Countries with evidence based screening like the Netherlands and Finland do not offer pap testing to those under 30 and Finland has the lowest rates of cc in the world (the Dutch no more than us) and both countries refer FAR fewer women for colposcopy/biopsy. (fewer false positives) Pap testing young women can endanger their lives as a false negative result can lead to false reassurance and a delay in seeing a doctor about symptoms and so a later diagnosis and poorer prognosis.

    To suggest all women start pap testing at 21, regardless of sexual activity, is a VERY concerning statement. Sexually active women under 30 don’t benefit from pap testing and most countries exclude women who have never been sexually active from this testing for obvious reasons…it’s risk for no benefit.
    As I understand it…it’s only the States that promotes pap testing for those not yet sexually active…this can only be about the profession “assuming” all women have been sexually active by age 21…IMO, this is arrogant and inappropriate. Women should be provided with balanced and complete information and left to make up their own minds…the profession should not be assuming anything about women. Many American doctors still coerce women into elective cancer screening and unnecessary exams to get the Pill, so women need to be careful when they choose a doctor and make a formal complaint when faced with this sort of outrageous conduct. Find a doctor who will act in your best interests and respect your right to make an informed decision about testing…to accept or decline as you see fit…and to foster a respectful two-way relationship.
    I’d urge all women to look at the evidence before following recommendations or your doctor’s advice – make sure these things are in YOUR best interests.
    Thankfully, things are changing and those doctors who promote harmful excess and give women disrespectful orders or misleading information will find fewer and fewer women in their waiting rooms. Speak with your feet…there are great doctors out there, you just have to search for them.

    Also, we now know only roughly 5% of women aged 30 or older can benefit from a 5 yearly pap test, those HPV positive. Most women are HPV negative, not at risk and cannot benefit from pap testing. It’s risk for NO benefit.
    Population pap testing is now outdated…see the new Dutch program, go to
    HPV Today, Edition 24 – replacing their 6-7 pap test program, 5 yearly from 30 to 60 to 5 hrHPV primary triage tests offered at ages 30,35,40,50 and 60 and only the roughly 5% who are HPV positive and at risk will be offered a 5 yearly pap test. Women also have the option of self-testing, using the Delphi Screener. (also in use in Singapore, Malaysia and elsewhere)

  3. Dr Pate, please do not insult the intelligence of the women of this forum by telling us that you have seen women in their 20s dying of cervical cancer. Appealing to emotions does not work with this group of informed women. You neglected to mention whether these women who apparently died had paps or not as we are quite aware that pap smears are notoriously inaccurate particularly when it comes to adenocarcinomas. Save your scare tactics for other forums. Also, please support your opinions with peer reviewed references if you want to appear credible. An MD after your name carries no weight around here. We are not gullible women, we are intelligent and capable of reading the literature and making our own informed decisions. The days of doctors telling women any kind of BS to get them to comply are numbered.We can access most of the journals that you read, so telling us misleading information such as cervical cancer is the 2nd leading cause of death worldwide is easily checked by looking at the incidence of the disease in developed countries before screening was introduced. Therefore, we know that the disease was never as prevalent in developed countries as it is in developing countries. Nice try.

    • Right on Mary! But try to remember that these exams probably make Dr. Pate a lot of money. The Dr. is so eager to sell pap exams that the Dr. is posting references that directly contradict previous statements. It is kind of like the car sales man trying to sell you a junky lemon.

  4. Ladies,

    I am not going to engage inirrelevant and counterproductive argument regarding statistics and medical recommendation. It was not my intent to “insult intelligence” nor to “use scare tactics.” My point was to reiterate the standard of medical care from the U.S. perspective. Some basic information in support of what I have previously written can be gleaned from the following websites:


    To Your Health,
    James Pate, MD

    • Dr. Pate, in your first comment you had stated ” Cervical cancer is the 2nd leading cause of death in women worldwide” but from visiting the WHO website it is possible to see your comment was inaccurate. The WHO states the top ten leading causes of death amongst women worldwide as follows:
      Ischaemic heart disease
      Respiratory infections
      Diarrhoeal diseases
      Prematurity and low birth weight
      Neonatal infections
      Hypertensive heart disease
      As you can see, cervical cancer does not even make it into the top ten. It is this type of careless misinformation designed to elicit compliance that leads to further mistrust of the medical profession.

      Oh, and you had also stated ” Please do not personally or encourage your readers to neglect their exams!” I would like to point out that nowhere on this blog site have I ever encouraged readers to neglect their exams. What I do attempt however, is to encourage readers to do their research, to know they have a choice, to take control of their own bodies and allow themselves peace of mind. What I would like to ask of you is this:
      Please offer women accurate information and allow them a choice
      Please do not withhold healthcare or medications if a woman decides to not screen
      Please do not bully or pressure women into screening against their will
      Please do treat women with the same respect as you treat men (drs offer men informed consent regarding prostate screening, there is no coercion or withholding of healthcare when men decline screening – even through prostate cancer is roughly 19 times more prevalent than cervical cancer)
      Please attend to other parts of a woman’s body

    • In addition, Dr. Pate, you’ve neglected to mention that statistically, cervical cancer doesn’t even scratch the top 10 in most common cancers in the United States or the UK, and the lifetime risk of getting cervical cancer is less than 1%. Cervical cancer diagnoses are far fewer than other gyn cancers, such as breast, ovarian and uterine, and for other “rare” cancers such as kidney and pancreatic.

      There aren’t any viable screening tests for pancreatic cancer or ovarian cancer, but tell me, how much do you screen your patients for those other cancers?



      Nor do you mention that the risk of getting cervical cancer for a woman who does NOT have one of the high-risk strains of HPV is somewhere in the neighborhood of .001%. There are several viable options to screen for HPV without a pelvic exam, including the Cervista urine test. If a patient tests negative for HPV, she has a better chance of being struck by lightning than getting cervical cancer. So tell me, do you routinely offer this alternative to your patients, or do you scare them into returning for their exam every year (which, in itself, is due to the high error rate of paps), withhold their birth control to coerce them into Paps, and make them think that cervical cancer is looming to kill them at any second?


      Do you fully inform your patients of the risks of testing, including false positives, incorrect interpretation and the possibility of needless follow ups? If they have these follow ups, such as LEEP, do you inform them fully of the risks of the procedure, such as an impact on their future ability to carry a fetus to term?

    • So the properties of a situation are irrelevant details & it’s counterproductive to factor them in? I suppose that IS the perspective with American medicine. Something that is a grave iatrogenic attack if imposed, that doesn’t work as advertised in both risk & reliability, for which there exists alternative testing methods for something that is massively uncommon to begin with- a real high-quality medical situation all around.

      Oh, but I left out the concept of intellectual negation! That’s when someone acts like their decisions outmatch someone else’s because they feel they have a higher “grade” than the other person (what comes from me is an “A” & what comes from you is a “B,” at best). The medical employee believes that they reform the structure of the situation by their mere decisions. That’s insane, in itself, since reality isn’t formed by recognition (otherwise, nobody would get hit by a car they didn’t see coming). I guess someone doesn’t have to be insane to antagonistic, though. Being hostile through medical methodologies is, apparently, the M.O. of the M.D.

  5. Ladies,

    You are correct about the “leading causes of death” not including cervical cancer. I am currently away from my computer on vacation and am attempting to contribute to this discussion via iphone which has its obvious limitations. The statistic I unintentionally misrepresented is the following: “Worldwide, cervical cancer is second only to breast cancer as the most common malignancy…”. It’s source is: http://consensus.nih.gov/1996/1996CervicalCancer102PDF.pdf.

    “Only one person can decide a screening test is ‘necessary’… the individual man OR WOMAN… all cancer screening is elective and legally and ethically requires informed consent. There are benefits with some screening tests, but also, there is RISK and only the individual can decide whether the benefits outweigh the risks.”
    — I completely agree.

    “…no one considers the HUGE over-treatment rates, especially in Australia and the States. We know many of these women then have damage to the cervix that can mean infertility, high risk pregnancies, premature babies, miscarriages etc.”
    — I can assure you that all medical organizations and competent physicians are constantly weighing the risk-benefit ratio of evaluations and treatments with the goal being the improvement of health. There is a lot of over treatment, however this is felt to be necessary to identify and treat women with early cervical cancer while it is still curable. Fortunately, colposcopic biopsies rarely result in the complications that you mention. There are higher rates of complications with LEEP that should be discussed as part of the informed consent process.

    It is very interesting to read your descriptions of different treatment guidelines around the world. I must confess that as a U.S. trained OB/GYN resident (I graduate in 6/2013) that I have not delved into other countries recommendations.

    “As I understand it…it’s only the States that promotes pap testing for those not yet sexually active…this can only be about the profession ‘assuming’ all women have been sexually active by age 21…IMO, this is arrogant and inappropriate.”
    — We do not assume that all women are sexually active. HPV is incredibly prevalent and up to 80% of the population will be infected at some point in their lives. There are case reports of women who have never experienced coitus developing HPV-related cervical cancer. Thus age 21 has arbitrarily been set by expert panel as the time to begin Paps in the U.S.

    “Find a doctor who will act in your best interests and respect your right to make an informed decision about testing…to accept or decline as you see fit…and to foster a respectful two-way relationship.”
    — I completely agree. Father does NOT know best and the doctor is not god. Your physician should serve as an expert medical advisor that assists you in making decisions about your personal heath care.

    “Also, we now know only roughly 5% of women aged 30 or older can benefit from a 5 yearly pap test, those HPV positive. Most women are HPV negative, not at risk and cannot benefit from pap testing. It’s risk for NO benefit.”
    — This is a very bold, unsubstantiated statement. The reason why we continue to do Paps in HPV negative women after age 30 is because humans are terrible at lifelong monogamy. Approximately 1/4 of relationships are impacted by sexual escapades and over 50% of marriages end in divorce. Just because you are HPV negative at one point in time does not mean that you are immune to (re)infection.

    “Save your scare tactics for other forums. Also, please support your opinions with peer reviewed references if you want to appear credible. An MD after your name carries no weight around here. We are not gullible women, we are intelligent and capable of reading the literature and making our own informed decisions. The days of doctors telling women any kind of BS to get them to comply are numbered.”
    — Having obtained the degree of MD personally I can assure you that no amount of self-study is going to give you an equivalent education. To discount expert “opinion” because you do not see value in our education is to your own loss and detriment. If you truly want to know all the nitty-gritty details of a medical education then I highly encourage you to pursue one legitimately. Be prepared to feel like you are drinking water from a firehose.

    “I would like to point out that nowhere on this blog site have I ever encouraged readers to neglect their exams.”
    — I am happy to hear this. I only stumbled upon your post and have not investigated your blog in any other depth.

    “What I do attempt however, is to encourage readers to do their research, to know they have a choice, to take control of their own bodies and allow themselves peace of mind.”
    — I love this and completely agree with this advice.

    “Please offer women accurate information and allow them a choice”
    — I do.

    “Please do not withhold healthcare or medications if a woman decides to not screen”
    — I don’t.

    “Please do not bully or pressure women into screening against their will.”
    — I don’t.

    “Please do treat women with the same respect as you treat men.”
    — I absolutely do.

    “Please attend to other parts of a woman’s body.”
    — I do. 🙂

    Congratulations on your efforts to inform and empower women to take an active role in their health care. Please do not breed animosity against the medical profession as a whole — we share the same goal of improving women’s health. You are wise to educate yourselves about these issues and to raise questions when you have them. On the other hand, to discard medical opinion completely is as foolish as throwing out the baby with the bath water. I hope I have contributed to your discussion in a positive way.

    James Pate, MD

    • The literature that claims that cervical cancer is “second only to breast cancer” is from 1996, and there are no actual hard numbers in that report to substantiate the claim. In the reports where we DO have biostatistics, cervical cancer repeatedly shows itself to be far rarer than you claim.

      As for the statistic that 80% of the population will get infected with HPV, well, you neglect to mention that:
      1. There are more than 100 identified strains of HPV.
      2. Of those 100 + strains, less than 40 affect the genitourinary tract and less than 20 are thought to be oncogenic.
      3. Of those 40, 90% cause genital warts.
      4. Only two strains, 16 and 18, are responsible for the vast majority of cervical cancer cases. These strains are covered under the Gardasil vaccine, and are also identifiable with testing.
      5. In addition, up to 90% of HPV infections, particularly in younger people, will resolve on their own, so the mere presence of HPV does not in any way guarantee that a person will develop cervical cancer.

      That puts that “80% infection rate” into perspective, doesn’t it?


      I’d also add that you have no idea what professions the women on this blog have – for all you know, you’re talking to someone with a PhD in epidemiology right now. Frankly, the fact that you’re able to pass the medical boards does not guarantee that you are an expert, and considering the high rates of death and misdiagnosis from medical error in this country, it would be foolhardy to think that doctors are infallible. Many tests, such as the pap smear, are promoted by those who benefit financially from it.

      And again, I would ask if you are so zealous in promoting testing and diagnosis for the myriad conditions and cancers that are far more common than cervical cancer.

    • Also, I’d ask you to take a look at how cervical cancer screening is offered vs. how prostate cancer screening is approached. The latter has a much, much higher rate of incidence and is undeniably the most common cancer in men in most of the industrialized world. In the USA a man’s lifetime risk of contracting prostate cancer is almost 20%. Yet, screening is presented as something optional, the risks of the available tests and overtreatment are addressed, and men are encouraged to weigh the cost/benefit ratio for themselves.

      Cervical cancer has less than 1% incidence, the pap is notoriously unreliable (you might notice that some reports encourage yearly screening specifically BECAUSE the pap has such a high rate of error), and overtreatment has longterm effects on sexuality, childbearing potential, et al. Yet paps are seen as a requirement and even here, you’re insisting that every woman needs to have them. Why is screening for a cancer with a >1% incidence rate considered more important and presented as mandatory when screening for a cancer with a 16% incidence rate is seen as optional?

      In addition, even though men have the same ability to pass on HPV and other STDs, and can suffer negative effects from it, such as genital warts, as easily as women, there is no compulsory screening for men.

      You might want to ask yourself why that’s the case, and wonder if it’s because of the paternalism with which the medical profession treats women. That is not speculation, either, there have been numerous studies that have indicated that women are less likely to have their complaints adequately addressed, less likely to receive complete information on testing, less likely to be treated as active partners in their health care, and less likely to receive adequate pain control than men.


      http://www.partnersagainstpain.com/hcp/pain-management-resources/gender-pain.aspx (has links to several clinical studies and peer-reviewed articles)

    • Dr Pate, this is amazing!

      You did not possess any correct information about cervical cancer incidence, nor you were able to interpret the manipulated “statistical data” that has been carefully composed and widely employed to coerce women into pap screening for ages, and yet you stated “cervical cancer is the 2nd leading cause of death in women worldwide” and used that as your main point why women should submit to pap smears and why it is so “necessary”.

      At the same time, you proudly emphasized that you went through serious training, graduated and consider your knowledge above anyone else’s here. How good is that?

      But there is something worse: you will continue telling your patients that pap smears are “necessary” and “save lives”. Just like millions of other doctor do.

    • ” Having obtained the degree of MD personally I can assure you that no amount of self-study is going to give you an equivalent education. To discount expert “opinion” because you do not see value in our education is to your own loss and detriment. If you truly want to know all the nitty-gritty details of a medical education then I highly encourage you to pursue one legitimately. Be prepared to feel like you are drinking water from a firehose.”

      Irritating physician arrogance noted!

    • “Worldwide, cervical cancer is second only to breast cancer as the most common malignancy…”.

      This statement is not even close to conveying the meaning of what you said. Where did you attend college?

    • HPV-related cervical cancer simply cannot exist unless a woman has had something infected with HPV put into her vagina – whether that was a penis, a finger, a tampon, or a speculum. Community glove boxes are one place this can come from, as is the practice of a medical provider putting on gloves, then touching the door not, counters, their clothing, and so forth. Furthermore, the standard medicasl teaching is that since the vagina is not sterile, there is no need for sterile procedures. As such, a woman getting a speculum exam late in the day is being exposed to all of the diseases – including HPV that all of the other women who have had that speculum used on them that day – or since it was properly sterilized. As such, pelvic exams may be a leading cause of HPV in non-sexually active women – and other women who are in mutually-monogamous relationships, and have been for many years, as well as women who have not been sexually active for years.

      This is one of the risks and harms that proceeds from routine pelvic examinations. There are ways around it, such as using sterilized equipment, one-time-use equipment, and adhering to sterile procedures. Until it is done, this risk must be weighed in too against any possible benefit.

      • Ladyprotips, my doctor once fished a speculum out of the sink, cleaned it off, and proceeded to insert it. I allowed it to happen because back then I trusted everything doctors did. So when you say “they won’t reuse that speculum until it has been properly sterilized” you are speaking about your own experience – but that has not been my experience.

      • What most likely happened is they had it in the sink to keep it at a comfortable temperature after it had already been sterilized. That’s what most practices do. Also, a little bit if water can do a lot-viruses outside the body are very weak and don’t survive long. I’m all for fewer Paps, pelvic exams being reserved for asymptomatic women, OTC birth control pills, and informed consent, but claiming pelvic exams are the reason HPV is so widespread is exactly the kind of argument that gets your (our) cause blown off.

      • Ladyprotips, the speculum was in the same sink where the doctor washed his hands. In addition, Bethkz brought up the excellent point that the doctor’s gloves are not sterile, which also increases the risk.

        Bethkz did not claim that pelvic exams are the reason HPV is widespread. She stated: “pelvic exams may be a leading cause of HPV in non-sexually active women – and other women who are in mutually-monogamous relationships, and have been for many years, as well as women who have not been sexually active for years” (bolding mine). She also stated “This is one of the risks and harms that proceeds from routine pelvic examinations”.

        I do not see any claim by Bethkz that pelvic exams are the reason HPV is widespread, and I do not agree that this is the kind of argument that gets our cause blown off. Bethkz was making excellent points, and I agree that unsterilized gloves and instruments may cause bacterial and viral infections during pelvic exams.

      • That might be true in an ideal world, where the single-use speculums remain packaged until ready for use. The fact is that very seldom are we living in an ideal world. People cut corners for profit, for convenience, because they’ve run out of supplies.

        The fact is that HPV-16 & 18, along with other pathogens HAVE been found on clean/sterile “ready for use” medical devices in doctors’ offices and clinics.

      • Ladyprotips,

        We really do not know the percentage of HPV and other infections including STDs which are spread by these exams. That is because it has not been studied!

        Will Loxley in _Fatal Probe_ 2004 ISBN: 0975565702 discusses this in great detail.

        It is known that most metal specula have hinges and springs which can become gummed-up with lubricant and other products. This gets in the way of effective sterilization.

        Things which have been setting out very long in a normal room environment become unsterile.

        This is widely known by purchasers of medical devices:

        If reusable specula are indeed safe, and do not need sterilization, why does every medical supply firm make the following prominent claims in their advertisements of disposable, vaginal specula? They are marketing to a real need. To do otherwise would be a waste of these corporations’ advertising dollars.

        E. S. Medical Supply: Disposable Vaginal Speculum “Reduced risk of cross contamination”

        Welch Allyn: Disposable Vaginal Specula – 580 series “Eliminates cross contamination”

        Pelican: Disposable Vaginal Speculum “Provides protection from cross-infection”

        Surge Industrial: Disposable Vaginal Speculum “Reduce possibility of cross-contamination”

        Leespec® Speculum: Improved disposable vaginal speculum “Eliminating the risk of cross infection”

        Ask yourself: Why are these medical supply firms so very aware of cross-infection from reusable speculum?

        You could look at the OSHA Healthcare adviser which recommends against the widespread practice of washing speclula in dishwashers rather than autoclaves.

        BTW, do you understand the difference between the words clean, disinfect, sanitize, and sterilize?

        3 Gynecologists were fined $1000 each for using a household dishwasher to sterilize their speculums. http://www.wset.com/story/21884930/three-roanoke-gynecologists-fined-for-improper-cleaning

        Nonsterile gynecological swabs are readily available through many manufacturers and supply houses.

        How do you know that your clinic is using a sterilized speculum?

      • Bethkz thank you for the information and for these excellent links. The synopsis of Loxley’s book is horrifying:
        There is a real possibility that an otherwise healthy woman can walk into a doctor’s office for her annual pelvic exam, and walk out infected with a deadly disease. The health provider may not be breaking any laws, recommended procedures or ‘Standard of Care’, but the outcome is just as lethal . . .

        During these yearly exams an estimated 6.6 million U.S. women are being cross-infected with life-threatening pathogens: i.e. HIV, HCV, HBV, CJD, HPV (cervical cancer), unnerving and troublesome yeast infections or one of a number of other infectious/contagious diseases.

        This conclusion was reached as the result of an in-depth, six-year review of over 400 studies and articles; discussions with hundreds of medical professionals and patients; the valuable contribution of an internationally recognized microbiologist; and the wisdom of a world renowned infectious disease physician. http://www.amazon.com/Fatal-Probe-Will-Locksley/dp/0975565702

      • Not exactly related, but there’s a good book Rain Forest Home Remedies (by Rosita Arvigo & Nadine Epstein) that mentioned numerous things for women (including a how-to on Mayan uterine massage). Plenty of reasons for more self-sufficient treatment.

        Sue- I was also thinking maybe of an Alternative Methods thread. What do you think?

      • Excuse me for getting into this interruption of a two year old thread. We need a new topic heading here because this is important.

        Dental office have higher standards of infection control. They sterilize all instruments and sanitize surfaces between patients. Doctors do not. The standard is that INTACT mucous membranes do not require sterilization of instruments. However what is doing a biopsy? Once a cut is made the membrane is not intact. Also there is no way of knowing whose membranes are intact and not until they get in there. This is for vagina, throat, colon exams. They do not consider these areas where they need sterile equipment.

        If a doctor is really cheap they buy the bulk package speculums which might be sterilized but once the large bag is opened, not sterile anymore. Wetting the speculum in the hand washing sink is really a bad idea. The water splashes up and they were washing their hands from numerous patient consults in there. Now it is not sterile anymore. Even professional kitchens, the chef wash the produce and pots in separate sinks from hand washing.

        If you check the CDC Website they state that IT HAS NEVER BEEN PROVEN that HPV is spread by clothing, towels, surfaces, hot tubs. That just means what it means, not that it could not happen. No one has ever done any research that proves that it is not spread that way because HPV is difficult to grow in a lab. Common sense tells you something about the spread of certain viruses. Kids get plantar warts from public pools or the family bathtub. It is the same family of virus. It sheds in the skin cells and maybe it is killed in the chlorinated pool water but it is on the floor and tiles around. They have shown that those foot wart strains are resistant to drying and survive for weeks on surfaces. Just look up some research papers. I don’t have time

        Don’t give me “the virus cannot live outside the body for more than a few minutes”. That might be true of some microorgasms but NEVER proven for HPV. Anyway it is in skin cells not coughed out in moist particles that dry up after 20 minutes.

        Doctors should have to use sterile instruments for anything going into a throat, nose, vagina, urethra or rectum. I do not think that they need to use sterile tongue depressors but it is not impossible for those to be packaged and sterilized. Who knows what dirty hands have been in those jars. All those bacteria collecting swabs are individually wrapped and sterilized by either radiation or gas. Doctor need to have similar standards of hygiene equivalent or better than those of dental offices depending on the procedures being done.

      • Just saw a thing called Freedom for Birth (I think it’s a DVD). Might be useful. Very much an unsung issue & it tends to be held that any argument against these things are attempts on the baby’s life.

        This gives me an idea for antoher thread: one on Antagonism During Childbirth (just an idea for the name).

      • Sue, I actually have worked in several gynecologists’ offices, including my own. Mine uses plastic speculums (which are basically guaranteed to not have HPV, unless somebody here actually wants to claim HPV is airborne). The ones who use reusable speculums (and fewer and fewer are) send them through an autoclave. Have HPV infections been caused by pelvic exams? Probably. More than 1%? Not likely.

        bethkz, they try to educate providers about possibility of cross-contamination because it’s just that-a possibility. They are trying to

        Moo, you yourself said they can’t get HPV to grow in a lab. If that’s true, and they can’t keep the virus alive under the most optimal conditions, then why on earth would it survive on materials that do not support HPV growth and are at the very least being rinsed off? It’s important to understand that viruses being in the same family does not mean those viruses will be exactly alike. Plantar warts and genital HPV are not the same virus, and thus have different characteristics. Honestly, if what you said about HPV was true, then it is very likely that HPV-related cancers would be very common, because HPV would be on everything, not just on people and in doctors’ offices. You wouldn’t get to pick and choose. If one of my sexually active friends came over and touched something in my house, and then I touched it, then I went to the bathroom, then I (never been sexually active) would have HPV and ACOG’s statement that even non-sexually active women need pap smears would actually be true. At that point, I would fully support pap smears in non-sexually active women, as it would actually be necessary.

        I really like a lot of things about this blog. I like that it empowers women to make their own choices regarding healthcare and spreads seriously lacking information. I don’t like that it demonizes modern medicine and male doctors. I’ve said it before and I’ll say it again: I’ve worked with male gynecologists. I’m very very close to a couple of them. The majority of them honestly do not get a sexual thrill out of it. My GYN is male because I flat out refuse to see a woman after being mocked by one and threatened by another. My male GYN gives me birth control without an exam where the women wouldn’t. It’s not right to lump them in as evil rapists, even though a small number are.

      • Ladyprotips- People weren’t saying that male doctors are universally rapists with unconventional methods. The point was that, where applicable, doctors act like what they say goes instead of it being your body & your rules. They figure they make their own decisions & if that happens to include doing something to the patient, that’s fine- as well as it being an attack for someone to counteract them. This is a fairly common thing, even if there’s a differing degree of how sustained an effort they make or what tactics are used. Some doctors prefer deception & coercion, others prefer physical force & taking liberites in someone’s sleep. Mental vitiation & physical vitiation are both vitiation.

        The patient being detrimented by certified medical practices- what’s qualified- is another point. The things that are taught not being effective, only approved of, is a huge problem. It is also characteristic of “modern medicine.” When something causes problems, it’s always seen as someone trying to get paid with a lawsuit.

        There is, and has been for decades, lots of propaganda & convenient legal backings. As it stands- there is shielding from lawsuits for phamaceutical companies, doctors get their misconduct handled “in-house” (if at all), and when someone complains of things it’s seen as universally immature. There’s a mssive amount of advertising, at least in America, for drugs & injections. Even education presents medicine in a way that leaves it looking good & other things looking like fantasy.

  6. Dr Pate, you state:
    “I can assure you that all medical organizations and competent physicians are constantly weighing the risk-benefit ratio of evaluations and treatments with the goal being the improvement of health. There is a lot of over treatment, however this is felt to be necessary to identify and treat women with early cervical cancer while it is still curable.”

    How interesting that you admit that over treatment is considered to be ‘necessary’ according to the ‘risk-benefit evaluations’ of ‘all medical organizations and competent physicians’. If this over treatment is acceptable for women, why is it not acceptable for men with regard to prostate cancer? I don’t understand the disparity.

    In the UK, men get information clearly stating that 48 men will need to be treated to save one life (and then left to make up their own minds).

    On the other hand, women are given no equivalent information with regard to cervical screening – we are just told that we should screen.
    I had to look for information in the BMJ, to find that for every life saved, 150 receive an abnormal result, 80 are referred and over 50 receive treatment.

    Not only is this considered by the medical profession to be acceptable, it then patronizes women by not disclosing the real risks of over treatment to women, whilst making sure men have enough information to make an informed decision.

  7. James, I appreciate you have a particular skill set in medicine, however don’t underestimate the research skills that many of us have acquired, you do not need a medical degree to apply critical reasoning when investigating a meta-analysis on cervical screening. Some of us have skill sets in statistical analysis, some of us have an interest in bioethics and most of us are capable of working from a scientific paradigm, don’t just assume that only medical doctors are the experts.

    Also, many of us respect your profession and utilise it when needed, though I am aware that medical doctors are also people, and fallible. Doctors work in an imperfect, highly stressful profession, and because of the nature of the work, should be subject to ethical scrutiny, not only by ethical committee’s (that are, by the way, are made of a cross section of people) but also health consumers.

  8. “Also, we now know only roughly 5% of women aged 30 or older can benefit from a 5 yearly pap test, those HPV positive. Most women are HPV negative, not at risk and cannot benefit from pap testing. It’s risk for NO benefit.”
    — This is a very bold, unsubstantiated statement. The reason why we continue to do Paps in HPV negative women after age 30 is because humans are terrible at lifelong monogamy. Approximately 1/4 of relationships are impacted by sexual escapades and over 50% of marriages end in divorce. Just because you are HPV negative at one point in time does not mean that you are immune to (re)infection.

    You might care to check out the new Dutch program, it’s far from unsubstantiated, it’s just that American, Australian and other women are not offered evidence based screening. Most women endure a lifetime of unnecessary pap testing and a high number go on to even more unpleasant things, like laser treatments and cone biopsies.
    The fact is Dutch women will be offered a hrHPV primary triage test at age 30 or they can self-test using the Delphi Screener and if HPV negative, they will NOT be offered a pap test and that will be about 95% of women. The roughly 5% who are HPV positive and at risk will be offered a 5 yearly pap test. (presumably until they clear the virus) There is no point doing pap tests on HPV negative women, they’re not at risk.
    The program will then offer women a chance to re-test for HPV at ages 35,40,50 and 60 (or self-test) and once again only the roughly 5% who are positive will be offered a pap test….this is to cover the possibility of a new infection.

    This takes most women out of pap testing and will greatly reduce referral and over-treatment rates. (and hopefully that means fewer premature babies etc) IMO, this is a massive step forward and will greatly improve the health and quality of life for Dutch women. It is also more likely to prevent this rare cancer…identifying the small number of women actually at risk – the only women with a small chance of benefiting from a 5 yearly pap test.

    Those women who test negative for HPV who are also confidently monogamous or no longer sexually active may choose to stop all testing and yes, that should be the woman’s decision, not the doctor’s…we have to move away from this notion that others should make decisions for women, make assumptions about us or our partners or accept risk on our behalf. I make decisions and accept risk every day of my life and take full responsibility for those decisions.

    I’ve spent decades researching this subject – initially to protect myself from these programs and to get to the facts, but later out of a sense of outrage at the shameful way women were being treated by the medical profession. Aussie women are still being told they need 26 pap tests, 2 yearly from teens to age 70, maximizing risk/harm for no additional benefit over a 6-7 pap test program, 5 yearly from age 30 to 60 (the Finnish program) and of course, we’re not offered HPV primary testing (that would take 95% out of pap testing)…in this country huge numbers face the ordeal of over-treatment, almost all is unnecessary and was avoidable with screening in ethical hands and now this damage is almost completely avoidable with something like the Dutch program…this should be a scandal, instead doctors remain silent and continue to promote and protect these programs…not good enough, not by miles.

    If you include ALL women at age 21 (far too early anyway) you will include women who are not yet sexually active (no genital contact at all)…all women have a right to protect their bodies and health…these women can only be distressed and harmed by pap testing. It is the profession making an assumption that all women have been sexually active by age 21 and that is not true for all women, we’re not all the same.

    Informed consent in women’s cancer screening is a foreign concept for most doctors, but a growing number of doctors are now just as concerned as we are…hopefully, you’ll be motivated by our comments to help change deeply entrenched attitudes within the profession.

    Also, this level of over-treatment is not about saving lives, the Finns have the lowest rates of cc in the world and refer far fewer women for these “treatments”…it’s been known for a long time that over-screening greatly increases the risk of over-treatment. Finland has had their 6-7 pap test program, 5 yearly from age 30 to 60 since the 1960s, this isn’t new…and we know testing those under 30 simply doesn’t work…the same number of cases will occur, but this age group produce the most false positives and that can lead to over-treatment. There was never a need to refer and over-treat so many women…never.
    We still “treat” women without first checking their HPV status…that would rule many women out of over-treatment. So, please don’t try to tell me that this level of over-treatment was necessary to save lives, sadly and tragically, that’s simply not true.

  9. Dr, this comment:
    “Having obtained the degree of MD personally I can assure you that no amount of self-study is going to give you an equivalent education. To discount expert “opinion” because you do not see value in our education is to your own loss and detriment. If you truly want to know all the nitty-gritty details of a medical education then I highly encourage you to pursue one legitimately. Be prepared to feel like you are drinking water from a firehose. ”
    is directed at me.

    Please don’t assume that I merely self studying. I am part way through a medical science degree. You may take the smears, but I may be the one looking at the cells under the microscope and giving you the diagnosis.

  10. “Please attend to other parts of a woman’s body.”
    — I do. …….(SmileyFace)……..

    I thought the “Smiley Face” icon at the end of this sentence was quite disturbing. What does the good doctor mean?

    • That James as a man went into the specialty of women’s healthcare as a man says already enough if you ask me..

      Jane, apart from the disturbing smileyface, I found it also disturbing he speaks to us using the condescending term ‘ladies’. It’s reflects his view on women as an OB/GYN very well, as just like in the old days- a ‘lady’, delicate as she is, was considered the property of a man .. this is exactly how OB/GYNs must think of women in order to justify their profession, they think women are so delicate they need constant medical surveillance so they can basically own womens’ bodies and claim authority over them.

      It’s also ridiculous to call yourself an ‘expert’ if you’re that foolish you can’t even interpret statistics correctly, not to mention the arrogance to claim that “Having obtained the degree of MD personally I can assure you that no amount of self-study is going to give you an equivalent education. ” ! If you can’t even question your own education, you can’t be considered intelligent.

  11. Yassmyne, I’ve found many doctors have a fairly poor understanding of screening, except to recommend it and stick with the official programs. I’ve provided my GP with information on breast screening…there are critical articles in medical journals, but most of it doesn’t get into everyday practice. So it’s almost like…they know and discuss it behind closed doors, but choose not to tell us or even mislead/lie to us and then there are those who haven’t kept up with their reading and haven’t a clue. As we’ve seen here with over-diagnosis in breast screening, they will hide issues that might put women off screening…until they’re forced to face them. ONE doctor in this entire country felt over-diagnosis must be mentioned to women, thank you Assoc Prof Robin Bell…and so for the first time it’s been reluctantly mentioned to women.

    My GP queried my total rejection of breast screening and said there was “still some” benefit, although she accepted risk was a factor with over-diagnosis…while there is “some” benefit, doctors will continue to recommend it and definitely when there is a formal program, I think many see it as “safer” for them. I pointed out the revised conclusion by the NCI…little benefit with significant over-diagnosis, they don’t recommend breast screening at all. She was surprised…but I’m sure the next woman will still face a recommendation to have breast screening, it seems if we don’t raise our concerns, they won’t mention them, even if they know about serious risks, no or little benefit and problems with the testing.
    Even if a doctor mentions over-diagnosis, it’s usually whitewashed (as we see with Prof Ian Olver and the Cancer Council) – “WE” still believe the benefits exceed the risks and therefore will continue to recommend it to women. It never occurs to Dr Olver or most others that it’s not their call…whether the so-called benefits exceed the risks is MY decision, it’s this sort of paternalism and arrogance that must be challenged.
    I respect my doctor’s knowledge in most areas, but there is no doubt my knowledge when it comes to cancer screening, especially cervical and breast screening, exceeds her knowledge. Most GPs don’t expect a debate when they recommend screening, they rely on our acceptance of their bald recommendation…we have to challenge them constantly so they get the message. Real and complete information and respect for informed consent, nothing less, they can manage it for prostate screening, so they can do it for women as well.

  12. Interesting study that confirms many American doctors are still doing unnecessary routine bimanual pelvic exams. It’s concerning to read the study did not cover the visual inspection of the genitals, just the bimanual exam. I cannot imagine a doctor suggesting a routine visual inspection of the genitals…poor American women might be finally rid of the bimanual pelvic exam and have fewer pap tests, only to find they’re expected to deliver up their genitals for unnecessary medical inspection. It’s unnecessary and a horrible violation of bodily privacy and dignity. I think most people in this country would run if a doctor suggested such a thing.

    • I’ve recently (in the last 2 yrs) been told by two seperate physicians that 1) a pelvic exam is not necessary to procure birth control, and 2) pelvic exams are recommended every 3-5 years. I do think there is progress on this.

  13. Although the high rate of false positives for Pap tests is an issue, one of the strengths of the test is the low probability of false negatives. If cheaper tests were available, I would suggest using the test in triplicate to decrease error. However, when someone’s life is in the balance, I can understand why more thorough exams are performed.

    • antonmedical,

      I couldn’t reply on your other comment in this thread where you ended with “This is why I love science, the truth will out!”, so I reply here.

      I assume you meant to write “This is why I love science, the truth will COME out”
      Well, if you’re so much in love with science, this blog should be of great interest to you because it refutes the many medical MYTHS concerning pap smears and cervical cancer, backed with real scientific facts.

      It’s quite arrogant to then come here and repeat the mainstream nonsense based on these very MYTHS that we are trying to dispel, but you don’t even take the effort to READ but simply *assume* that what we are saying is based on nonscientific ignorance.

      To me you don’t come across as a scientist as you don’t seem to be able to question the status quo and rely on information coming from mainstream sites like the NHS. You tell me, what does that have to do with science? Professor Michael Baum, Emeritus Professor of Surgery- a real scientist btw- can already tell you this about the NHS Breast Screening Programme; that they are deceiving women and that many women are having unnecessary surgery.
      Then why would you or anyone else even rely on what the NHS has to say about cervical cancer and PAP smears?

      Here’s some more info for you and hopefully your love for science is big enough to have interest for information not coming from mainstream sites that base their info on myths:

      “The Pap test’s role in the much-heralded “dramatic” decline in the cervical cancer death rate is overstated, according to Foltz and Kelsey, because the rate began to drop well before the Pap test became widely used.


      Whatever the reasons, the decline in cervical cancer deaths can hardly be described as dramatic. In 1968, there were 7,108 cervical cancer deaths in the U.S. (by 1973, nearly 50% of women reported having had one Pap test during the previous year). In 1976, there were 5,525 deaths. [In 2006, it was 3,700 deaths. For the role of the Pap test in half these deaths in 2006, see below.]

      Cervical cancer is not a major cause of death in the U.S. or other Western countries, wrote Foltz and Kelsey, who pointed out that screening people for a disease of low prevalence flies in the face of the medical research standards set by leading thinkers of the time. “The lower the prevalence, the less likely it is that a positive test will correctly identify a woman who really has cancer. This means that many women with positive test results but without disease will be referred unnecessarily for further diagnostic tests and treatment, with concomitant costs and worry,” explained Foltz and Kelsey, respectively, of the Graduate School of Public Administration, New York University; and the Department of Epidemiology and Public Health, Yale School of Medicine.”

      BTW the high rate of false positives from pap smears is not just “an issue” that you can shove aside by emphasizing on its supposed strength as the false positives combined with the recommendation of having frequent pap tests from a young age on cause MAJOR DAMAGE, both psychologically and physical which simply doesn’t add up to the small benefit. The point is that frequent pap smearing of all asymptomatic women does more harm than good.

      You seem to suffer from ‘tunnel vision thinking’, not able to look at the larger picture of things which I thought was well illustrated in an anecdote about a doctor who said: “The surgery was a success, we have successfully removed the cancerous organ.” Yet the patient died. I hope you can realise what the problem is with this doctor’s idea of a “successful” operation..

      Another thing, HPV has never been proven to be the cause of cancer. The FDA knows this since 2003 AND there are women with cervical cancer who were not infected with HPV.

      As a last note, I want you to broaden your mind a bit and get out of that tunnel vision thinking and start to ponder upon this: what is the point in scare mongering asymptomatic women worldwide into having invasive pap smear tests on a frequent basis for a very rare disease, with an inaccurate test leading to much unnecessary harm and stress, leading as well to many unnecessary hysterectomies (it is said that 90% of them are unnecessary) and hysterectomies, mind you lead to an increase in heart disease and heart disease is the leading cause of death amongst women! Knowing this, we should be questioning whether the PAP smear programmes across the world are responsible for an *increase* in mortality rates in women, aside from a severe decrease in quality of life, due to iatrogenic medical treatment resulting from the high rate of false positive test results in pap smears.

      • You’re kidding me? You attempt to refute peer reviewed information by quoting a wordpress blog (medicalconsumers.org)? You do realize that anyone could have written that, right?

        “The truth will out” is an old English phrase, please don’t correct my writing ability.

        Furthermore, I did not quote the NHS (I think you’re referring to the UK health care system). I did however refer you and your readers to the NIH (National Institute of Health), and the CDC (Center for Disease Control).

        I gave data, you wrote with hyperbole and don’t cite your sources.

    • Ah, medical arrogance once again rears its ugly head.

      The irony is that the data you posted above – saying that almost all cervical cancers are caused by HPV – backs up what the women on this blog have been saying, the treatment protocols they’ve been promoting, and the information they’ve provided here.This blog has provided link after link to peer-reviewed research, medical journals and treatment protocols. Nobody’s going to spoonfeed you – try actually reading the links posted above, and elsewhere in this blog. And get over yourself.

    • The site did not allow me to reply to the relevant post, so I am replying to another of your posts.

      antonmedical wrote: ““The truth will out” is an old English phrase, please don’t correct my writing ability.”

      “The truth will out” is a Shakesperian idiom, the use of which implies that the truth has been previously concealed (intentionally) and will be revealed. Is this the meaning you meant to convey? Why? It is inconsistent with your other statements on the issue.

      By the time this idiom was coined (late 1500s), Old English was non-existent. Middle English was transitioning (rather quickly) to early Modern English by this time. The idiom is not “old English” in the least.

      It appears you *need* someone to correct your writing ability. Was the pedagogy available to you at Cal State- East Bay insufficient?

  14. Lol, you obviously didn’t bother to read it or you would have noticed that the non-profit organization attempting to help people make informed decisions concerning their health I linked to, quoted from another article they re-uploaded on their wordpress blog from which the authors are known. Besides, the article you can also find here:

    My mistake for misreading about the NIH comment. But speaking of citing sources, there’s plenty of them you can find from previous posters in this thread which you obviously didn’t bother to read or you wouldn’t have stepped in here to arrogantly post stuff we already heard a million of times and constantly have to refute with data you probably don’t like to read, because you just like to be ‘right’ apparently, so who do YOU think you are kidding?

    Besides, the first exercise for you should be to broaden your mind, use some common sense and question your beloved peer reviewed journals if you want to know the truth, instead of staying locked up in that tunnel vision mind of yours.

  15. Regardless of your views on pap screening Antonmedical, your dismissive, arrogant attitude makes me want to avoid your type of doctor at all costs. You are insensitive, have zero empathy for women and the adverse effects of treatment for false postives – physical and mental and you are incapable of critical thinking. It’s all the ingredients for being a bad doctor – and you will be getting poor reviews on rateMDs unless you change your thinking.

  16. Antonmedical,
    The reason for blogs such as this is because we have had enough of the lack of adequate information fed to us by the medical profession. We have been led to believe that cervical cancer is rampant and that we are taking huge risks if we do not screen. We are also not told of the huge over-treatment meted out to women who are not given the full facts of the pros and cons of screening.

    As you can see I am from the UK. In my country men are given adequate information and actually told that for every life saved that 48 men will need to be treated (and then left to make their own minds up). Women are not given equivalent information, we are given a patronising leaflet and basically told to screen ‘for our own good’. Information regarding the risks/benefits of screening is hidden in the British Medical Journal (over 50 women are treated for one life saved).

    Perhaps you need to ponder on why the women on this blog are so angry. And to perhaps consider that the ‘hyperbole’ may indeed belong to the medical profession and the ‘information’ they deign to give to women.

  17. http://www.ucsf.edu/news/2012/12/13312/study-questions-reasons-routine-pelvic-exams
    Incredible that such an invasive exam is still being recommended and performed by so many doctors when it carries serious risk and is unhelpful. (and this has been known for a long time) The reasons given for doing the exam are shocking….profits, an erroneous belief it’s a screening test for ovarian cancer, (so the doctor is way out of date and incompetent) to reassure the woman (false reassurance, not a good thing) or because she expects a pelvic exam. (usually after years of pressure/coercion, misinformation and this unnecessary intrusion on her body)
    It also shows how little they care about our bodily privacy…and our health and well-being. So much for doctor knows best…this is one of the reasons why women must be careful with their choice of doctor and avoid anyone who recommends a routine pelvic exam. IMO, they are very likely to harm you and disgracefully, the talk continues, yet no real action is taken to stop these doctors. (even when it’s clear these exams can lead to unnecessary surgery) It’s clearly up to us….to protect our healthy bodies from the perverse, the incompetent and the unethical in the medical profession.
    Happy New Year everyone….let’s save some more women from medical abuse.

    • This was a great article, nice find Elizabeth! I got so much satisfaction from reading the following:
      “Why do we continue with these invasive, unscientific, unpleasant, and illogical examinations? It’s time to recognise that these routine gynaecological examinations are
      bad medicine.”
      That question sounds familiar, but to hear it coming from a doctor is ultimately gratifying.

  18. “Antonmedical” appearst to believe those contributing to this blog are “irrational.”

    “Anton Power
    December 30, 2012
    Rule 1 of blogging, don’t start flame wars with irrational people on irrational blogs…”

      • Your facebook “account” is private. However, you had your entire timeline set to public until you cahnged it upon reading the above post.

      • It takes a bit more brain to understand online security than to insist on shoving instruments into women’s genitals, doesn’t it?

  19. Anonymous the information regarding “flaming” is very interesting. Here is what Wikipedia says about “flaming” or “flame trolling”:

    “Flame trolling is the posting of a provocative or offensive message, known as “flamebait”,[17] to a public Internet discussion group, such as a forum, newsgroup or mailing list, with the intent of provoking an angry response (a “flame”) or argument over a topic the poster often has no real interest in.[18] While flaming can occur as a result of legitimate debates or grievances, flame trolling implies the intentional posting of inflammatory, grossly offensive or menacing rhetoric or images for the fun of it in order to cause others harm.”

    One does have to wonder about the intentions of a male “hope to be” medical doctor who would comment in a derogatory and uneducated fashion on a site devoted to uncovering medical harms done to women. I would have appreciated it if antonmedical had read the comments on this forum and had educated himself prior to making a comment that appears to have had no other purpose than to cause the women here further harm.

    • First: all angry responses seemed to be coming towards me. Second: where was I derogatory? I reacted to you response. How else would you expect I would? Third: you are not a legitimate source of scientific information. Your disregard for science is astounding. I refer to the snide comment about “peer-reviewed journals.” I made my intentions clear with my website. Fourth: what does being male have to do with any of this? Finally: If you wrote this post as in the format of a scientific article with references next to every single data value that you used, I may have believed everything that you wrote. However, since your article was meant to insight distrust in not only the people who spend their lives studying human biology, but their theories and ideas, I am convinced that this website is nothing more than an attempt to mislead the public. Next, you’ll be telling everyone to avoid vaccinations.
      If you don’t wish to be tested for cancer, that’s your business. But don’t drag unsuspecting victims with you.
      I put my name out there so everyone knows where I’m coming from. I’m a scientist. Who are you?

      • I am hesitant to put a great deal of time into a response to you antonmedical as you appear to have a dubious ability to read/retain information. However I’ll give it a go.

        First: Please take some time to consider why you received a response you call “angry”. As a previous poster stated, I am not going to spoon feed you. If you don’t understand why you got the response you did, then I’m afraid I will have to put you in the category of “beyond all hope”.

        Second: You were derogatory by assuming you knew better than the women who have spent a great deal of time and energy uncovering facts that are often hidden from us. You were derogatory by assuming you knew better than very well educated women, some of them with twice or more years of education than you yourself possess. You were derogatory by not bothering to take the time to read what had been written on this site.

        Third: There are many links contained within the comments on this site which will take
        you to peer reviewed articles. But again, I am not going to spoon feed you. Try clicking on some and reading what you find.

        Fourth: In case you haven’t noticed, this site is called “forwomenseyesonly”. Not that
        men aren’t welcome here, but that should at least be a warning to tread cautiously. In other words, educate yourself and comment with respect for the women here.

        Finally, I have provided links to support everything I wrote – but again – you seem incapable of clicking and reading.

        In response to the following “If you don’t wish to be tested for cancer, that’s your business. But don’t drag unsuspecting victims with you.” I would like to say that I wish that it were that easy for me. The main message on this blog is to ask the medical community to offer women INFORMED CONSENT in regards to pap tests/pelvic exams. Women are unable to access health care without being bullied into pap tests. In my own and other women’s experiences, we are denied access to health care (kicked out of dr’s offices) and denied medications (especially birth control) unless we submit to screening.

        Cervical cancer is rare, pap tests are unreliable, and women face risks of further harm from follow up procedures. However, these simple facts are hidden from women. In fact, women are rarely (if ever) offered information or given a choice to screen. Men are when it comes to prostate screening, even though prostate cancer is roughly 19 times more prevalent than cervical cancer.

        Men are treated with respect, women are not. I am not advising women not to screen. What I do attempt is to offer the facts, peace of mind, and to let them know that screening is a choice. Paps are simple cancer screening tests, and ALL cancer screening is optional. Many women are unaware that they are within their rights to say no thank you to screening. That is how well the program has worked – women don’t even know they are “allowed” to decline screening.

      • antonmedical says: “If you wrote this post as in the format of a scientific article with references next to every single data value that you used, I may have believed everything that you wrote. ”

        As a credible academic, I should tell you that as a credible scientist, you should never do this.

        antonmedical says: “However, since your article was meant to insight distrust in not only the people who spend their lives studying human biology . . .”

        “Insight” is an apprehension of meaning. “Incite” is to encourage unlawful or violent behavior. Neither is an appropriate word for your sentence.


      • “Anger” would be hyperbole. Please see my post regarding intellectual generosity. Hyperbole is inappropriate and, frankly, odd.

  20. If you want to be a legitimate source of information, write compelling articles. Don’t attack people who comment on your blog.

    Actually, now that I thought about it a little longer… who are you? How do we know your name is Sue? How about Steve, Dan, or Carol?

    Anonymity is a dangerous thing when you have a megaphone.

      • For God’s sake, you are completely missing the point!~

        If YOU write an article, it is YOUR responsibility to provide sources for EVERY piece of information you state is true, okay? Your readers are NOT supposed to be the ones looking for information just to prove that what you are saying is true.

        The simple fact that you did NOT provide this information IN your articles, any of them, while continuing to attempt to convince your audience that you are right makes YOU dangerous.

        That was my whole point. You are so wrapped up in your world of conspiracies against women, that you are completely unable to understand why people don’t believe you.

    • If and when you attend medical school, many courses will cover issues in medical ethics. Some courses will include curriculum covering the history of the evolution of medical ethics in the United States. I would encourage you to take this seriously, as it will provide you with an understanding of why some people in society have developed a distrust of the medical profession. That distrust is a long-standing, understandable, and rational issue. That you did not glean any of that from your undergraduate education is disconcerting.

      As a professional, it is not appropriate to simply yell, “you should trust us, because if you don’t you are an idiot!” You are responsible for building and maintaining that trust, and ensuring integrity. Failing to understand this from the start makes you a liability to the profession. You will need to juggle ethical issues constantly as a medical professional. If you start with the baseline disregard and lack of clarity that you’ve demonstrated here, you will encounter ethical, practical, professional and legal problems. Your general feeling that those stating their concerns are “not as good at science as you” is not a sufficient reason for your confusion on the issue.

      If you are unsure about the concept of informed consent and how that plays a role in medical ethics and maintaining integrity in the profession, I suggest starting with these titles:

      Beauchamp, Tom L. 2010. Autonomy and consent. In The Ethics of Consent, edited by F. G. Miller and A. Wertheimer. New York: Oxford University Press.
      Dworkin, Gerald. 1988. The Theory and Practice of Autonomy. Cambridge: Cambridge University Press.
      Manson, Neil C., and Onora O’Neill. 2007. Rethinking Informed Consent in Bioethics. Cambridge: Cambridge University Press.
      O’Neill, Onora. 2002. Autonomy and Trust in Bioethics. Cambridge: Cambridge University Press.

      If this is more reading than you’d like to do, at a minimum read the Stanford Encyclopedia of Philosophy entry on Informed Consent, available at http://plato.stanford.edu/entries/informed-consent/.

  21. Antonmedical,
    Sue mentioned informed consent. This is the issue. Women are treated differently to men with regard to informed consent and respect for our bodily autonomy.

    I see nothing wrong in looking for information that I cannot get from my own doctor. No, I am not a medical professional, but I do have the mental capacity to read peer reviewed papers and understand risk versus benefit with regard to medical screening.

    No-one has the right to make that judgment for me.

    • No, they don’t. But I seriously doubt that your doctor is overtly attempting to conceal information from you. If they are, go to a different doctor. If it’s a gender issue, go find a female physician you feel comfortable with.

      Just remember, there is always a risk and benefit to all tests. There is no such thing as a perfect test. Even the articles that are cited here from government websites state that is so. I see no grand conspiracy.

      • antonmedical that is the first thing you have said that makes sense. As for continuing to accuse me of not providing information in any of my articles does make me wonder . . . please provide some specific information. Which claims have I made without providing supporting evidence?

        Or are you continuing to flame throw/cause harm? Just what were you discussing in your facebook comments that Anonymous shared with us. Oh, and I do hope you have figured out how to set your account properly so that incriminating discussion where you call women “irrational” has been covered up. Sounds familiar . . . hmmm, which body of people does that type of thing to women?

      • I change the setting of my facebook to better protect my family from anonymous posters on your blog. Blanket statements about gynecologists who “like” to do pelvic exams is ridiculous. That’s basically slurring. If nefarious did actually happen during an exam, you have the right to notify the police. However, your attempt to discredit the scientific and medical community is pointless and makes readers distrust science, in general. That, in a nutshell, is my problem with your blog. Also, the sources you cite which are legitimate are not attempting to discredit the necessity of pelvic exams. On the contrary, they are simply helping recalculate the parameters under which physicians should be recommending tests. Your statements are disingenuous.

      • That you didn’t have your facebook timeline set to private from the start shows poor judgment.

        No one is actually claiming a “grand conspiracy.” Erecting a straw man is useless. Why would you feel compelled to do it? it would be more respectful to discuss the issues regarding informed consent on their face.

      • Change my doctor?
        In the UK GPs are provided with financial incentives to screen the maximum number of women with regard to cervical screening. This financial payment produces a conflict of interest for doctors.

        Why would any doctor supply information that could lead to my declining screening and a loss of revenue for them? Why would changing my doctor make any difference?

        There is no such conflict of interest for my husband with regard to prostate screening and he is able to obtain the relevant information to enable him to make an informed decision.

        ‘Grand conspiracy’? These are your words, not mine and an attempt to belittle and diminish my voice and viewpoint.

      • He has no understanding of the UK medical system, so he wouldn’t realize the bind you’re in.
        And actually, he doesn’t have much understanding of the inherent issues involved in *any* system of medical care; it’s a bit worrisome.

    • Unfortunately, you have made no “grammatical mistakes.” You have, however, demonstrated poor verbal acuity and a lack of reasoning skills. It’s possible to subsist as a medical profesional with that capacity, but any real success “as a scientist” will require you to improve your academic skills.

  22. antonmedical, you thought your facebook account was private, and felt you could freely attempt to discredit me and others on this blog without our knowledge. That doesn’t sound like the work of someone with moral or ethical values.

    I was not making “blanket” statements about gynecologists. In case you haven’t noticed I was able to use evidence from a doctor’s comments. It seems with all the convictions of gynecologists and other doctors they are doing a fine job of incriminating themselves and need no help from me.

    You still have not provided me with specific examples of where I have made claims without supporting evidence.

    Also, you are still missing the point. I am attempting to provide women with the knowledge they have a choice – something the medical community does not do. I am not the one attempting to cover up facts and withhold freedom of choice – the medical community does that.

    • I made no mention of your blog on my facebook comment. I have no interest in directing more traffic to this website. Comments are anecdotal, and have no value as evidence.

      Anecdotes are another thing I attempt to highlight as insufficient evidence on my website. This is a consistent issue with your website, and most media for that matter. People who don’t know what they are talking about attempt to interpret information they are not trained to understand (yes, you do need training to see data without bias). I challenge you: read a few hundred journal articles, understand the structure, purpose, and discussions.

      You want an example?

      “Pleasure” section- you cite yourself…
      “Extra Fees” section- PBS highlights financial incentives, but does not overtly state that doctors do this, only suggests that there is a possibility of abuse.
      “Further Tests” section- you highlight the Harm section of the study, forgetting that the authors also provide a Benefit section. This is completely disingenuous to your readers:
      Screening With the Papanicolaou (Pap) Test: Benefits

      “Based on solid evidence, regular screening of appropriate women for cervical cancer with the Pap test reduces mortality from cervical cancer. The benefits of screening women younger than 25 years are small because of low prevalence of lesions that will progress to invasive cancer. Screening is not beneficial in women older than 60 years if they have had a history of recent negative tests.[1,2]

      Magnitude of Effect: Regular Pap screening decreases cervix cancer incidence and mortality by at least 80%.

      Study Design: Population-based and cohort studies.
      Internal Validity: Good.
      Consistency: Good.
      External Validity: Good.

      • There is a basic virtue of intellectual discouse called “intellectual generosity.” It requires, before you attempt to refute another person, that you do the best you can to understand their position. When it is impossible to do that, the only thing to do with integrity is to bow out. It’s unclear why you are acting without honor or integrity here. I would encourage you to cease.

      • antonmedical says: “Comments are anecdotal, and have no value as evidence.”

        Anecdotal evidence does have evidentiary value, both scientifically and legally. I would suggest doing some reading on empirical research and the development of the scientific method. I still do not understand how you managed to graduate from college without understanding these things.

  23. Thank you antonmedical, this is the first time you have provided evidence of having read something on this blog.

    “Pleasure” section: I cite myself (true) but the post I cite provides comments made by a male doctor. It also provides comments made from other women who have been victims of harmful practices.

    “Extra fees” section: I trust readers to form their own opinions from the link I provided. Here is further evidence if interested: http://www.cbc.ca/news/health/story/2012/12/04/nb-medicare-billing-auditor-general.html

    “Further tests” section: The purpose of the task force is to attempt to reign doctor’s overuse of poor medical practices which leads to harm of women, particularly young women who suffer most. As for highlighting the section which was most incriminating – yes I’ll admit I did that. I also provided a link to the entire article in hopes readers would click on it. Again, trusting readers to form their own opinions.

    I appreciate you reading the links I provided and attempting to educate yourself. Here is a link to an interesting article written by a doctor: http://bad4umedicine.blogspot.com.au/2012/03/most-gynaecological-are-unnecessary.html?showComment=1357303900857#c4821358360181991399
    which basically states what women on this blog have been stating. The link was provided by Elizabeth (above), and you may have more “trust” in something written by a doctor.

  24. http://www.independent.co.uk/life-style/health-and-families/features/why-im-saying-no-to-a-smear-7577967.html
    This doctor has a problem with the way screening is presented to women and the lack of respect for our right to decline. Is she misleading women, creating victims, simply by speaking her mind and referring to the studies that have also been cited on this site?

    “In the NHS cervical screening programme around 1000 women need to be screened for 35 years to prevent one death
    Over 80% of women with high grade cervical intraepithelial neoplasia will not develop invasive cancer, but all need to be treated
    For each death prevented, over 150 women have an abnormal result, over 80 are referred for investigation, and over 50 have treatment
    Before the 1988 relaunch of screening with strict quality standards, for each death prevented there were 57 000 tests and 1955 women had abnormal results”…

    You won’t find this information in a screening brochure and I’m yet to meet the woman who was offered screening with a run down of risk and actual benefit. Most women are told they must or should screen with very little (if any) real information and many are coerced into testing.
    WHO is misleading women and creating victims?

  25. “People who don’t know what they are talking about attempt to interpret information they are not trained to understand (yes, you do need training to see data without bias). I challenge you: read a few hundred journal articles, understand the structure, purpose, and discussions. ”

    Once again I have to comment on your arrogance which seems to know no bounds.God help your patients.
    I myself am studying medical science and the references cited here are one generally of high quality. Knowing that Elizabeth has been reading medical journal articles on this subject of cervical screening for over 20 years (probably since before your were born and before the internet so she had to visit university libraries for this information) I would hazard a guess that she is more informed and interested than you on the subject.
    So she may in fact have read a few hundred journal artcles on the subject over the last 20 or so years.

    If you are so informed on the subject then you would know that Angela Raffle is an expert on the subject of cervical screening. So I would give credence to her papers more than anybody else’s. She also has written a book on cancer screening.
    Another expert on cancer screening, but breast screening Peter Gotzsche in his book “Mammography” says that ” a study showed that most gynaecologists think the risk is greater than 80% that a woman with a postive mammogram at screening has cancer, but it is actually only 10%” (pg 17).
    So I that illuminates your point “People who don’t know what they are talking about attempt to interpret information they are not trained to understand “

      • Why would you believe otherwise? You’re a young man with a bachelor’s degree and a bit of work experience as a lab monkey. Hubris based on self-perceived potential is rather concerning.

  26. Anomedical, it’s very arrogant to assume that the people on this website do not possess adequate research skills to understand the topic being argued, how could you possibly know someone’s professional and educational background if they haven’t already informed you. I know there’s few of us who have also read many hundreds of peer reviewed journals; reviews and discussions on this topic, compiling a substantial meta-analysis, and the arguments being presented here are sound.
    We may not have a similar level of medical training to you, but most of us have access to empirical evidence and the aptitude to comprehend our findings, some of us may even possess analytical skills you do not possess.

  27. Antonmedical: What I find most disturbing is your statement “If you don’t want to screen, don’t”, and that you doubt that a doctor is purposefully “hiding information from you”. Also, “find a female doctor if you are having a problem” as though they are any better.
    From my own experience within the last few years I have been to three different doctors trying to locate one that will simply give me a yearly blood panel and cholesterol check without the subject of a pap smear and pelvic exam dominating every visit. I have been unsuccessful. The first doctor was female, and informed me that she would give me something for insommnia ONLY after I let her perform a pap and pelvic. My blood panel which she did a week prior was fine. I faired better with the second doctor for the first visit (male), but the follow-up for my slightly high cholesterol was a nightmare. I was treated like a naughty child for “playing Russian roulette” (his words) with my health. I wonder if he says that to men declining prostate screeening. And now this third doctor. I had blood drawn and was told it is his policy to deliver the results in person. I got a call the other day from his office that I am “due” for a pap smear and they can do it when I come in for my blood results. I told them “no thanks”, but I sense another arguement coming. Doctors don’t like to be questioned or their recommendations declined when the patient is female. That is MY experience.

    • Thank you for sharing this Anonymous. Your experiences are similar to my own. I have stopped going to see doctors for any reason because the thought of having to do battle to decline a pap is extremely stressful for me. I worry I would not be able to stay calm and rational. My plan for future health care includes alternative practitioners, such as naturopaths. However, there are times you have no choice and I did need to see a doctor a while back. I took a companion with me into the consult room and I was prepared to walk out if there was any issue with paps – but the male doctor did not even mention paps. Companions and recorders are useful in situations where you have no choice but to see a doctor. Suggestions from others include stating you are menstruating (heavily – otherwise they may try to go ahead regardless) and when seeing a male doctor state you only allow female doctors to do paps.

      By the way, it appears antonmedical has deleted his blog.

  28. http://www.cbc.ca/news/health/story/2013/01/07/cervical-cancer-pap-hpv-test.html
    After decades of testing it’s shocking that so many women have been seriously misled…and that there is so much fear and concern about this rare cancer. (but not other rare cancers)
    A doctor has also commented…he can’t see any harm over-screening women, apart from mild discomfort during and after the test. I think it highlights how misinformation is now accepted as fact, even by some doctors (of course, IMO, this makes them incompetent or unethical) and that many women have been brainwashed and misled. Now they want to scale back pap testing, after decades of excess and huge over-treatment, many women are terribly concerned….for decades they’ve been told annual testing is best, lots think they had cervical cancer or that early “treatment” saved them, some think cervix cancer is rampant, that it runs in families, that women not yet sexually active should be tested or that those in lifetime mutually monogamous relationships can also get cervical cancer.
    When you set out to deceive, this is the result. When you ignore proper ethical standards and informed consent, this is the result.

    It will take decades to change the way many women view this rare cancer and this testing. Many are lost forever in this make believe world of rampant cervical cancer. Hopefully, the next generation of women will be open to real information and not see everything through decades of misinformation or from a survivor’s viewpoint. (after a telling very early “treatment”) It is nothing short of evil that the medical profession has gone out of it’s way to mislead and harm so many women. How many lives have been affected by fear and serious concern about this rare cancer that most never had anyway…living the life of a “survivor”? The numbers are damning…and their daughters are vigilant because, “my mother had cancer cells off at 19, she’d have been dead by 25″…Umm, no, almost certainly she would have been a healthy woman with an intact cervix. So the damage and misinformation extends across generations, “it runs in my family so I get tested every year”…
    It was easier to achieve wide coverage by creating this intense fear…by deceiving women and creating this mess.

    Before screening started few women worried about cervical cancer, just as few worry about thyroid cancer today. (and thyroid cancer is more common than cervical cancer) If you mentioned to many of these women you were going to channel many more millions into cervical screening and forget heart disease, they’d probably agree, it’s a great idea….yet the reality is most will die from heart disease. By creating this intense fear and pretend world of survivors…it will be difficult to move away from excess and to finally tell women the truth….the brainwashed and the huge numbers of survivors will simply put it down to cost cutting. We greatly fear the rare cancer and ignore far few likely and serious risks to our health.
    Oh, what a tangled web we weave when first we practice to deceive……

  29. http://www.guardian.co.uk/society/2002/apr/29/medicineandhealth.lifeandhealth
    The daughter of this man has posted over at Blogcritics. I adored my father and cannot imagine how shattering it would be dealing with this…but the sheer number of women who came forward telling strikingly similar stories of abuse, unknown to each other in almost all cases…well, I simply don’t believe all of these women are lying or mistaken. (and these complaints extend over many than 20 years)

    • Elizabeth, thank you for this link (and for the previous one!). I agree with you, I also cannot imagine how shattering that would be for the daughter. I also agree that the sheer number of women unconnected to one another would not be lying or mistaken.

      I found this part of the article particularly disturbing:
      “Ayling was convicted of 13 indecent assaults on 10 women patients and jailed for four years in December 2000, but his trial answered none of the most important and disturbing questions about the abuse he perpetrated – such as why he was not stopped years earlier.”

  30. This is an interesting study comparing pap testing in the States and the Netherlands…American women have a lot more pap tests for no additional benefit. (and there is no doubt American women would also end up with lots more false positives, excess biopsies and over-treatment)
    “The result is unnecessary suffering and expenditure of precious resources for no additional benefit,” Dr. Moyer said.
    Dr. Brown noted that he’s “worried, as are a lot of people” about the possibility of overuse of the HPV vaccine and HPV DNA testing now coming into use. “Will [these technologies] be used effectively and efficiently? I am a little worried, given what we showed in this study, that they won’t be initially.”
    The actual study…

    • Thank you Elizabeth for these excellent links. From the study:
      “Conclusions: Cross-country studies like ours are natural experiments that can produce insights not easily obtained from other types of study. The cervical cancer screening system in the Netherlands seems to have been as effective as the U.S. system but used much less screening. Adequate coverage of the female population at risk seems to be of central importance.”
      It is so important that women be made aware of what is happening within the scientific community, especially given the lack of information being offered to women by their doctors.

  31. I am 20 years old and before i could have my first test done i fell pregnant (yes very young) but the point is. Today i went in for my first pap test and the Dr told me there was no other alternatives to having this done. I explained to him that my son was born through cesarean since my pelvic bone wouldnt fit him. Im a very small frame, he said it will not hurt just be uncomfortable. I trusted this Dr and thought that i had to have it done at some point so now was as good a time as any (all my life i have been told it had to be done and i had no choice).
    Before he had even gotten past my vaginal opening i was in severe pain. See i have always had a small vagina and it has never stretched. He continued to force it in and it made me cry out, he pushed it in and by this time i was in tears (i went through labour all the way to 10cm without any pain medication or a peep) after a moment he pulled back a little and pushed downways and opened it again. This hurt me to much so i screamed at him to stop. This made my mother rush into the room and as soon as he figured out what was going on he stopped. Apparently my uterus is upside down? my my frame is smaller then i thought and my entire area down there is severely small. After getting dressed and stopping the bleeding my mum grabbed my hand and didnt let me go since i was so upset. The Dr kept telling me and my mother i was being dramatic and putting on a show and it didnt hurt. How would he know? he doesnt have my body. So again after asking him if there was an alternative he said no, if it did not hurt so much i would go through with it knowing the risks but the pain is to great and i know that is not normal. The pain after forgetting to take my medication the day after my csection when i stood up for the first time hurt less.

    In my opinion something less invasive and painful needs to be thought of. Maybe some new instruments and putting you under and making sure that nothing would be damaged would be fantastic but i dont think that will happen anytime soon. Ive read about a CSA blood test? not to sure about it but i think with how painful it is i might have to go with this one and try my luck, as the information above and other information i have read says, its a small chance that i will contract Cervical cancer.
    If anyone else has experienced the amount of pain i have would you please reply and tell me about your experience and what you did?

    After this painful and traumatic experience i dont think i will be trusting the new Gyno i was sent to anymore then the dr. I just wish to find out about my uterus and what that means for future children.

    • The sad thing is that there IS an alternative. It’s called HPV self test. Not only it is painless and privacy-respecting, it is also much more reliable than pap smears and much more informative. However, only progressive countries in Northern Europe and Singapore offer it to women. The rest of the world still prefers to put women through pain and to lie to women that there is no alternative to pap smears, saying that smears are “the best screening tool”. There is no truth, no compassion, no respect and no attempts to reduce pain in women’s health care in most countries. Very sad.

      • I wonder how that creep would feel about the same procedure on his penis, perhaps, then he might better understand how many women feel and what they go through with this test. As mentioned, there is an alternative, no testing until age 30 and definitely not before 25, and then HPV self-testing. The Delphi Screener can be ordered online by Aussie women and I imagine UK, European and Asian women could order it from Delphi Bioscience in either the Netherlands, Singapore and Thailand. Women should send them an email if they’re interested, it’s being rolled out in more and more countries, but may be kept very quiet in some countries, those where doctors rely on the pap test to boost profits and to use/take advantage, control and harm women.
        When I read these horrifying accounts, it makes me wonder about some doctors, do they enjoy the power, hate women, and perhaps, enjoy humiliating and harming women? The callousness is shocking…

    • Emily-jane, there is obviously something wrong with a man who will continue to try to insert a speculum into a woman’s vagina when that woman is screaming in pain. Also, the fact you are only 20 should exclude you from pap tests given women your age are at increased risk of false positive results, and at great risk of harmful biopsies/colposcopy. In the U.S. the recommended age to begin screening is 21, in Canada it is 25, and in some Northern European countries it is 30. Also, every woman should be offered information and a choice. I’m sad that happened to you and sickened by the thought of the man who put you through that awful experience.

  32. Emily-jane, I am sorry you had to experience this with such an uncaring and callous doctor. Blaming you for ‘putting on a show and being dramatic’ is unfortunately a tactic this type of medic uses on women when things don’t go their way. Not only is this patronising, it also means they don’t have to change their behavour as it is convenient to blame the patient. To be honest, this guy is a complete jerk and unfortunately there appear to be plenty of them in womens health care.

    • I just lost a post, but basically many American doctors are still Ignoring the changed guidelines to protect income and profits from the annual well-woman excess. So excess is still recommended to protect excess….it’s concerning that so many women trust doctors and this is what they get, doctors promoting harmful excess for their own benefit. Also, they arrogantly and paternalistically say women won’t get STi checks without the need for an annual pap test…oh, and we need to discuss birth control with them.
      Yet we don’t recommend pure and harmful excess to men to force STI testing…and doctors have done nothing but obstruct access to birth control, using it to take advantage and control women, harming and distressing huge numbers. Also, they often deny the Pill to those who refuse to submit to excess….resulting in relationship issues, unplanned pregnancies, anxiety etc.
      What a disgraceful track record….and these people feed off our trust and need for healthcare and birth control.

  33. Where I live the government has the right to collect all the information including name, address, etc on every women who has a pap test. It is kept in a database. Apparently it is law that the lab submit this information and women cannot be asked for their information to be deleted from the database. The information can also be used to generate “studies”.

    I disagree with this. If I choose to have a pap test then I believe my information should be private and not kept by the government.

    • Where do you live?

      Keep in mind, there may be legal support for something- but that doesn’t mean they have a “right.” A good distinction to know, seeing as people tend to phrase things “Can they…?” instead of steering their own situation & the tactic of “informing” someone of something (falsely informing them, but acting like this is actually something in place).

    • Cytobase by Insytce corporation gathered the 4 main labs in Ontario and basically stole all the women’s privacy since 1997 when they built the database “to protect women’s health” – Cancer Cares Ontario has now bought a download of that database that has all of your identifiable information and have started writing women to attend for pap smears for surveillance of all women cytology information over her life time with not once seeking consent, no one knew. It was a big secret and continues to be but now a letter campaign has started from Cancer Cares Ontario who got itself marketed as a prescribe provider under the HFIPPA along with Cytobase to do this against the will of many women in Ontario. The government has eroded women’s privacy rights to nothing and there is nothing you can do about it. In addition stay away from mammograms they are put in another database for surveillance and don’t get a Fecel Blood test either that is another reporting database to take more of your privacy away.

      I found this all out when a letter arrived at my and didn’t know how who what or why this letter arrived and called to tell them back off. They asked for my HIN, what? birthdate WHAT? and told me my age WHAT?????? they also get a data dump of your OHIP eligibility information directly from the Ministry of Health to get all of you personal information………. I freaked and will not get anymore testing because of the government interference with my privacy on things that are so intimate to me – Should I get cancer from anyone of these parts of my body and die my estate is set up to sue the Ontario Government for allowing me access medical services to protect my health resulting in my untimely death…….. I am now studying the charter for right for the right to be let alone in a democratic society and I am sure as the sun comes up tomorrow that I will break that invasion of privacy – CONSENT is just part of their language and angry doesn’t even scratch surface of how pissed off I am about this invasion!

      • I actually found a transcript of the parliamentary discussion and the women representing cancercare Ontario said that consent does not have to be given for the screening registries because people would not want to participate and as in Germany the programme would fail. They made it law that all labs must report cancer findings and all results of Pap tests, FOBT, and mammograms. All cancer diagnosis are registered and I think they have also tried to register all diabetics into a database.

        The ehealth records programme go on and on about privacy yet no one can access their information very easily but “health professionals can”. You can get a form online and mail it in and you will not receive letters for paps, FOBT or mammograms but you can never delete your personal info from the database. However you will put on a list given to your family doctor of people due for screening and harrassed by their office.

        Some women go to naturopaths to get cancer screening (pap) that are sent to labs outside of Ontario to avoid the registry. Once there is a diagnosis, especially of cancer, there is pressure to treat. Some women prefer natural treatments. Once a woman is deemed “noncompliant” she will be told that the treatment is leep or worse rather than “wait and see” for women who pap on schedule. Of course doctors do not want women to know this. In Ontario you can get a lousy HPV along with a pap but you have to pay $80 for it. The test just says positive or negative for high or low risk HPV.

        FOBT is unreliable and the instructions given written by the Ontario ministry is wrong. Too many people would get colonoscopies on positive FOBT and never find any polyps. The FOBT card can be developed at home with 3% hydrogen peroxide that way the results are private. However read the John Hospkins hospital article for information about what foods cause false positives on the FOBT. Either that or pay $150 for a FIT test which is specific to human hemoglobin.

        Getting a cancer diagnosis is very devastating. This is recorded In the government database and the eHealth record. It gets difficult to try alternative therapies since doctors will not tell people about them. It affects careers, family and insurance. Also some are in danger of getting arrested for mental health if they refuse conventional cancer treatment. This will be on record and they will not be able to travel over the border for many years after that.

        You can not be denied medical services for refusing screening tests. Any doctor who threatens you with that – ask them for a letter saying that they ared removing you from their practice, the reason why and sign and date it. They will not do it. It is often an empty threat. They push screening because ohip pays the incentive bonuses, up to $13,000 per year for their percentage of patients doing screenings, vaccines, etc. I would take the government to task about that money wasted since doctors are paid for doing these services anyway.

        Please be aware that there is a difference between screening and diagnostic testing. You also do not have to get “physical exams” if you are not sick. Your choice. So keep healthy, see someone at a health/herb store or visit the pharmacy (pharmacists are knowledgable). You do not have to register with a family doctor and you can just use walkin clinics and ER.

  34. http://www.dailymail.co.uk/health/article-2420525/Over-1-300-women-hepatitis-C-alert-helpline-learning-infected-gynaecologist.html
    An article about a gyn who may have infected over 1300 women with hepatitis. Almost each day I spot an article about “iatrogenic abuse” in the UK media, on Friday I saw in Metro an article about a GP who molested children, a few days ago was something about an gyn who filmed his patients.. and I am just a casual news media consumer! I bet if I was specifically seeking, I could find such a scandal for each day. It’s been priests, teachers, even BBC celebrities, when is it finally the turn of doctors???

    • It’s good that it comes up in the media. You don’t really see or hear much in America (funny, considering they were always the ones with the reputation for honesty & directness- the Brits were proper to the point of withdrawn & repressed). I do very much wonder if they think things like that are a problem. What I mean is: that it’s always camoflauged here & I figure that might be sign of their approval of the situation. It makes no sense for someone to think that whatever comes from medicine isn’t harm. That’s like saying “whatever a priest does isn’t wrong” or “nothing law enforcement ever does is bad.”

  35. http://doc2doc.bmj.com/forums/off-duty_general_should-women-feel-pressured-having-cervical-smear-test#plckforumpostonpage=1&plckpostid=&plckforumpostshowfirstunread=&plckfindpostkey=
    An interesting discussion between doctors on cervical screening – should women feel pressured to have cervical smears?
    It’s clear from the comments which doctors are respectful, knowledgeable and ethical…and those to be avoided at all costs.
    I always wondered about the high percentages given for women who screen, I thought they must be inflated…turns out 90% screened is actually about 70%.
    Now why should that surprise me…creative statistical methods is the cornerstone of women’s screening propaganda. Interesting one doctor says that if women got all of the evidence, fewer women would be screening. Exactly…

  36. Those Dr’s who think that women should be pressured really concern me. Someone needs to explain to them that pressure/coercion plus an intimate exam is a sexual assault. They really need to be educated on the fact that a woman makes the decision to screen with knowing all of the facts. The one poster seems to think that a woman’s sexual history determines if she gets to make an informed decision or not. It is very concerning that these attitudes exist.

    • The more sexual partners or early sexual abuse, the greater the risk – so pressure the patient into more testing – how judgmental and abusive. As if someone who was abused could actually say there was a partnership in regards to the abuser as a sexual partner.

      The odds of winning the lottery with one ticket might be 1 in 10 to the power of x. Buying three, four or five or even a dozen tickets does change the odds but it is still UNLIKELY that a person will win the big jackpot. The odds of winning are still low. It is the same with the changes of cervical cancer because if having more than 5 sexual partners increases the risk by a factor, it does not make the changes of getting cancer HUGE.

  37. These programs don’t care about women. It’s as simple as that…
    After decades we still have very little critical research into this testing – it’s simply not funded. Fortunately, we’re seeing more with breast screening, although this country was very slow to come to the party. We have a few in this country who aggressively protect the program, and use scare tactics and hysteria to push away the Nordic Cochrane Institute’s assessment of breast screening.

    I’m highly suspicious of the doctors and others who defend screening, but can’t meet the evidence and even worse, don’t believe they should, and keep urging women into testing. “Don’t be a statistic, get screened”…etc.
    It’s ignorance at best, but IMO, probably closer to evil. Self-interest protected at the cost of our health and lives. I blame these high profile and influential people for the silence that’s reigned in this country for decades and the attempts now being made to protect the programs while damning evidence continues to emerge overseas, prompting reviews and change. These people have been very effective for decades keeping excess and non-evidence based testing in place and informed consent out of the equation. (The States, Canada and other countries are in the same position, but even they have seen some change in official recommendations, even though not much has changed at Clinic level)

    Of course, there was never a need to harm so many, but this testing has been used recklessly and IMO, mostly for the benefit of vested interests…those with a higher risk, like the victims of early sexual assault, could be offered a HPV self-test at age 30, but no, they’re pressured into early and excessive pap testing which is of no benefit, but exposes them to high risk from a false positive and colposcopy/biopsy/over-treatment.

    So the entire program and testing is IMO, conducted to maximize harm…not to benefit women.
    That’s what makes me furious, almost all of this damage and some of the deaths from cervical cancer could have been avoided with evidence based testing and informed consent.
    I have never considered women’s cancer screening a health initiative, the way it’s conducted, it’s harmful and benefits very few women. In the haze of harmful over-treatment they “might” manage to save a few lives, but with evidence based testing we could have saved more and spared so many the agony of over-treatment and all of the horrible and tragic aftermath. (premature babies, infertility, unnecessary hysterectomies and mastectomies, and even death, some women lose their lives as a result of over-treatment)

  38. Thank you for an interesting blog. I’m a 5th year medical student and I just had a few comments to make regarding some of the points raised.

    ————What doctors don’t tell you is that the results from a pap smear are often inaccurate (between 10 and 60% of pap smears are inaccurate) and will show a false positive for abnormal cells if you have recently had intercourse, taken a bath, used a tampon, or any number of such things.———–

    It is unfortunate that, as with many other screening programmes, pap smears can be inaccurate and therefore will lead to some women either being unduly subjected to treatment or given false reassurance. This is more or less unavoidable since a better option doesn’t exist, and it is always going to be a cost-benefit analysis in which we balance how much harm is caused by screening tests with the number of lives saved. It is a raging debate even among medical professionals of course!.

    In consultations I have sat in on, the doctor has always been very clear about the accuracy of the test with patients, and have not coerced them into getting it done – though that is just my own personal experience. The NHS website itself seems to be very open and transparent about the accuracy of the test, which would suggest that there doesn’t exist some big conspiracy to hide the facts, as your blog would seem to imply: http://www.nhs.uk/conditions/Cervical-screening-test/Pages/Introduction.aspx

    ———–Doctors also don’t want you to know how rare cervical cancer is. Your odds of getting cervical cancer are 1 in 13,699 (in developed countries). Your odds of dying in a motor vehicle accident each year are 1 in 6,535. ———-

    I don’t really know what this is supposed to prove. Comparing cervical cancer to another big killer does not seem to achieve what you think it does. 759 women died of cervical cancer in 2008. That’s a large number of mothers, sisters, and daughters, regardless of how it compares to road traffic accidents. It is difficult to demonstrate conclusively that any one screening programme has reduced a significant number of deaths in any one country, due to a large number of confounding factors, however it seems that the same trend has been found, with regard to cervical cancer screening’s impact, in multiple countries that have introduced it:



    ———–Doctors are able to charge extra fees for pap smears. Doctors don’t want you to know that they are making more money from your visit every time you agree to a pap test. ———–

    There is certainly a lot to be said about the ethics of using monetary incentive to encourage medical professionals.to manage patients in the recommended way. However, you have to think about where this financial incentive is coming from. The NHS would only spend relatively large amounts of money on things it considered worthwhile. It is far more plausible that the NHS were incentivising provision of pap smears by GPs in order to improve health outcomes rather than the idea that there is some kind of NHS-led conspiracy to line the pockets of GPs at the expense of other stretched NHS resources. For example, GPs are also paid extra to encourage patients who come in, for whatever reason, to quit smoking.

    ——–Studies have shown that no abnormalities have ever been accurately detected by inserting fingers into a woman’s vagina.——-

    You may very well be right about this, however the ‘study’ you cite does not come to the conclusion that “no abnormalities have ever been accurately detected by inserting fingers into a woman’s vagina – in fact it doesn’t even come close to saying that.

    ————-Some doctors enjoy performing pelvic exams.———-

    Right so you post an anonymous blog from one supposed doctor, with a URL that does not lead back to the original source but to an ideologically-related website, and we are then supposed to extrapolate something meaningful from this? It is a very sad thing indeed that some doctors do exist who act in a disgraceful and perverse manner, but I would be surprised if such doctors were anything other than few and very far between.

    ————-Many women who receive a false positive pap smear result are sent for further and more invasive testing. ————-

    Well we must go back to the first point you made – that the pap smears themselves are not always accurate.which is precisely why there is a need to do further tests, so women are not subjected to unnecessary cancer treatment. It is not only women with “false positives” who are sent for further tests; to word it in this way is to imply that doctors somehow know which tests are false positives – if that were the case we wouldn’t need the further tests!

    Unfortunately this is the nature with screening programmes; the initial test is often less accurate than we would like and therefore further tests are usually needed. In bowel cancer screening, for example, positive faecal occult blood found in the stool routinely leads to a colonoscopy which is much more invasive (requiring sedation, in fact) but which has led to a substantial reduction in mortality from bowel cancer: http://gut.bmj.com/content/50/6/840

    It can be argued that cervical cancer screening is more effective, in principle, in that the aim is to detect abnormalities at the pre-cancerous stage whereas faecal occult blood aims to detect cancers at their earliest stages.

    There is clearly no straightforward answer to the question of screening programmes and the cost-benefit calculations involved, but the debate should be based on good quality data and facts rather than polemic and anecdote.

    Thank you again for an interesting blog post.

    • @mahmoodnaji, you imply a conspiracy is being projected here. Well conspiracy would mean conscious planning, plotting, but what I think is happening and has happened that this absurd screening REFLECTS deeply ingrained attitudes ABOUT TEACHING WOMEN THEIR PLACES. look at this: http://www.cervicalscreeningproject.com/whatdidwedo/developandtest/phase2/servicepush2.php the NHS publishing a disgusting poster like this
      https://forwomenseyesonly.files.wordpress.com/2013/03/46302_2715666748462_1831164053_nsmr.jpg aimed at ACORN GROUP N, M, O, yes, yes, poor and struggling people. That holy cow NHS has spent £ £ £ £ £ £ £ £ £ to do focus group research to find out how to bully struggling and uneducated women to SPREAD THEIR LEGS AND LET DOCTORS PENETRATE THEIR VAGINA, so an inaccurate and dangerous “test” (no, sorry tests are accurate) straight from the 1930s can be done? “Because it saves lives” Oh give me a break, my local A and E closes you know, but hey women should be saved from their vaginas, never mind A and E, vaginas don’t suffer accidents… To quote you “The NHS would only spend relatively large amounts of money on things it considered worthwhile.” I can tell you, this poster campaign IS worthwhile, because it might save the jobs of some high-flying f—cks who are well invested in this screening, and it gives work to their mates in consultancy and the endless chain of “professionals” involved in the mediation of this crap. For me, X female, postcode XXX XXX, it mean money spent and public messages perpetrating the usual misogynistic victorian nonsense- women are there for their children, they are essentially community property, but they are not very reliable to maintain themselves (for the common good, of course) doctors need to look into their vaginas from time to time, they can’t run around like stray dogs and spread diseases and disorder, and they can’t just think they do with their fertility as they please. Chauvinists like this test, because it regulates and humiliates women, and feminists like it, because (it is a long story, look up the history of Planned Parenthood) some women like it, because they are brainwashed to be scared of their bodies, and they welcome any “solution” I never had this test, and will never have this test, but It does shape my lived experience, and my subjectivity as a women as well. I see this test almost as a battleground- are women inherently diseased, does being female needs to be managed? Did you know it all began in the Napoleonic wars, when individuals became a sort of reservoir for army conscription, that regular physical checks on healthy people began? It was about processing civilians into militants, weeding out bodies not standard, and breaking and standardising minds. No, there has never been any randomised controlled trials before this test was implemented on a national level- I find it simply criminal, and I think there should be an inquiry, but it is probably too late now, after decades of brainwashing, and all the careers, the survivors, and the people who simply like the idea of vaginas being checked and regulated. You are saying “759 women died of cervical cancer in 2008” well, I am sure many more dies in diseases no-one hears about, but my internet keeps cutting out so I can’t google
      mortality statistics. (Btw, 30m(or a million or two more) stays alive, and I am more than happy to take my chances, and do not care what you think is lot or not, as you said and opinion is an opinion.) But what I wanted to say with that, who would be hysterical about kidney cancer or gallbladder cancer, since controlling kidneys and gallbladders has never been about strategy and politics?
      How much better is this NHS patronising nonsense than the patronising nonsense this clerics in Saud Arabia bs-es about (http://edition.cnn.com/2013/09/29/world/meast/saudi-arabia-women-driving-cleric/) who wants to ban women from driving because “medics have shown it moves the pelvic bones and damages ovaries”, it is all so BLATANTLY about shaping subjectivity, what it means to be female, how one should “live” a female body. Obgyn was essentially a counter-movement to feminism, surely (I hope so) you know the whole seedy history of the discipline, from J. Marion Sims to the contagious diseases act, to every third women in the USA getting a hysterectomy. Again, I am no believer in conspiracies, I hold them sort of a poor man’s Hegel or Marx, you know, that any driving force is there behind history at all, and here, or at least to me, no-one seemed to talk about conspiracy. Technology DOES embody social norms, worse, it furthers struggles, strengthen roles and actively shapes human interactions, your computer configures you, the user, and these wretched tests shape the patients and to some extents other women’s lived i mean gendered experience, if you read into the Unnecessary pap smears thread, women talked about losing their innocence, feeling dirty, anxiety depression, all these horrible traumas, and it DOES shape the experience of the doctor as well, power and dominance, they get to coerce women to allow them to penetrate their vaginas, AND FOR THIS THEY ARE PAID AND EVERYONE SHOULD CLAP THEIR HANDS AND SCOLD THE SILLY LITTE GIRLS WHO ARE TOO SHY OR BUSY SO THEY NEED TO BE PESTERES as you surely know rape is about power, what else do you think this test is about, besides money of course????
      Sorry about all the shouting, yes, I am angry.

    • You state that in 2008, 759 women died of CC and because you are talking about the NHS I’ll assume that you are talking about the UK. In 2011 there were 32.2 million women in the UK. You do the math on how rare CC is. In 2009 2,605 people died in car accidents and if we extrapolate that possibly half were women we can conclude that car accidents are a greater threat to women’s lives than CC. I think that does prove our point. Heart disease is the number cause of death world wide (according to the WHO) and in 2010 33,977 women in the UK died of heart disease. In that same year 15,488 women died of lung cancer. Compare that to the 759 who died from CC. So explain why CC is seen as such a threat and why there is so much focus and money spent on testing for such a rare cancer when it is not a threat to the lives of women. I think I’ll take my chances with not screening.

      • There are several things to say to this comment:

        1) I still don’t see what the use of comparing deaths from CC to deaths from car accidents, as if this somehow shows that the CC deaths are low. Clearly RTA deaths are a serious problem, so this comparison is completely irrelevant.

        2) Heart disease and lung cancer are also diseases on which billions is spent on treatment and prevention, so I have no idea what relevance this statistic has, other than to say that there are things far more dangerous than CC…which no one is disagreeing with. You know we can worry about and try to treat more than one thing, the fact that there exist things more dangerous than CC does not mean that we should no longer worry about CC

        3) CC is not “a rare cancer”, far from it. The UK statistics for CC are so low precisely because we have such a successful screening campaign! It is no use pointing out that deaths are now low and then saying we should not bother with screening. That would be like saying deaths from certain bacterial infections are now so low we should not bother with antibiotics. Clearly that is a silly argument. Compare the UK statistics to the worldwide statistics where CC is a huge killer of women; it contributes to 9% of female deaths: http://www.cancerresearchuk.org/cancer-info/cancerstats/types/cervix/mortality/uk-cervical-cancer-mortality-statistics

        4) “When it is not a threat to the lives of women”: really? So 759 mothers, daughters and sisters were not under any threat? I’m afraid we just hold different opinions on what is an insignificant number of deaths.

        5) “I think I’ll take my chances with not screening.” – and you are completely free to!

    • When you say “unduly subjected to treatment,” does that imply that there exists “due subjection” to treatment? Overall, any interface with a sexual area as the product of someone else’s decision-making is an attack (an “iatrogenic” one, in this case). The additional risks & inaccuracies are aggravating factors & if any detriment befalls the patient due to these conditions- that is now an “aggravated assault.” Just like if someone gets dragged into a stairwell & gets a disease from it as an extra problem.

      Apparently there ARE alternatives (I believe a blood test is one of them & is 90% accurate) if she even is curious about something that is massively rare to begin with. The point about a car crash is that nobody gets paranoid about getting into one, but there is a huge amount of “fanfare” over these particular kinds of cancer. The ones only a woman could get, so it must be that she’s got a high probability of getting them.

      Polemics are warranted, given the frequently antagonistic nature of medical behavior. The anecdotes are accurate, so what’s the problem with those? Maybe that they’re not medically affirmed? I believe that’s called a “conflict of interest.” Of course, there’s the concept of ulterior motives (both at an organizational level & at an implementation level). Maybe a vicarious thrill or two for people that arrange things to happen? Maybe some extra thrills from deceiving people on top of it? Not even at the point of mentioning money, yet.

      So many things that come from the medical profession are not as advertised. It’s a constant theme of something being antithetical. It doesn’t matter how complex something is, mere complexity does not render efficacy. When something is unsafe, it’s deemed safe anyway. When something doesn’t work, it’s presented as effective.

    • I seem to remember an article about how it was estimated to be the cause of death of numerous women. It was merely a guess- like a “doctored” body count in a military conflict. More & more it seems that doctors don’t presume themselves the patient’s assistants, but their substitutes.

      Someone is not “perfectly free” to not have these tests done if they’re getting harassed about it. What about that “call & recall” system? The concept is to “try & try again,” to keep trying to induce someone into doing something that they obviously are not intent on doing. What about deception? That vitiates consent. What about outright force with childbirth? Attacking a pregnant woman mid-labor is an act of compassion? How about all the miscarriages caused by these procedures? That’s a life-saving situation? Not, quite the opposite.

      I wonder if medical personnel feel free to exert themselves in whatever manner they decide? Maybe to interpret the patient’s output however they please? I guess it could just be outright disregard? The concept of intellectual negation (“what comes from me is an A & what comes from you is a B, at best- so I outmatch you”) is pretty damn prevalent with medical personnel. You do realize that if reality were formed by recognition nobody’d get hit by a car they didn’t see coming or drown trying to walk on the water, right?

    • CC is rare and has always been rare. A drop from say 4000 to 2000 is a 50% decline but it’s still rare when you look at the fact that there are millions of women in the UK. Yes the numbers of deaths have dropped from the 1970s to now but that cannot all be attributed to a screening campaign. Greater education on sexually transmitted diseases and use of condoms along with greater understanding of nutrition and hygiene and better treatments for cancer can also be attributed to the decline in deaths. Stomach cancer has dropped in occurrence without a screening campaign. It is also interesting to read that many women who develop CC have never been screened or haven’t screened recently meaning that for a large number of women who screen they still developed CC which means the pap test did not protect them. Yes it is sad that women die from CC and I don’t deny that women do. But for the number of deaths now and back in the sixties when the NHS set up the screening campaign the numbers did not and still do not warrant the amount of attention that it receives. It is a rare cancer and always was. There is more to women’s healthcare than the pap smear and there have been blatant lies about this cancer along with coercion by Dr’s to screen women including linking it with access to the birth-control pill. The focus on and hyperbole surrounding it is disproportional to the actual threat to women’s lives. That was the purpose of showing those other stats. There are greater threats to women’s lives that include suicide (1,493 female suicides in 2011 per 100,00 population in the UK) to car accidents to heart disease. Yet when we as women enter the Dr’s office the focus is on our cervix regardless of our broken toe or chest pain or feelings of depression. When was the last time a Dr asked a female patient how they are feeling emotionally or psychologically or if they wore their seat-belt on the drive over. Nope it’s always about when our last pap was. That is what upsets us. The fact that it’s a rare cancer makes it even more frustrating.

    • “In consultations I have sat in on, the doctor has always been very clear about the accuracy of the test with patients, and have not coerced them into getting it done – though that is just my own personal experience.”

      I’m a biology student and I intern with a gynecologist and have worked with several others (I’m even related to one!). No they aren’t, and yes they do.

      ” 759 women died of cervical cancer in 2008. That’s a large number of mothers, sisters, and daughters, regardless of how it compares to road traffic accidents.”

      Not sure how many women are in the UK, but here in the States the number of women per year who will receive a cervical cancer diagnosis is .007%. The number of men who will receive a prostate cancer diagnosis is 1.5%. That means the number of prostate cancer diagnoses will outnumber the cervical cancer diagnoses by a factor of 217. But let’s look at the difference between how the two are handled in the States.

      Prostate cancer is rarely, if ever, talked about in the media. Men are given all of the information and allowed to make their own choices regarding screening, and are NEVER shamed for whichever choice they make. Prostate cancer science is kept up with and has some of the best research going into it, and how to make screening better for men. Prostate cancer is rare under 40, so we don’t screen under 40.

      Cervical cancer is the forefront of every healthcare movement ever. Doctors do everything they can to keep women in the dark.

      Ex: I volunteered at a women’s clinic putting patients back. The patient was under 21 but was there for an Annual. Now, I know my chart says “Annual” when I go in to my gynecologist, but that’s not actually what happens. I knew several of the doctors were fellows of ACOG, and I knew ACOG’s guidelines say no paps before 21. I gave the girl a gown and went straight to the office manager. I asked her what the office policy was on ACOG’s guidelines. Her response? “Well the doctors here know the guidelines, but they’re not mandatory, so most of the doctors aren’t following them. Oh! And make sure you never talk to the patient about guidelines. It’s up to the doctors to decide if their patients know the guidelines, and most of them don’t want their patients knowing.”

      Women are almost never allowed to make their own decisions. I watched a doctor laugh in a woman’s face when she asked if she could start having pap smears every 3 years instead of every year. I was told I needed to start having pap smears and pelvic exams… when I was 11. Thankfully, my mother called the doctor out on her bullshit.

      Cervical cancer research is done, and we know many things. However, the information is largely hidden and ignored.

      Cervical Cancer is rare under 30, so here in the States we start screening at 13.

      “It is far more plausible that the NHS were incentivising provision of pap smears by GPs in order to improve health outcomes”

      Yeah, thaaaaaattt’ss how consent works.

      “You may very well be right about this, however the ‘study’ you cite does not come to the conclusion that “no abnormalities have ever been accurately detected by inserting fingers into a woman’s vagina – in fact it doesn’t even come close to saying that.”

      We can’t conclude that sticking a finger in a 10-15 year-old boy’s rectum has NEVER diagnosed prostate cancer. So by your logic, all teenage boys should be getting prostate exams? Oh, wait, I forgot-it’s not okay to treat men’s bodies with such disrespect.

      “It is a very sad thing indeed that some doctors do exist who act in a disgraceful and perverse manner, but I would be surprised if such doctors were anything other than few and very far between.”

      This I actually agree with you on. I’ve shadowed several male gynecologists and am related to one. They don’t get a thrill or talk disgustingly about their patients. I can say, it’s actually very very easy to forget that you’re looking at a woman’s sex organs, as it does become very medicalized in your brain. However, it is almost never the case from the other end, and that’s what really matters.

      “There is clearly no straightforward answer to the question of screening programmes and the cost-benefit calculations involved, but the debate should be based on good quality data and facts rather than polemic and anecdote.”

      You mean like the only information ever given to women?

      The point people are trying to make here is not that cervical cancer and auto accidents or prostate cancer have anything to do with each other. It’s the misogyny women face the second they step into a healthcare provider’s office that would never ever ever fly with men.

    • Cervical Cancer Screening in US – 6 billion dollars annually. What! physicians are only recommending the screening to average risk women (everyone) and there is no monetary gain? 29.4 million cervical cancer screening test were performed in 2013 to diagnose 12,000 women with this cancer. Ladies demand to be informed and make the best decision for yourself. Cancer awareness is helpful when used to educate. It should never be used as a scare tactic or to coerce women into unnecessary exams or tests without providing the risks & benefits.

      • I agree (I can sense other heads nodding in agreement)
        I heard a US medical group argue that HPV primary testing would lead to lots of unnecessary colposcopies. (I kid you not…)
        Used the wrong way it’s true the HPV primary test could make things worse, that’s why every screening test (and exam) must be used correctly (after clearing RCTs) and not just added to the mix, excess on top of excess.
        They rely on the mis-use of the HPV test to keep out evidence based testing.

        You don’t do HPV primary testing before age 30, it should always stand alone, (do not combine it with pap testing as we see in the States) and the roughly 5% who are HPV+ should be offered a 5 yearly pap test, not sent for immediate colposcopy and biopsy.
        If it’s used correctly, it’s smarter testing, used incorrectly it adds to the misery of this testing, sadly, too many benefit from using the test the wrong way.

  39. The fact is: if screening was supposed to save as many lives as possible, we wouldn’t be wasting resources and harming huge numbers of women with non-evidence based screening and awful over-screening, we’d have followed the Dutch or Finnish evidence based programs. We’d also, move with the evidence and now we’d ONLY offer pap tests to the roughly 5% who are HPV+ at age 30. These are the only women who can benefit from pap testing, and most of these women won’t benefit either, a rare cancer means few will benefit from screening. There is no benefit to be gained screening the 95% of women aged 30 and older who are HPV-…so, why are they being tested and over-tested? These women can only be left worried and harmed by false positives and over-treatment.
    Now consider the millions lost to vested interests if only 5% of women were offered a 5 yearly pap test…and the number being over-treated and having excess biopsies plummeted, that’s a lot of $$$ down the drain.

    Our program urges women to seriously over-screen , this harms huge numbers for no additional benefit over an evidence based program…and we miss some of these cancers with our inefficient over-screening/excess. Profits come before the evidence, our legal rights and health.

    Also, these programs have mostly operated without informed consent, and even consent itself is often missing, that makes them unethical and I’d say, illegal.
    Focusing on a rare cancer has resulted in a huge misallocation of resources with far more likely risks to our health largely ignored. (heart disease, mental health etc.)
    There is no doubt in my mind that vested interests have shaped women’s cancer screening into their business model, what’s best for women doesn’t enter the equation. It was an easy exercise with women denied real information and informed consent.

  40. To me the bottom line is, if people really were free to make their own decisions in regards to this wretched “test”, they would be presented with facts, and the facts only, there would be no coercion and no propaganda. If this “test” really was any good, the numbers alone would be enough to convince people, without ridiculous arguments like comparing health risks in the third world to health risks in the UK. Many more people die in malnutrition in the third world, and no-one lectures women to go home and eat more, I wonder why..? They have a completely different set of risk factors, and making such comparisons just does not make sense, it is also very patronising, the idea that those people need doctors do-gooding and checking their vaginas, when they don’t have sanitation, clean water and enough food, but hey, to hell with living standards, (never mind the direct correlation between CC and povery) women should be saved from their vaginas all over the world!

  41. First do no harm

    How can coercing women into Pap smears, pelvic and breast exams every time they walk into the clinic harm them? Victims of sexual abuse do not want it. It causes them great anxiety and they will even avoid getting ANY medical attention because of the pap ambush.

    The problem is that the Pap test is inaccurate but also the system in how the pap is used in some countries. If I was offered a 5 yr self HPV test and then paps for any problem when I wanted, I would agree. I just do not want the coercion, threats to make me “conform”, letters to my home about my Pap test schedule, details of my personal life in a regional computerized directory without my consent that I cannot be asked to delete.

    Does anyone ever think that such information in some cultures could lead to a woman facing family violence? A women does not need a letter arriving at her door saying her Pap test needs to be reviewed by a doctor when her husband has not allowed her to go to a doctor to get that exam. Now he is going to kill her.

    Some women suffer from PTSD before, during and after such procedures as pelvic exams/Pap tests, ultrasounds,

  42. “Victims of sexual abuse do not want it”

    I would not even bring up sexual abuse in this context. One does not need a reason to not want it. I have never been sexually abused, I just do not want it, and I do not need to explain or provide a reason, neither anyone else of course.

    • Karen, I agree one does not need a reason to not want it. In fact, coercion into unwanted vaginal penetration is a form of sexual abuse. The fact this is viewed as acceptable by society in general is wrong, and the fact doctors are permitted to get away with it says a lot about how women are viewed. Men are not coerced or bullied into bending over for a prostate check.

    • Well said, Karen & Sue. Something being antagonistic to your alignment is a point on it’s own. It’s like trying to get someone to justify their not wanting to be dragged into a basement. Something that’s easy to miss is that “justify” means “get the other party to agree” in this case. Since they’re inclined in one direction, attempting to convince them to move in another. Keeping in mind that control freaks aren’t big on altering their behavior & there isn’t always someone sane to be dealt with.

      Another point is that if medical personnel do things like this, they can’t very well be trusted with anything else. If someone were to molest their daughter in this way, they wouldn’t be considered trustable (not that any other would be fine, of course). If someone so much as smacks their wife in the face, not even a punch, that’s an attack- but much worse is not only acceptable, but high-quality? These people obviously have “compasses” that point backwards. To my mind, not everyone’s opinion is valid- for instance: doctors thinking that they have self-determination with someone else’s self is not valid. It has no quality, it just exists.

      I’ve got to wonder at the correlation between CC & poverty. What are these tests supposed to be, then? A status symbol? Maybe it’s the “everything’s got to be perfect” angle in a sense of looking shabby? A variation of “that makes you look ugly” coupled with falsified science. Any thoughts on that?

  43. Have you noticed how when a member of the medical profession makes a comment on this blog they dismiss in their medically superior tone that there is “no conspiracy” in women’s cancer screening? That they personally have “not noted any coercion” and that “polemic and anecdote” is worthless in this kind of debate?

    Aside from the fact that they probably haven’t bothered to read the numerous excellent links provided repeatedly on this site, the implication is that our opinions, insights and experiences are insignificant. THEY ARE NOT INTERESTED IN WHAT WE HAVE TO SAY.

    The following statement is from the link he quoted from the “open and transparent” NHS screening programme:
    “It’s important that you do all you can to prevent cervical cancer from developing. This involves attending all cervical screening tests that you are invited to and making sure that you get your results.”

    Does this sound like it’s OK not to get screened?
    Patronising BS.

    • “Spot-on,” as the British say. I’ve personally found polemic & anecdote to be their style with a lot of things (someone’s always being ridiculous or immature & they always know someone that’s been saved by things like this or have died from not having it). Intangible stuff is hard to point out (a dictatorial or superior tone, for instance), so that’s why they use it. It makes them look like the poor little victim when someone brings it up & they deny it, too. Hell of a gamble, that they’ll hamstring or impede their own initiatives in any way.

      Can’t help but feel that maybe the (allopathic) medical profession needs to be conquered? They definitely have a stance that they’ll do as they chose & that’s all. They’re not going to be “pushed around” by patients or their families. That’s not to say that you don’t sometimes get mid-wives that pull the same things as regular doctors or touchy-feely massage therapists, but it doesn’t seem to be their general tradition & culture.

      Something else I’ve been thinking of: The medical personnel act like cult memebers, don’t they? Doing all kinds of crazy, off-the-wall shit for one thing- but the fanatical way that they stick to whatever pattern (like a ritual or some kind of mindless chant), that they all cover for each other & act like the “outsiders” are out to get them whenever something horrendous comes up (isolated, “us against the world/we’re the chosen ones” mentality), zero critical thinking or situation-based assessments of conditions or the groups activities (or total support for it, masked as blind faith).

      I remember someone on here saying something about the mid-wife always giving her breast exams when she came in

    • It does seem strange to think that in 2013 there would be a conspiracy in women’s health care. But then I compare it to testicular cancer which occurs at about the same rate as CC. There are no screening programs with call and recall systems and incentive payments for Dr’s despite the fact that in the UK cases of testicular cancer have doubled since the 1970’s. There are no awareness campaigns or awareness weeks or posters with a crying child on them or clinics offering walk-in appointments for testicular exams. Men don’t receive letters in the mail “inviting’ them to an appointment with warnings that if they don’t attend they will die. When they attend a medical appointment their concern is addressed and there is no questioning of their last testicular exam and guilt and shame if they refuse the exam. Testicular exams have not been tacked onto access to unrelated medication and medication is not held hostage if the exam is refused. There are no lies and hyperbole surrounding testicular cancer including statements that it’s a major killer of men. I’m sure if you asked any Dr they would likely say it’s nothing to really worry about but men should be aware of symptoms and have them checked out. There is truthful information including that lower deaths rates from testicular cancer is due to advances in cancer treatment. Not wrongfully concluding through correlation and ignoring other variables that lower death rates from CC are due to a successful screening program.
      It is astounding how two rare cancers with similar occurrence rates are treated so differently.

  44. A status symbol, could make sense, or a sort of badge of honour, being the responsible women. No wonder these “responsible” types are then defending this “test”, they need it to continue feeling smug and self-righteous, to feel they EARNED the right to lecture other women from the moral high horse.

  45. You ever notice how most types of abuse to women or children such as female genital mutilation, honour killing, child prostitution, foot binding, baby boy circumcision, ritual scarring are accepted by the culture and even encouraged by the family.

    It is very proven by the medical community in North America that pap tests are abuse that are tolerated since very rarely are the intrusive genital exams and “treatments” clearly outlined before they are forced on the patient. How many women went into their first “pelvic” exam not understanding that they would be penetrated vaginally and anally while their lower body and the implements were hidden from view by a drape? How many tolerate it because they need their birth control or are lied to that they will not be given other medical treatment if they refuse?

    Sounds like a conspiracy, it is. As much as all the above listed abuses.
    The proof is that self tests for HPV are made unavailable, women are coerced into treatments when they go for colposcopy (“wait and see” is discouraged and “diagnose and treatment in one visit” is encouraged). The very fact that HPV is known to cause cervical cancer in very few cases and it is introduced into cells by microabrasion. The pap test and pelvic exam causes much damage to the skin layer with the scraping down and the brush. NO one could be so stupid as to keep wanting to use that same method of testing (pap test first then HPV test later). Yet there is no change.

    The vaccine is a hoax too. I read one paper that said immunity by the viral protein was for up to ten years. So why then is the vaccine given to 9 year old girls? Are they expecting all the girls to be raped or have sex before age 19. Even “early intercourse” before age 20 is cited as a risk for cervical cancer. In many countries girls are married long before that age and even in Western cultures more than 200 years ago it was common for most women to be married long before age 20. HPV has been around for a long time and cervical cancer is not an epidemic. It does not have to be promoted as much as polio and flu vaccines.

    The argument that the Pap test is not very accurate BUT it is all there is to detect cervical cancer is really getting old. There are emerging technologies coming but none seem to be any less intrusive. Further more they will all be too expensive for the masses to get access to courtesy of the pharmaceutical companies. I have to wonder at the dost of a pap test $30 (insurance covered) compared to the cost of an HPV test $90 (out of my pocket) which must be added on to the pap test and not allowed alone. How is the test feasible alone in the Netherlands then and how much does it cost the user?

    • Conspiracy Theory: Maybe the people that don’t get health insurance here are labeled the poor. “They don’t even contribute to society & everyone else has to pay their medical bills,” sounds a lot like what they’d reasoned in Germany. Even if it was because of coercive probing getting integrated into getting or having insurance- it’s not like imposed situations of that nature are considered a problem here. It seems there’s a bunch of “FEMA camps” that got built completely under-the-table & there’s been a massive increase in the cops getting tyrannical with everyone (lockdowns at schools can have all kinds of implications & that sort of thing happens from rumors of a gun or something being in the school- nothing to say there actually WAS a rumor of anything, either). Can’t help but wonder if that’ll be used to snatch people’s kids up. There’s already a big question mark about those forced home inspections under Obamacare (and part of that seems to include possibly railroading women & their daughters into various exams- whether through insurance coverage conditionals or through simply deciding to give an order). It’s looking worse & worse over here.

      Also, did you notice how the women were beheaded & men only hanged? Plus, how the same monsters that did all this were the ones that taught the new breed & who everyone else trusted with their health?

  46. my daughter got vaginal warts from a cheating ex husband had them burned off twice was talked into a biopsy and has had lymphedema in her leg for 17 years, no insurance no help take an aspirin and put your leg up, not very easy when you are on it working 10 to 12 hours a day, she did not have a pap for many years until about 2 weeks ago, came back abnormal lsil what does anyone think she should do go for the c word test i cannot spell or wait and get another pap later help!!!

    • Keeping in mind, just because it’s “abnormal” doesn’t mean anything. Lots of low utility in the medical field (particularly with this type of thing), so there’s no real reason to get all cranked up about anything. There are actually a lot of “interpretations” in medicine, so don’t be too trusting of results (particularly one that would generate a repeat cost & get them some incentivies- there actually ARE bonuses for reaching different quotas on top of their fees).

      There’s a massive amount of natuaral stuff for that like eliminating all processed foods, taking things to improve circulation (Butcher’s Broom was one suggestion, but I’d imagine garlic & cayenne pepper both help), fish oil and that massage stuff that Moo suggested. If you Google it (“lymphedema natuaral cures” is what I did) you can find lots of stuff on it.

      Keeps something else in mind: these are the same people that are very dictatorial & antagonistic to women (imposing interfaces with sexual areas is an attack, whether it’s an iatrogenic/medical variation or not)- this, in itself, is a reason to distrust them. The things they “suggest” have a massive amount of risk and inaccuracy, as well (this is an “aggravated assualt” when any detriments are realized, by-the-way). They also omit details like alternatives or massive rarity of conditions that people get all kinds of tests “just in case of.” I know it’s not common to say “them” and “they,” but this is a prevalent pattern & their are massive financial and ulterior motivations. All I’m saying is that it might not be a good idea to trust them too much.

    • Welcome Kathy,
      If informed consent were respected for women, it would make these decisions a little easier, we’d already understand the significance of hrHPV and that very few women can benefit from pap testing, and that false positives are common and condemn many women to unnecessary and potentially harmful biopsies and over-treatment. We’d know at the outset and could make an informed decision about testing, rather than be confronted with an “abnormal” test result and hear about biopsies etc. at that stage, when many are afraid and worried sick.
      IF we knew the facts…few women would agree to pap testing without first establishing their HPV status. (that’s why we keep the significance of HPV under wraps, so we can keep testing and “treating” huge numbers of not-at-risk women)

      Your daughter could contact Delphi Bioscience in the Netherlands and see if there is some way she could order the Delphi Screener. This self-test device would provide her HPV status, HPV+ (about 5% of women aged 30 to 60) and she has a small chance of benefiting from a 5 yearly pap test (until she clears the virus)
      hrHPV+ and an abnormal pap test = you have a small risk of cervical cancer (and I mean SMALL, it’s a rare cancer)
      HPV- and your abnormal pap test is a false positive caused by either inflammation or trauma, infection, hormonal changes etc.
      The new Dutch program will not even offer pap testing to the 95% of women aged 30 to 60 who test HPV-…there is no point doing pap testing on these women.
      I watch the Finns and Dutch closely, they follow the evidence and put women first, providing the best chance of preventing the rare cases of cc BUT at the same time, minimizing the risk of false positives and over-treatment to the majority of the female population who are HPV- and not at risk of cc.
      Australia, the States and others don’t follow the evidence and maximize the risk of excess biopsies/over-treatment and medical profits.

      Of course, once women get an “abnormal” pap test result it can be hard to resist being pushed into colposcopy, punch biopsy and for many…into the day procedure room. The shocking fact is that many/most of these women would be HPV- so the biopsies/”treatments” are completely unnecessary. We don’t offer women HPV primary testing or HPV self-testing or tell women about the real significance of HPV so we can pretend over-treatment “might” be life-saving. This is about huge profits, not women’s healthcare.

    • Kathy, it is worth bearing in mind that the “c word test” (colposcopy) often comes with a cervical biopsy, which is an EXTREMELY PAINFUL procedure with a high risk of subsequent inflammations and recurring pain. Many women feel very violated and depressed after cervical biopsies, and start having problems in their sexual life.
      Abnormal pap test result often is caused by temporary condition and very rarely means actual cancer risk. But doctors don’t tell their patients any of that, because excessive pap-testing, biopsies and surgeries bring more money than letting the patient go and heal on their own.

      The best thing your daughter can do is to reduce her levels of stress, quit smoking (if she smokes), eat healthy, do some enjoyable exercise (like walking in beautiful places), ask her intimate partner (if she is in a relationship) to use condoms and wash his hands before being close with her (this will greatly reduce the viral load and will help her to heal the lesion). Actually, washing his hands before a sexual contact is something any loving and caring man shroud do.

      If your daughter is really worried about a small chance of cervical cancer, she should do an HPV test for high-risk HPV strains. It is much less painful than a biopsy or “treatments”, yet very informative. And if it turns out she doesn’t have any high risk HPV, she should not go to any further painful tests. She is safe and healthy.

  47. She can try some home treatments such as hydrogen peroxide or green tea extract or other herbal ones. Much cheaper than the c word test colposcopy.

    Lymphatic problems can be helped by a special type of massage.

    Look up on the internet or find someone who loves todo that.

    As someone mentioned the poor getting their healthcare paid for by others. I am canadian. I love that the poor get their healthcare as well as the rich.

  48. Pap smear actually could advance infection if HPV is present already. This is something your doctor does not know. Published article in 2011 but how many people are thinking like this scientist? http://jnci.oxfordjournals.org/content/early/2011/04/11/jnci.djr061.full
    “Although the incidence of cervical cancer has decreased, the rate of human papillomavirus (HPV) infection, the main cause of cervical cancer, has increased. Damage to the cervical epithelium such as that produced during a routine cytology screening procedure (Pap smear) may increase susceptibility to HPV infection.”
    “The procedure for collecting cervical cytology specimens, commonly known as a Pap smear, inherently disrupts the cervical epithelium. To effectively collect specimens for testing, the instrument used must dislodge cells from the deepest (basal) layer of the stratified squamous epithelium, the only layer in which low-grade dysplastic lesions are detectable. In addition, in the delicate tissue of the endocervix, which is a single layer epithelium, removing cells creates erosion that exposes the basement membrane to material in the endocervical canal. In a mouse model of HPV genital infection, we previously showed that this physical disruption of the endocervix leads to binding of pseudovirus (PsV) to the basement membrane and to a dramatic increase in susceptibility to infection (5,6).

    We hypothesized that if infectious HPV capsids are present in the human genital tract during cytology screening, increased infection of the very tissue that is most vulnerable to HPV-induced oncogenesis could result.”
    “In our study, we confirmed the histological similarities of the human and macaque cervix and established that the transformation zone was not preferentially susceptible to infection in the absence of trauma. Infectious events did occur in the endocervical epithelium, but they were exceedingly rare and occurred after exposure to a very large HPV16 PsV inoculum. The trauma associated with a Pap smear collection substantially enhanced experimental infection. This potentiation was largely reversed by the simple intervention of replacing the lubricant commonly used for the internal digital examination with an iota-carrageenan gel.

    Data from human studies are conflicting as to whether trauma may occur in the area of the transformation zone as a result of consensual intercourse. Recent consensual intercourse (<24 hours) was strongly associated with minor trauma of the genital mucosa, including the cervix, albeit on the forniceal surface thereof (12). However, magnetic resonance imaging of the anatomy of the coital act shows that the cervical os may not contact the male genitalia (13). Therefore, infection may occur more frequently in the vaginal epithelium, particularly in the lower portions which are more prone to intercourse-associated microtrauma, and the resulting foci continually shed infectious virus into the vaginal lumen."

    In other words if a women has some HPV infection and she goes for a pap smear and a bimanual exam, the HPV is going to spread to her cervix. If a brush is used after the spatula then any HPV will be introduced to the endocervical canal where adenocarcicoma occur.

    Has any doctor read this study? I want everyone to read this study and give me some answers why pap tests are standard when an HPV test and vinegar test should be done instead.

    • Moo, thank you for the link!

      I have always suspected that scraping during pap smear and – even worse – damage after cervical biopsies assist with advancement of HPV (if it is already present) and make it harder (sometimes impossible) for the woman’s body to clear the HPV on its own after the damage has been done.

      I guess this suits the medical profession perfectly well: they make profits on pap tests that take the superficial HPV infection into deeper layers of epithelium and give it a good chance to cause a lesion; then they get paid for biopsies of those lesions; and then, once the damage from biopsies causes further problem and inflammation, tell the woman she needs a surgery, which means even bigger profit. Great business model, isn’t it? The the amount of pain and suffering women are put through doesn’t count, of course.

    • Alice, and for many women it ends in an unnecessary hysterectomy. Even then women don’t escape the excess, with many women with no uterus/cervix continuing to have pap tests and pelvic exams for the rest of their lives. Many doctors, especially American, will do pap tests on women who’ve had a hysterectomy for benign reasons, so you can imagine the reaction if you’ve had a hysterectomy for “persistent dysplasia” or a “pre-cancerous” condition, a pap test every 6 months? Nothing would surprise me.

  49. The fact is…if women were given real and helpful information, MOST of the over-treatment and a few deaths could be avoided, but they go out of their way to scare, mislead etc. in the name of profits. It’s shocking to think all of this damage has been caused quite deliberately…knowingly over-screening for decades despite the clear evidence of harm for no additional benefit over something like the Finnish program.

    The pathetic excuse that’s been made for a LONG time is…we’d have to do our own research, our situation is different. What absolute nonsense, why are American or Australian women so different, it’s an insult to our intelligence. Or they’ll claim to be fearful of changing such a successful program, which is a disgraceful thing to say, showing a complete disregard for women, putting us through excessive invasive testing that leads to nothing more than huge over-treatment rates. The callousness is difficult to comprehend, that a medical profession that’s “supposed” to be acting in our best interests, is IMO, knowingly risking our health to further their own interests.
    We could have saved more lives and spared huge numbers the heartache of over-treatment, premature babies, miscarriages etc. if someone (anyone…) had been prepared to challenge this program and force change. (or even warn women)

    Was anyone sufficiently concerned for women? No. The silence has been deafening, except to urge the screening “story” onto us and to devise more ways of “capturing” us. How could we possibly trust the medical profession after such long-standing deception, a shocking lack of proper ethical standards and for informed consent, and this level of abuse?
    AND STILL…they fight to protect the program and their profits at the expense of our health and well-being. They expect us to fear a rare cancer, when the threat THEY pose to our health and well-being with their programs is a MUCH greater threat.

    • Yeah, “helping women” isn’t a very apt phrase, is it? “Harass, harm & generally abuse” women is a much more apt term. They deliberately do just the opposite & what? People are supposed to believe “they tried?” They constructed their actions in a way to accomplish a goal- they didn’t trip.

      They’re NOT trustable, because of doing these things. Any of them in isolation is pretty bad, but all of them together is absolutely foul! The just seem to always arbitrarily redefine what “attack” means & it basically boils down to “I know it’s a problem, but I like problems.” Sometimes you have to go by someone’s actions, because their words might not always be honest.

  50. An issue I would like to bring up ….. Women are not talking to each other too much about their pap and colposcopy experiences. I did have a few friends tell me about what happened to them when I was younger. So I spared myself.

    One friend of a friend was on the “pap train” since her early twenties and sick of how she was treated in colposcopies. She even bought a wedding band to wear. She tried to refuse treatments and biopsies. She eventually started treating herself at home. She had huge problems getting basic supplies such as speculums, long swabs, herbs etc.

    At the age of almost fifty I have a few friends who will talk a bit. Now after doing some research I might be in a position to advise if I am asked. I do not feel that I can push myself into my friend’s intimated medical and sexual issues.

    I have a few friends tell me about their experieneces of biopsies which were terrible. They were afraid to say no. Even then they were not given much information other than they could have cancer. Everyone thinks I am crazy not to get Pap tests. Now I am going to get the same arguments when I am going to refuse FOBT tests and mammograms at age 50 .

    What is so disappointing in my life is the lack of care I received for infertility. Ten years ago I met a women in a premie ward with her baby. She looked like a grandmother but it was her baby. She told me she took vitex. I went off to the walkin clinic and asked about how I could get vitex. I was greeted with get a Pap test (how does that in anyway help fertility), asked if I wanted clomid (too expensive for me at that time) and told that vitex …. We don’t do that here .. As if I had just asked for some illegal narcotic. There is so much information on the internet but much to sort through and decide what is useful or marketing.

    I praise these types of websites for information. Also people should look at women against stirrups.

  51. I pulled this off some message board. I do not mean to cause harm to anyone except maybe this woman’s doctors.
    What happens when a woman gets an abnormal pap smear.
    “I am 61 yrs old, post-menopausal and had a very abnormal pap smear in Sept. I had a colpo and leep done on Oct. 13th. I should mention that I also had a large cervical polyp removed and part of the polyp was in the endocervical canal. I had not had a pap done for ten years, but previously had normal paps. My husband and I have never had other partners….monogamous for 42 yrs. I live in a rural area and traveled 250 miles for the appt. with a ob/gyn. The results of the colpo and leep did not match the pap smear. I thought I would post both.

    Endocervical transformation zone present
    Epithelial cell abnormalities
    High grade squamous intraepithelial lesion(HSIL)
    Atypical endocervical cells, favor neoplastic
    Colpo and Leep
    Polyp, cervix( specimen #!)
    -Benign endocervical polyp with acute and chronic inflammation and reative changes
    -no dysplasia or malignancy identified
    Cervix, ectocervical, Leep ( spec. #2)
    -atrophic cervical squamous mucosa, focally atypical, not diagnostic of dyplasia.
    Cervix, apex Leep (spec.#3)
    -marked cautery artifact with focal glandular atypia.
    -no dysplasia identified

    At my follow -up visit Oct. 27. the dr. said I had 2 options.. to have a ckc biopsy or wait 6 months for another pap. Considering the results I am confused as to what I should do. What does focally atypical mean? The dr. did not explain it very well. I have read that it is not uncommon for post-meno women to have abnormal paps. Hope this wasn”t too long and that maybe some of you knowlegeable ladies would have some insight.”

    No one would explain to her what was going on. Just give her a copy of the report. I doubt that many women even get that even when asking for it.
    No idea if she was HPV positive or not. Her pap was AGU and HSIL

    *****cautery artifact means there was some burned tissue from the procedure in the sample

    ****atrophic squamous cells, focally atypical, not dyplasia – means this: Focal means the cells are contained and not spread out. Atypical, obviously means, not typical. That means the cells have changed, mutated, not necessarily cancer or even pre cancer.

    So in other words she was given a LEEP for a polyp that was benign, totally benign.

    Another woman
    “I recently had a pap smear come back with atypical glandular cells (AGCUS). My doctor says they are of unknown significance but on the report it says endocervical cells. Anyway, he did a colposcopy and told told me that if the colp was inconclusive he would have to do a d&c. A few days later he called me back to say that he was going to have to do a d&c and also a LEEP (loop electrosurgical excision procedure) because the colp showed acute to moderate focal atypical cells. What does this mean?”
    the colposcopy was inconclusive because they could not visually observe any abnormality outsid of the cervix. There could be something inside the cervical canal but the biopsy (assumed it was done at the colposcopy) showed benign disease.

    Another procedure for benign disease. Totally irresponsible. These women were confused and thought they had cancer.
    Their cancer of the cells becoming cancer could be somewhere around 10%. Were they told? No likely it was determined if they could pay for LEEP before and then just not told the truth.

  52. Great Article. I’m a female in my late twenties and have NEVER gone to an obgyn, EVER. And it feels Awesome!! Pelvic exams are unnecessary, dated, and just plain dumb. Sorry. But the stats show that they clearly are. Sorry, not preventative in any way shape or form, but they are detecting an abnormality ALREADY there. I know my body very well and will know if something is wrong. I know myself than any doctor ever will. I am sexually active, but use protection everytime, and take very good care of myself (exercise and eat organically). I literally laugh out load when I hear one of my girlfriends is going to their annual checkup. The idea of a man, who will never have a baby, a period, a menstrual cramp, a vagina, or the feeling of a barbaric tool up their nonexistent twat (that a simple blood test can solve), putting his face between your legs once a year rattles my bones a bit. Poor sheeple and their white coat syndrome. Pass! Besides cevical cancer is RARE!!! Doctors are not into healthcare, they DO NOT promote health, they are into the sickcare business, and help the sick.

    • It’s good that you’ve got yourself so solidly aligned. Money seems to have an effect, but don’t rule out gerneral pervyness (don’t forget: women can be lesbian or bi, as well as aggressive about it- deception vitiates consent so that also counts as aggresion). I think outright malice motivates a lot of things (particularly in medicine & especially with women).

      “White coat syndrome”- never heard that one & it’s a very good term. Got a good laugh out of it, too.

    • Hey Alex, thanx for your reply (what a freakin’ awesome website this is! Girl Power!)
      Anyways, to the comment about Lesbian Obgyn:
      When you get an exam done by a female gyno there could be a 50% chance she could be a homosexual. OK. At least this “lesbo” get periods, has a vagina, a uterus, knows what it is like to get cramps, and may have had a baby etc….
      When you get an exam done by a male gyno there is a 0% chance he could be a homosexual. Because baby, a homosexual ain’t gonna be looking at vaginas all day long!
      Oh the ol’ “well your girl gyno could be a lesbian” argument, gotta love it.

  53. Again, great article!
    This response is in regards to the link about male doctors getting pleasure out of exams.
    I strongly believe males should not be gynos. I know it sounds foolish but hear me out.
    First off, out if all the medical fields and professions he chooses female care, or simply examining vaginas all day.
    Secondly, he is not a woman and will never have a vagina, a baby, a period, a menstrual cramp, etc…so why ask the mechanic about how nice the car handles if he has never driven a car!?
    Third, the tests are dated. We know this and data shows it. Cervical cancer is extremely rare, yet we are told to get the century old test annually. Also, knowing we live in the techno age age and all, the 21st century, does sticking two fingers in your twat with the other hand on your belly or one finger in your a**hole really going to solve anything!? This is the funniest thing I have ever heard. Yet millions of brainwashed women willingly subject themselves to it, and PAY for it. Extremely unreliable.
    Fourth, the hype is now for young girls to get tests even when they are not sexually active. So we have teenagers seeing male obgyns. Ask any adolescent girl if they want a male or female doctor looking at their boobs and between their legs, chances are they want a girl. But mothers take them to a male doc anyways and they are told the ol’, “he’s a doctor or get used to it” story. Disgusting. I would not want any one looking, poking, touching, penetrating, or examining my most intimate virginal body part even if the man is a professional. He’s a man at the end of the day. He’s not an asexual void of any sexual chemistry or desire.
    A woman relates more to us, she is a woman! Some patients prefer a male obgyn, because their argument is that they had a bad experience with a female. Did they try seeing a different female?
    “But, male gynos have been caring for women for hundreds of years!”
    No sh**, women were not allowed to be doctors.

    • Healthwise,

      You made excellent points about male gynecologists. Actually, before 1800s male doctors were not allowed to examine women’s private parts. Look at some information about the history of pelvic exams at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3296153/.

      We have an article on Medical Patient Modesty’s web site about why women should avoid male doctors for intimate health issues at http://patientmodesty.org/avoidmaledocs.aspx.


      • [QUOTE who=”Medical Patient Modesty”]
        You should never go back to him. He is apparently taking advantage of you. You should only go to a female ob/gyn. I encourage you to check out why you should avoid male doctors for intimate exams at http://patientmodesty.com/avoidmaledocs.aspx

        “Medical Patient Modesty” is being run by a troll hiding behind and disguising herself as being a health organization, in reality she probably has little or no health experience or certifications at all. Her Organization is just herself. She follows the right-wing banner and makes derogatory comments about gays and lesbians. Similar to Muslim modesty, she is projecting the religious view that males and females should be separate for each-other if they aren’t related and married.

        Sure everyone has their own positions and views, but is unethical to hide behind and pretend that you are a health professional and organization.

  54. Someone posted this statistic.

    “2. Pap testing did not “largely eliminate” cervical cancer. It’s a hype used to coerce women into pap smears. There is less than 1% difference in chance of getting cervical cancer between women who pap-smear all their lives and women who never do pap tests.”

    I love it! I would really like to know where it came from.
    Another reason why I do not want to pap ever again is because women over 35 get a different protocol so that ANY abnormal pap is pushed for a colposcopy. No way! So that any woman over 40 with endrometrial cells in her pap sample after day 12 of her cycle is going to get colposcopy when HEY menopause causes weird stuff to happen. There are four types of endometrial hyperplasia but only one type has a good chance of being cancer.

    I am going to take the risk. No more pap tests EVER! I will be on the look out for red bleeding after sex or bleeding after menopause which could be cancer. Otherwise get away from my vagina!!!!!

  55. I forgot that this was the 1950’s and women dont have a say in what happens to their own bodies. I would love to see a grown man, starting at the age of 21 go annually for a test where the cells of a testicle are scraped off for testing, while getting anally probed. But just remember people, testicular cancer is the 2nd highest cause of death in men, so this is significantly important and shouldn’t be an option. In case you were wondering, all of that is complete nonsense I made up, which is probably the tactic used to pressure women into getting pap smears. BTW I would LOVE to see the reaction from the male population if such test existed. But since it doesn’t, women open your legs and get ready for pain. No thanks. I’ve never had a pap smear, and probably never will. I will take my chances, and I will protect my body.

    • The reaction would be pretty violent, let me assure you. In all truth, you’d probably hear more than a few stories about that situation being turned around (double entendre intended). Reversals work well for prevention as well as for revenge.

    • It has always surprised me that so few women question this testing, even those who hate the test often don’t bother to do any research, they accept the mandate handed down by the medical profession, women’s groups and others.
      Many women don’t believe pap testing is really a choice, it’s something we must do unless we’re crazy and happy to accept the “high risk” of cc…little do they know, almost all of the “facts” provided to them amounts to propaganda.

    • That situation has basically happened with prostate screening for men. Men didn’t like the DRE so they were quickly given a blood test and now men are given a choice to screen or not. Here is what the Canadian Cancer Society says about prostate cancer screening: “Large, reliable studies haven’t been able to tell us clearly whether it’s a good thing to use these tests to look for prostate cancer. And so, we recommend that you talk to your doctor about your risk of prostate cancer and about the benefits and risks of finding it early.” To put in perspective the Canadian Cancer Society estimated that there were 23,000 new cases of prostate cancer in 2013 and it is the third leading cause of death in men from cancer.

      To contrast here is what the Canadian Cancer Society says about CC and the pap test: “Women who are sexually active should have regular Pap tests by the time they are 21 years of age. Women who are 69 or older should talk to their doctor about whether they can stop having Pap tests. The decision to stop is often based on a woman having 2 or 3 previous normal (negative) Pap results. Women who have never been sexually active should talk to their doctor about whether a Pap test is necessary. Some women may have been exposed to substances that put them at higher than average risk of developing cervical cancer. A Pap test is done every 1–3 years, depending on the screening guidelines in their province or territory. Women who stop having sex should continue to have regular Pap tests.” They even have a seven page booklet titled “A Pap Test Could Save Your Life”. There have never been any research studies on CC and pap smears to show it’s effectiveness and the Canadian Cancer Society estimated that in 2013, 1,450 women would get cervical cancer.
      The contrast is shocking in how a common cancer is treated for men compared to how a rare cancer is treated for women. Informed consent is given for men and women are told what to do.

      • Ok so what are the substances that some women have been exposed to that will put them at higher risk of cervical cancer besides some strains of HPV?

        Also the pressure to pap is there as cervical cancer is the “easiest cancer to prevent” as in have an abnormal Pap test and then they want to cut off the abnormal tissue with LEEP, cone biopsy or hysterectomy. No mention ever of herbal or hydrogen peroxide therapies. The first two procedures LEEP and cone are quick and easy and make people money. Probably they are not required most of the time but. Look at the statistics if they are ever made available. Most women with HPV infection or dysplasia never get cervical cancer. They heal with vitamins. Pap test is pushed as prevention. It is not prevention because it is screening for who will get pushed for LEEP or cone biopsy. Most people are really scared by cancer and will follow their doctors recommendations.

        I would like the protocol of HPV type testing first, then If positive visual test with vinegar and Pap tests and biopsies if only necessary since Pap tests would spread HPV infection. I would like to know if I have dysplasia because then I could use alternative treatments early when they are more likely to be more effective. No point in trying herbals at stage 4 cancer, it is too late. but since I cannot get solo HPV test without a pap where I live what can I do to prevent cervicalc cancer or dysplasia? Not much except avoid sex.

        By contrast, Lung cancer kills more people but no so easy to detect or treat in early stages. Screening tests for lung cancer are not really used and not making anyone money.

      • Another point is that it’s somehow a badge of maturity to let someone else make their own decisions with your body (in this case, penetrative ones). Isn’t it mature to assess risk & results, anyway? It’s a “rite of passage?” Why? Because it’s antagonistic to someone’s alignment & the theme is that you should always go against the grain?

        I’ve got to ask: Have any of you (and I’m sure you all have) heard this question: “How do they get taught this if it’s not true?” The specific question can vary, but it revolves around the theme that there has to be proof & then it gets taught & then someone gets into trouble (appparently without anyone making any complaints on the situation) & then it would stop happening. It’s like they believe everything exists in a state of being present because it’s good!

        Maybe it has something to do with the belief that when science is involved, there is never a “maybe” at the end of the researching & that scientist are never dishonest or wrong. It’s a lot like the way things were with the church ages ago- execpt there was more room for interpretation & the idea of God bolstering life (so God wouldn’t be okay with someone attacking life by eroding the quality of life). Just realized that maybe that’s a possible religious argument. It’s an attack on someone as well as reproductive endangerment, the whole sanctity of life argument might work.

        In the first place: medical quality is determined by patient satisfaction, not academic value. It really doesn’t matter if something has utility or not, but that lack of utility can always be included as a problem.

  56. Yes, the difference is stark when you compare official attitudes and the approach taken in prostate and cervical screening, it says to me the medical profession still views women differently, men are independent adults while women must or should do as they’re told for their own good, others know best, others will decide and all we have to do….is follow orders like good little girls. The profession hasn’t moved much since the 1950s, when it comes to women, which means IMO, every woman needs to remind them how grossly inappropriate and unacceptable these attitudes are, something we reject completely. How dare they presume to make screening decisions FOR me and accept risk on MY behalf, who do they think they are?

    • Well put Elizabeth! This article might please you: http://www.cbc.ca/news/health/breast-cancer-death-rates-in-canada-didn-t-improve-with-mammograms-1.2532730
      From the article: “Dr. Mette Kalager from University of Oslo called for more efficient ways to reconsider priorities and recommendations for mammography screening.

      This is not an easy task, because governments, research funders, scientists, and medical practitioners may have vested interests in continuing activities that are well-established’, the editorial concludes”.

      The article makes it clear that “vested interests” are responsible for harmful screening practices. A link from the article: http://www.ncbi.nlm.nih.gov/pubmed/22072221 concludes with this piece of evidence: “Avoiding getting screening mammograms reduces the risk of becoming a breast cancer patient by one-third.” Conversely, your risk of becoming a cancer patient increases by one-third if you undergo screening mammography. You can’t spell it out much more plainly than that. Now if they would just tackle cervical cancer screening!

    • These things are inflicted ON you, because they are the product of someone else’s decision-making. They’re implementing their decisions ON you, they’re PUTTING you at risk, they’re FORCING these things on you- phrasing these things in terms that denote the antagonistic nature of the situation is important.

      [I don’t mean to split hairs with you, Elizabeth. I just figure it’s something that doesn’t really get framed as an attack, so it gets kind of an innocent reputation. This can have a real corrosive effect on counteraction. The argument that “they care” & “only want to help,” makes it seem like they do these things accidentally & it’s somehow hurting someone that’s not an enemy to counteract their actions (even though it’s not an attack to self-determine one’s own situation, anyway).]

      A lot of doctors are VERY arrogant. I think a lot of it has to do with how people treat them & the amount of money they make. I guess they also figure they can act like assholes if they’re the source of something important (not exactly a monopoly, but the same kind of theme). Also if someone else is in a position of vunerability, they might feel very safe acting like an enemy.

    • The article is good in that it suggests some practical health and
      Life style tips to improve the immune system. What I find fault with is suggesting that those abnormal cells can be removed in a simple in office procedure, namely what? That is rather a deceptive statement.

  57. I’m so happy for this website. I have had abnormal then normal paps for the last two years. Two paps ago was normal, this last one abnormal. I was called into the dr’s office for her to tell me to go get a colposcopy. Luckily I had been reading a lot about it before I went to see her. I came armed with questions … surprisingly..she couldn’t answer them. She was surprised that I even questioned the procedure. I’m 44, I am HPV positive with an ASCUS result on my pap. I said I would like to wait 6 mos and come back for a pap to see if my body cleared itself of the infection. She was shocked and said that’s not normal medical practice and that I should get the colposcopy. When I asked the questions she said I should ask the people at the colposcopy clinic and seemed offended that I even questioned it.
    Well the lady from the colposcopy clinic called to tell me when my appt was and I said to her that I had some questions first. She then said that if I didn’t show up at this appt they would only book me 2 more times then they wouldn’t allow me to come to their clinic at all! Really?? wow!
    She said I would be able to ask the nurse questions before the procedure. I said I would like to wait 6 months (Aug 6 would be 6 months from my last pap) and get another pap done to see if it returns to normal. She asked me if I was willing to take the risk that it could turn to a high grade lesion…which is such a crappy thing to say. So of course, scared…I said fine, I’ll come to the appt..when is it. JULY 21 – seriously!!! it’s not for another 5 months anyway!!!
    What if I was really scared about this? She has filled me with panic and worry for such a low risk cancer. I am just shocked at this. The way I was treated and talked to it makes me feel stupid .. and trust me..I’m not stupid.
    Thank you for this website. I haven’t made a decision about if I’ll go in for a pap again or not. But at least I am more informed and I will continue to read and research this.
    Thank you thank you thank you to the women who have spent so much time researching this….

    • Dear original poster. Hope you are ok

      A few points about this situation make me really angry. First ASCUS is not a big deal only that you are over the “magical” age of 35 on the protocol. Second, asking for a retest pap after six months is not unreasonable. Third, they MAKE the appointment for colposcopy and you HAVE to show up or you are banned. So if a women did have a serious problem she is supposed to drive 200 milesor farther to the nearest clinic? Ridiculous and then you have to wait 5 months, your case is definitely not a priority. Forth, maybe get a speculum, some vinegar and some iodine and look at your own cervix. See for yourself. Fifth, if you are HPV positive then some tests show either high or low risk strains. You could be infected with a low risk strain. Sixth, if you go to a colposcopy do not sign a consent form if you do not want biopsies or immediate treatment sometimes pushed on women. If you are only ASCUS then then they do not see anything visually they will push for biopsies because “the lesion could be farther up the cervical canal”. The transformation zone moves up the cervical canal from the OS as women age. If they cannot see it then they are going to want to a CC biopsy. So just be prepared for a biopsy because some women want to take some pain relief before or just know what is going to happen. Ask what procedures they are going to do before you go. Be firm with your decision. It’s your body.

      I know one women you said the colposcopy appointment was just made for her. They kept calling and calling. She did not want to go. A friend told her to say that she was going out of the country on a important family matter and she did not know when she was coming back.

  58. Marnie, So pleased you found us and yes, don’t let them bully you into a colposcopy, which almost always means a biopsy as well and may lead to a “treatment”. I use the inverted commas because almost all treatment of the cervix amounts to over-treatment.
    The threat it might leap somehow to a high grade lesion is pure ignorance, cervical cancer takes a long time to progress from a low grade lesion to high grade and of course, almost all low grade lesions amount to nothing. Even CIN 3 regresses or does not progress in most cases, some studies say only 12% progresses, others say 20% or 30%.

    You don’t even have a low grade lesion, ASCUS is “Atypical squamous cells of undetermined significance (ASCUS)”. The poor cervix is subjected to such scrutiny every tiny thing is “dysplasia” or ASCUS. I know Dr Gilbert Welch says that ASCUS is his favourite non-cancer term.
    It’s all a bit absurd and, IMO, more about medical profits. I don’t think any other body part is subject to the same level of scrutiny. In other words, ASCUS is nothing to worry about, it’s not going to leap anywhere.

    The best program in the world for those women who wish to test is, IMO, found in the Netherlands, they’ll ONLY offer a 5 yearly pap test to the roughly 5% of women aged 30 to 60 who test HPV+ (and you can test yourself, no need for a speculum exam) Having too many pap tests means a false positive is more likely, so even HPV+ women need to avoid over-screening.

    So I think you’re wise to do your research and take your time, too many women face unnecessary and potentially harmful biopsies and “treatments”.
    Understand the risk as well: 0.65% is the lifetime risk of cc, yet here in Australia, and the States would be similar or even higher, 77% is the lifetime risk of colposcopy/biopsy. HUGE over-detection and over-treatment to cover a remote risk. There are FAR better ways of dealing with this rare cancer.
    You say you’re HPV+, but it’s a good idea to check your HPV status every few years, most women clear the virus in a year or two and then you might want to consider whether you want to have pap tests, you might prefer to simply check your HPV status now and then. (as per the Dutch program) I’ve had women say I’m HPV+…many assume HPV+ = always HPV+, not true, most women will clear the virus within a year or two. So most women find on re-testing they are HPV-
    So only 5% of women aged 30 to 60 are HPV+ (and we shouldn’t be pap or HPV testing those under 30) so 95% of women aged 30 to 60 cannot be helped by pap testing. (but can be harmed)
    That is the level of unnecessary testing – burning down a forest to find a few twigs.

    Women who are HPV- and no longer sexually active or confidently monogamous might choose to stop all further testing.
    So many women end up on the abnormal pap test merry-go-round of worry, re-testing and treatments, almost all of it is unnecessary. (and avoidable)
    IMO, following the evidence and making informed decisions is the best way to protect our life, health and peace of mind.
    Welcome…keep us posted.

  59. Thank you so much Elizabeth (it’s Marnie here signed in with wordpress). Your words of encouragement are welcome. I am angry…so angry…because after reading everything here, clicking on every link, finding some on my own…I know that our ‘poor cervixes’ ARE over treated. And yet, the doctor and the woman at the clinic have instilled fear in me. It’s ridiculous.
    I am going to make this my cause…making women aware. There is a consumer watch reporter on our news and I’m going to see if I can get a story on this. I doubt it seeing as the medical industry has more clout than I do but …I’m angry. I want women to know.
    I’m angry for my friends who have gone through ‘procedures’ and ‘treatments’ needlessly. For all the worry that they make us go through. For treating us like it’s no big deal to go in and have our parts poked and prodded and that we should just do it ‘for our own good’.
    Thank you for your support and I will keep you posted.

    • “I’m angry for my friends who have gone through ‘procedures’ and ‘treatments’ needlessly.”
      Interesting: before screening started few women had heard of cervical cancer, no one worried about it, and doctors were lucky if they saw one case over their entire career.
      Now every second woman has been “saved” or “treated”…there is a clue there.
      Also, thyroid cancer occurs more often than cervix cancer, compare the way the cancers are viewed? How many articles can you find on cervical cancer and how many on thyroid cancer? The most fuss in women’s healthcare is made about the rarest cancer. (and it’s not rare “because” of screening as we’re so often told, it was always rare)
      I smell a rat, well, I did decades ago…I’ve just turned 56 and have never had a pap test and never will. (and I don’t have routine pelvic, breast, rectal or recto-vaginal exams or visual inspections of the genitals or breast screening)
      Almost all routine screening exams and tests of the female body are not backed by evidence and are FAR more likely to harm us. There is no need for asymptomatic women to submit to a lifetime of medical surveillance and intervention, in fact, IMO, it’s harmful and a very unpleasant way to live.

  60. Marnie, you now join the ranks of the informed and angry. You are so right, my younger sister had a completely unnecessary cone biopsy, so many women have been harmed.
    My sister knows her cervix is damaged and wonders whether that means a prolapse is more likely in the future, will that lead to a hysterectomy? Needless to say there is VERY little research into the risks with over-treatment, no one cares and no one wants to know. There is no or little funding for anything that might put women “off” this testing.
    Most women here have no idea the program carries a *77% lifetime risk of referral or that the cancer is rare (always was and it was in natural decline before testing even started)…now that *study by Kavanagh et al goes back to 1996. (http://www.ncbi.nlm.nih.gov/pubmed/8861048)
    You’d think that study would have at least prompted further research, nope, nothing, who cares if 77% of women end up having a colposcopy and biopsy as a result of screening for a cancer with a 0.65% lifetime risk? Women don’t know so it’s safe to carry on harming women.
    You’d think there would be some respect for our right to decline given the unlikelihood of benefiting and the risks of testing, nope again. In fact, we do everything to increase risk – testing far too early, too often and for too long. Now there is something even better, (HPV self-testing) but no, we’ll stay with population pap testing, the medical profession’s cash cow. America ADDS the HPV test to pap testing which creates the most over-investigation for no additional benefit to women. (fabulous profits though…)

    Most health reporters won’t touch cervical screening, that gives you an idea of the power of those who protect this testing – what are they so afraid of, what are they protecting? The millions made from over-testing and over-treatment is what they’re protecting, they don’t give a damn about us. If they did they’d follow the evidence and respect our legal right to make an informed decision, including a NO, but honestly, how many women even realize refusing pap tests is a reasonable decision? Most don’t even consider it a choice.
    Good luck though, hope you find a receptive ear, I’ve written to all sorts of people over many years with no success.
    We only heard about over-diagnosis in breast screening last year and uncertainty of benefit, even though this has been the topic of hot debate in medical circles going back over a decade. One or two reporters and a few doctors are now warning women, the crickets are still chirping with cervical screening.
    So that’s part of the problem, women never hear anything but, “get your pap tests!” so if they hear something negative, dismiss it as the ravings of a rogue ratbag. I’ve often been called an “anti-vaxxer” on women’s health forums, even though my comments are backed by medical journal references.
    You’ve made my day, every woman who becomes informed and speaks out, helps another woman….together we’re making a difference. Some women WILL listen, they are the women we need to reach.

  61. By the way, my sister’s “abnormal” cells/pap test were probably caused by mild inflammation caused by a new brand of tampons. If women use tampons, try to avoid those containing anything that might irritate and change them regularly. Also, some condoms can irritate and lead to an “abnormal” pap test.
    In fact, inflammation, transient and harmless infections, hormonal changes, (menopause, pregnancy) trauma (childbirth, rough sex, some sex aids/toys) can all lead to “abnormal” pap tests. Many of these women end up losing some of their healthy cervix…in almost all cases that’s completely unnecessary, most of these women are not even at risk.
    In some cases there is no reason for the “abnormal” result, the test result is just plain wrong.

  62. Thank you again Elizabeth and yes as I read more I see what you are saying about tampons etc. It just fuels my anger. I’m angry because I’m scared and I really have very little reason to be scared. I am also so angered by my Dr’s ignorance and inability to answer my questions and really her shock that I even asked any questions. Furthermore, the woman at the clinic who used scare tactics to tell me not to wait and made it seem urgent that I get this colposcopy and yet booked me for 5 months from now.
    It’s really incredible how these ‘professionals’ just follow a certain policy and don’t understand when we question it. It’s insulting.
    I agree that it is a long shot that the media will do anything about it. The risk for them is too high. They will unlikely want to piss off the big money makers….

  63. I’ve been looking for statistics on cervical cancer prior to paps and I’m not having the best of luck. Because of course the argument is that the reason cc is so low is because of paps and moreso because of the ‘treatments’ such as leep, etc. Yes, my friends that have been ‘saved’ from cervical cancer early detection.
    I want to tell ALL of my friends the truth and want to back it up …. do you happen to have any good links to that information? I’m sure something has been posted on here but i’m having a tough time finding it.

    • [Might have posted this already, but I don’t think it went throught]

      That’s a little like the argument that keeping a rock in your pocket keeps tigers from mauling you. You might very wel not get mauled by a tiger, but it’s not caused by keeping a rock in your pocket. Pretty sure that’s called “specious reasoning.”

      I know that doctors don’t seem to think anything is “hard evidence” if they don’t declare it to be true. A major conflict of interest & very crazy to think that way. Some people also see agreement as defeat, so it’s now that they’re being MADE to agree. They’ll probably clash with someone as a general response, regardless of the subject- and might not “go with” someone refusing a sitaution.

      They seem to use their certification as some kind of proof that reality doesn’t apply to them.

    • Marnie you are asking great questions – I’ve been enjoying the dialogue between you and Elizabeth! Factual information is very difficult to find, as you’ve been discovering. As Elizabeth has said, there is virtually no research that tells us what we most want to know, because it has not been done – and if it has been done is not available to us. When statistics on cervical cancer were collected prior to the screening programs, they were calculated together with all reproductive cancers so included uterine and ovarian cancers in the stats. Also, this is pre-computer era we’re talking about, thus adding to the difficulty in tracking the stats.

      The best research (in my opinion) on the subject of cervical cancer, pre and post-screening can be found in this article: http://www.ncbi.nlm.nih.gov/pubmed/7769901 Unfortunately I believe it is behind a pay wall but sometimes there are ways around this. Other references can be found in the earlier comments on this post. There was a link posted above that takes you to some statistics. Basically, cervical cancer has always been a rare cancer!

      Other sources for factual information can be found under the post “references and education and other women’s health topics” as well as the “references and education” link on the top bar.

    • Hi Marnie, as Elizabeth said welcome to being informed and angry. Now that you know the information about how rare cervical cancer you will find yourself amazed at how much effort and coercion goes into screening for this rare cancer. Unfortunately what is behind that effort is the fact that in many places Dr’s receive incentive payments for reaching screening targets. The focus is on money and not women’s health care. The hyperbole that surrounds this cancer far exceeds it’s actual risk especially when you consider that heart disease is the number one killer of women. I have never had any Dr discuss that with me but they certainly talked about pap smears. Lung cancer, brain cancer, pancreatic, and kidney cancer are all cancers that are more common than CC but women don’t go every year to be screened for those cancers and worry about them. Mental illness is also a greater threat to health and well-being but Dr’s don’t talk about or screen for that. What has happened with CC is the popularity paradox. The pap despite not being intended for it was made into a mass routine screening test and it is inaccurate so it creates a lot of false positives. The false positives are recorded statistically which creates a perception of a greater risk and women think they had a cancer scare and tell people to get screened.
      I can’t find any statistics on CC before pap smears (as was written above it was recorded as part of gyne cancers) but I often see written that is has decreased deaths by 50%. So if (in Canada) 400 women died from CC that means before Paps that 800 women died. In Canada there are 17.2 million females you can see how rare CC was and is. As one of the articles posted on here states “a thousand women would have to be screened for 35 years to save one woman from cervical cancer” (I hope I quoted that right). When I first learned the numbers I was shocked and am still angry especially when I read about women worrying and when it is brought up in Dr’s appointments. I really do believe that medical professionals learn that women need paps and that it saves women’s lives and that is all. They don’t learn the real numbers or that there are false positives and why. Your Dr and the woman at the clinic likely didn’t know the answers to your questions. Unfortunately so many women just go along with the recommendations and don’t question. That shows how successful the propaganda has been. There have been no randomized controlled trials on the pap and if it really lowers deaths from CC. What is happening is that lower deaths rates from CC are being attributed to the pap. Correlation is not causation and outliers such as better hygiene, greater use of condoms, better nutrition, and less smoking are not being taken into consideration. I believe lung cancer has declined in incidence without a mass screening program.

      • Thank you so much for your feedback. I am trying to tell everyone at the office everything I know…which is not a lot yet but I endeavor to become as much of an expert as I can. I have absoutely decided NOT to get a colposcopy at this time. well…in 5 and a half months. And I am upset with myself that I am …at 44…only learning to ask questions about this invasive test/procedure.
        Thanks to Elizabeth I actually watched Dr H Gilbert Welch talk on Overdiagnoses on Youtube. It was facsinating! I never would have thought that I would ever be interested in listening to a doctor yammer on for an hour and a half yet I was rivetted. For those of you who haven’t watched … here is the link

        It also helped me decide to never get a mammogram either.
        I am loving getting feedback and having dialogue with intelligent women about this so please keep it coming…. thank you again

      • If you’re interested Gilbert Welch has written books on cancer screening. There are three, OverDiagnosed, Should I be Tested for Cancer Maybe Not and Here’s Why, Seeking Sickness: Medical Screening and the Misguided Hunt for Disease. I haven’t read the last one.

      • I actually attended a conference on evidence based medicine in Oxford last year and I can tell you I was riveted for two whole days. I was also, in awe of the amazing people who’ve taken on the system, rare individuals, and some have been punished harshly for their failure to play the game and keep women ignorant and compliant.
        Yes, the Raffle et al study is a good one and the summation, 1000 women must screen regularly for 35 years to save one woman. It’s shocking, we waste millions focusing on a rare cancer while other areas of medicine struggle for funding.

        I’ll pull together the best references for you, sadly, some of the good ones are locked behind pay walls, can’t be too careful, don’t want ordinary women looking at the evidence.
        I’ve found most doctors, nurses etc. have just accepted the screening story or just feel it’s safer for them to push screening, or they put incentives ahead of informed consent or consent itself…the harms of screening have always been dismissed as minor, without mentioning them to us, so the view is cc is a serious matter, biopsies etc. are not life threatening, so even if we save one life, the impact on healthy women is worth it from a public health point of view.
        The problem with that thinking is the outrageous assumption they have the right to make that call for me, this is my asymptomatic body and I’ll decided what will and won’t be done, and I do not consider over-treatment to be a minor thing. I think that assessment came about because the medical profession still harbors unhealthy and outdated attitudes about women, our rights and bodies.
        Many women will not accept your advice, you may even get some angry or rude responses, you might be called crazy, but as more women get to the evidence (and that’s not easy) women will start to hear more from non-screeners. When I was 25 in 1983 you wouldn’t dare say you didn’t have pap tests, the atmosphere was so oppressive you could barely breath, now more women are speaking out, that’s a good thing.

        I was amazed when Dr Margaret McCartney publicly stated she does not have pap tests…what? Unthinkable that someone in medicine should make this admission, at the very least you keep that to yourself. Women have felt cornered because everyone seemed to say pap tests were essential and you were mad to “avoid” them, it’s a serious crack in the fortress wall when someone in medicine alerts women that they actually have a choice and that refusing them must be a reasonable choice if a doctor has rejected them. That is the fear, you can discredit a woman, but it gets harder when doctors speak out.

        Prof Baum was attacked when he first questioned the information being provided to women on breast screening, really savage stuff, yet now he’s one of many who all say the same thing. Safety in numbers has still not resulted in more honesty in cervical screening, I think the promotion of the pap test to the status of a feminist icon hasn’t helped either.
        A small number of women may be helped by pap tests, but that does not make screening a mandate, it should be our choice. Also, there were far better ways to reach these women without causing this level of harm and worry.
        I think the casual dismissal of female autonomy and bodily privacy seems to stem, in part, from the fact we might or have given birth, so self-testing and less testing is viewed as unimportant, women are supposed to get used to intimate examination, we have babies after all. That’s clearly an outrageous statement, we need to challenge those who think they have the right to dismiss our rights, tell us how we should feel etc. these attitudes must be driven out of medicine and that will start with individual women rejecting these attitudes.

        Don’t beat yourself up, many women NEVER find out, Dr Joel Sherman was amazed by our posts and did his own research and was amazed to find the cancer was indeed rare, from the start, not because of screening, so many, even in medicine, accept screening has made this cancer rare, which is not true.
        He was also, surprised by the level of over-detection and over-treatment and the lack of evidence and risks with routine pelvic exams etc. in response he wrote a rare article, “informed consent is missing in cervical screening” which appears in the WSJ and on the Kevin Md site. His own wife has had more than 40 pap tests!
        So the important thing is your mind was open enough to question and look for answers, so many women just climb into the stirrups, I don’t blame them, I blame the powerful system that intended to turn us all into a compliant herd.
        As well as this site, The Violet to Blue site lists lots of articles and studies, it hasn’t been updated in a while, but is still worth a look. Google Violet to Blue and cervical screening.
        Another interesting lecture is “Breast Cancer Screening, the inconvenient truth” by Prof Michael Baum. (You Tube and the London University site)

    • Just a quickie Marnie!
      The pap smear was introduced in the USA at around the same time as the incidence rate began to decline – so the thinking has always been that that decline has been due to the Pap. Which is, as we like to say on this side of the pond, a load of cobblers!
      If a disease is rare in the first place you have to screen huge numbers in order for the test to have any impact. And mass testing in the US didn’t start until decades later. So that decline is purely coincidental.
      It might help if you look for statistics from other countries… I spotted a graph with UK statistics from 1950 onwards – it shows quite clearly that the mortality rate for CC was in decline long before our national screening programme began (in 1988).
      Also, don’t forget the hysterectomy rate is the USA is the highest in the world and most are performed for benign conditions… you can’t get cervical cancer if you no longer have a cervix, right?

      • Thanks Kate! Gosh I love this group of women. I’m trying to make myself feel better … really I am. I”m trying to focus on the fact that in most cases HPV does not lead to cancer and for most people…goes away on its own with no symptoms or problems.

      • Don’t know if you saw this in the UK, but Angelina Jolie apparently got her boobs cut off because she heard from doctors that she had a high potential to get cancer. Potential! Didn’t even have cancer.

        They made it out to be some kind of “empowering” thing. Particularly a “female empowerment” thing. But I don’t get how it’s empowering for a woman to get parts of herself cut off- much less distinctively female ones. I also don’t get why they didn’t portray leading a less cancerous lifestyle as a preventative or treatment measure as empowering.

      • Hi everyone again…. well I’m for sure on a bandwagon now. 🙂 I want to start putting a more positive spin on all these diagnostics and stats I’ve found.
        Without screening at all … over a woman’s lifetime she will be fine 98.5% + of the time.
        With screening 99.5+ % of the time she will be fine.
        It has been hard to find but I did find some sites that gave me stats on HPV + cases and now I can’t find them but I did write down that even in women 40 and over who are HPV+ 80-90% of the time they never have abnormal cells. And even when they do have abnormal cell , it does not mean they will get cancer.
        My friend has suggested I start a video blog of my journey with this and I think I might do that. Let me know if you want me to post it here if I do…. I don’t have to but if you’re interested.

        Also, I found a pamphlet on colposcopy treatment and I love the part where is says that there is less than a 2 % chance of infection and they brush it off like it’s nothing. But…isn’t that more than my lifetime chance of getting the cancer in the first place? crazy.


  64. I found this interesting article, I’m not sure if it’s ever been shared or not …
    I made special note of where the author says ‘colposcopy itself presents no significant risk to patient health’. I’m thankful that the author’s reply ‘respectfully disagrees’ with this.
    I must admit that I am in a real conundrum here. Because of the beliefs I’ve had all my life regarding paps and cervical cancer, I am so very concerned about my risk now that I know I have HPV. Even though I have read several articles saying that most HPV goes away on it’s own, most of them refer to ‘young women’. I desperately do not want to get my cervix cut up…. and so…. I don’t know what to do. I’m going to keep following this…I’m going to keep reading….I will stay informed. I’m trying to find out if I can self test for HPV here in Canada and I haven’t found how to yet. I’ll let you all know….

    • Why not contact Delphi Bioscience in the Netherlands? They post the Delphi Screener, (the HPV self-test device) to Australia (from Delphi Bioscience in Singapore) so they might be able to help you. Hopefully, it would get through, although I know Canadian customs are tough and confiscated the Pill that was ordered online by one of our members. Tampap is available in the UK, do they post off kits? Anyone know?

      In some countries being HPV+ means being over-screened with the pap test and having an immediate colposcopy/biopsy, regardless of the pap test result. (they know the pap test is unreliable) It’s going gangbusters, the Dutch simply offer a 5 yearly pap test to the 5% who are HPV+ (and aged 30 to 60)…and with ASCUS I imagine they’d re-test you in 6 months or a years time. I doubt very much they’d do a colposcopy/biopsy for ASCUS.
      I’ll check HPV Today and see how they manage women in your position. I think following an evidence based program gives you the best protection from rare cc and from the much greater risk of over-treatment/excess biopsy. (for those who wish to test)

      If you were tested for HPV+ more than a year ago, you may well have cleared the virus.
      I can understand why you’re worried, but remember even the 5% of women aged 30 to 60 – well, most will not benefit from pap testing, the risk is just so low, 0.65% is the lifetime risk of cc. Rare is rare.

  65. There is an article called, “How should HPV+ women be triaged in population based screening?” in Edition 24 of HPV Today. Those who test positive for a high risk strain of HPV are offered an initial pap test (the baseline) and then another one at 6 or 12 months, this system reduces the number of women having colposcopies. You could send them an email to find out how they manage a HPV+ woman with an ASCUS pap test.

    • Thank you so much for all your replies and sensitivity to my fear. I am going to be fully informed before I make a decision about anything. I just talked to a girlfriend about it and she said that she had two cryo (i forget the name) treatments before she was 25. She said she was hpv + and had ‘stage 1’ the first time and ‘stage 2’ the second time. The sad thing is that she believes she was ‘saved’ from cancer. After reading all I have I realize that she likely would have cleared it all on her own.

      • Marnie, perhaps you should ask your friend if she was in a relationship at the time of her initial HPV diagnosis – if the answer is yes, ask her if her partner was also treated.
        Well of course he wasn’t – no man in his right mind would allow his happy place to undergo such barbaric ‘treatment’, especially when the virus really isn’t a problem for him.
        Think about it though – HPV is now being classed as an STD, and if you’re diagnosed with an STD you’re advised to tell your partner/previous encounters so they can get tested/treated too, right? Common sense.
        So… if her partner was also infected with the virus, then providing the cryotherapy (I love how medicine classes cut, poison & burn as ‘therapy’) actually removed all of the infected skin, her partner would simply have reinfected her. Or maybe there was some residual infection left behind which simply got worse due to the ‘treatment’. Remember that women’s healthcare is still reliant on practices from 60+ years ago – it sure ain’t rocket science!

        Our NHS says that if you need to have a repeat pap smear, usually due to an inadequate sample, you should wait at least 3 months – because apparently it takes that long for the skin to fully regenerate afterwards!
        So it takes 3 months to heal after a simple scrape, yet, if you have ‘treatment’, you’re advised that healing takes place in 4 – 6 weeks. Doesn’t add up, does it?
        I’ve seen posts all over the web from terrified women who’ve had a follow-up pap less than 3 months after a lletz – these poor women often have *yet another* abnormal result because their bodies haven’t had time to heal properly.

        If your friend was indeed reinfected, her cervix was likely still going through the healing process and was thus more vulnerable to the virus. Or any type of infection, for that matter. That may have been the reason her colposcopy results were worse the second time round. Just a theory, of course, but something to think about.
        That’s if the ‘abnormal changes’ were caused by HPV in the first place.

        Anyway, Elizabeth’s quite right as always. In many other countries she would never have been tested at such a tender age and yes, most likely would have cleared the virus in due course.

        P.S. Personally, if I wanted to check my HPV status and discovered I was HPV positive, that might be a cause for concern because I would know in my case it was a persistent infection – since I haven’t done the horizontal tango for a few years now (as Boy George once famously said, I’d rather have a nice cup of tea!) it couldn’t be a recent infection.
        I guess what I’m trying to say is that YOU are the best judge on such matters, not some quack who’s thinks they’ve got the right to make decisions on your behalf.

        Sorry for the ramble, folks. Time for bed methinks. 🙂

      • Thanks again for everyone’s support. I know that it comes down to me to make a decision, and as funny as it sounds…I didn’t really know that before.
        Also, I am trying to find more and more about HPV but it’s hard to get some hard facts on it as well.
        I know most women under 30 will clear the infection but I’m not sure about women in my age bracket. Also, what percentage of ‘persistant’ infections actually cause cancer? I doubt there are numbers on it because everyone gets ‘treatment’ for it.
        I did find another doctor who is more patient centered than most
        The comments after are also very encouraging.
        So there’s lots of news on paps. I get it now that paps are not as necessary as I once believed. Now my goal is to find out more on HPV.
        And here’s a question….Why isn’t there a vaccine for men? They get it too then pass it onto us. Shouldn’t there be a vaccine for both? (Not that I believe that vaccine does a lick of good. My point is that this is really a problem for both sexes. Michael Douglas’ throat cancer was apparently from HPV so that’s why I raise the question.)

  66. If she’d been Dutch, Finnish or even British she would have avoided the treatments, she would not have been pap tested at all for her own protection.
    No country in the world has shown a benefit pap testing those under 30 and the UK concluded it was unethical to screen those under 25, 1 in 3 will be “abnormal” – either the pap picking up normal changes in the maturing cervix or transient and harmless infections. HPV primary testing is not recommended either as 40% would test positive, by age 30 that number drops to 5%…so pap and HPV testing is NOT recommended until age 30 in evidence based screening found in Finland and the Netherlands. (and the UK does not test before 25)

    The sad fact is these very rare cases in those under 30 will occur whether you screen or not. You’ll notice the rare cases involving a young woman are often those who’ve produced a recent normal pap test (false negative cases), the reliance on the pap test may falsely reassure women so that a normal result wins out and symptoms may be ignored or result in a delay in seeing a doctor. (so later diagnosis)

    Finland and the Netherlands advise young women to see a doctor with any unusual and persistent symptoms, they don’t complicate the matter by pap or HPV testing these women.
    These very rare cases tend to be adenocarcinoma, an even rarer form of cc and a type usually missed by pap testing. (which was designed to prevent squamous cell carcinoma)
    So I’d say your friend was almost certainly over-treated, she should not have been tested in the first place.
    You see the problem though, this screening, of all screening programs, has the most “survivors”…read over-treated. How many will believe they were screened and treated unnecessarily?
    By Stage 1 and Stage 2 I assume she means CIN 1 and CIN 2, young women can produce very abnormal pap tests, but this does not amount to “catching” or preventing anything, we just worry, damage and mislead a lot of women.
    Interesting in countries that test young women you find huge numbers having biopsies etc….yet the countries that don’t screen have the same or lower incidence of cc without the horrible over-treatment.

    • Sounds like Britain is better than America on that. I notice the Brits seem to call things like it is much more than the Yanks do (and it’s weird, because the reputation is the exact opposite).

      Anyone know how the Slavic countries work with that? I know Jola said Poland was pretty dictatorial. I think they even tried to make it compulsory for work!

  67. “A woman with persistent ASCUS/LSIL or ASCUS HR-HPV positive cytology should be referred for colposcopy as directed by provincial/territorial guidelines. (III-A)”
    A Canadian study: http://www.ncbi.nlm.nih.gov/pubmed/23231803 (2012)
    So part of your consideration should include when you first tested positive for hrHPV and when you were last tested. Note the word “persistent”…

  68. AND whether this is your first ASCUS pap test result. I can’t bring myself to call ASCUS “abnormal”…

  69. Even here where we have an excessive program that doesn’t follow the evidence, a low grade result on a pap test means a repeat pap test.
    “If your Pap smear shows you have a definite or possible low grade
    abnormality, your doctor will usually recommend a repeat Pap smear in
    12 months time. This is because HPV is the cause of almost all abnormal
    results, and it usually clears up in one to two years”
    and, “For women who have not had the reassurance of a normal smear in the past two to three
    years, it is safer to have an early repeat smear or a colposcopy.”

    I don’t agree HPV is responsible for almost all abnormal results, a whole host of things can cause “abnormal” results.


  70. 20% of women who have LEEP will have the dysplasia come back. Strange because if they had cin2 before the LEEP apparently 80% would have regressed to normal.

    Where are the real statistics about numbers of women treated for cervical cancer (who actually had staged cancer stage1,2,3or 4, not CIN 3 (carcinoma in situ or stage 0 cancer which is NOT cancer) ? The death statistics are reported. No way of knowing how many women just moved out of the registry area or died of other causes. Of course a woman being healed or cancer or precancer sponteously or by alternative therapies would never be accepted.

    The problem is once a women has an abnormal pap result the hunt is on to find something which means biopsy. Colposcopy itself when just looking with various reagents vinegar (acetic acid) and iodine (Lugol’s solution) and different color lights is not really so harmful physically (only psychologically). The biopsies and the Pap tests themselves do the damage. Considering that the virus that is supposed to cause cervical cancer infects the skin layers by “micro abrasions caused by sexual activity” then how much more is the skin layer damaged by biopsies cutting deeply and scraping up with spatulas and ramming brushes up where penises cannot fit? It is as if they are determined to make the infection spread and go deeper instead of helping women heal or giving them time to heal.

    The “magical” age of 35 has no medical evidence just arbitrary as far as I can find out. Women are all different and they do not all have relationships and babies according to a medically set time line. When a women enters into a new sexual relationship of course she could be exposed to strains of HPV that are new to her body no matter what age.

    Taking time to clear might be longer depending on her nutritional status and immune system. No one here yet has mentioned that taking vitamins is important to help clear HPV. Take a good multi vitamin,even a prenatal one. Women with low folic acid tend to have more cervical dysplasia.

    • Hello everyone! Just an update here. I have great news…or at least I think it’s great. There is a woman’s show where I live and they are allowing me to put pamphlets into the showbags. I am working on writing one mostly about informed consent. I certainly will not tell people not to get paps done but to ask questions, know the facts and what risks there are in pre screening. what it really means to have an ‘abnormal’ pap. i don’t want it to be overwhelming, nor do i want it to be preachy or scary or any of that. ijust want women to know what i now, at 44, know about all of this. I’m excited! any thoughts anyone has on this…or if you think there is something i need in the pamphlet let me know. it will go out to about 10 000 women 🙂

      • Here are my suggestions:

        (1) That a situation is what it consists of & any interface with a sexual area as a product of someone else’s decision-making is an attack (just like if a doctor poisons someone with a needle, it’s still murder). Properties don’t change by designation, so this being a “medical procedure” doesn’t make it a fictional situation. Ultimately, reality doesn’t take a coffee break for doctors.

        There’s a woman on this site, Ro, that said mentioning all that about properties not changing because of designation really helped to get people to stop arguing the “party line” & actually started being more supportive!

        (2) Right here would be a good place to mention the various risks & inaccuracies. It all applies in the same way & it’s now fairly easy to flow from one to the other more conversationally. It’s a good idea to throw in the fact that if, for instance, someone’s getting backed into a corner with birth control that this is a coercive iatrogenic attack AND reproductive endangerment. Maybe that “iatrogenic attack” means an attack using medical methodologies.

        (3) Taking a second to point out that it’s not immature, stupid, or otherwise defective to have bodily autonomy & self-protectiveness. Nor is it any of those things to think compositionally.

        (4) That altruism doesn’t produce ownership. Even IF someone has charitable feelings, that doesn’t mean they annex people with their decisions.

        (5) If there are financial incentives for reaching target numbers in your country, bringing that up would be a good idea (maybe having the title/code included). Not real good at “following the money,” but I’m pretty sure it’s called a “service incentive payment.” I’m also fairly sure that America, Britain, Canada, Australia, and New Zealand all do this, but make sure if you’re going to add it in.

        These are my top five (in order, coincidentally). I’d really suggest mentioning these points, because a lot of their arguments amount to “what happens ISN’T what occurs.”

        If you’d like more, let me know- but I’d say these are the most important.

      • Easy, refer them to the NCI summary on the risks and benefits of mammograms, you can download it from their website, but it’s lengthy, perhaps, just print out the conclusion and give them the email address.
        Pap tests, now that’s harder, we don’t have an amazing NCI summary.
        (although I think they’re working on the Q: do the risks of cervical screening (population pap testing) exceed the benefits?)
        I’d refer them to the new Dutch program. (Edition 24 of HPV Today) I know many women have started doing their own research after hearing about the new Dutch program and I know more women are using the Delphi Screener.
        My point: it’s your body and your decision, but make sure you’re making an informed decision and focus on evidence-based testing. IF women want to test, HPV primary testing is smarter testing, giving you better protection from the remote risk of cc AND offering MUCH better protection from the high risk of false positives and excess biopsies/over-treatment. Most women cannot benefit from pap testing and the new Dutch program removes these women from the pap testing program, out of harms way.
        I think Dr Margaret McCartney’s articles are helpful too, especially when she admits she does not have pap tests and will not be having mammograms. This shocks many women, what? We actually have a choice…AND it’s a reasonable decision to decline testing, one that must be respected by the medical profession and others.

  71. I watched the youtube video of the overdiagnosis presentation by Dr Gilbert Welch. Fascinating. However cervical cancer screening (Pap test) was not mentioned. He has written several books, all not for profit. All his book profits go to charity. Has anyone read his books? And is cervical cancer screening mentioned?

  72. It’s interesting how women’s health care has been set up so that women don’t realize that they have the choice to make a decision about their health care. We’re not told that we have the choice to have a pap or the well woman exam or mammograms but that we have to especially when we need the pill. I was never given information to accept or decline the pap or the well women exam. The pap and well women’s exam are not required exams for the safe use of the pill. All that is needed is a medical history and a blood pressure test. Any Dr who requires those exams for the pill is acting unethically and is basically committing assault. When you look at the Canadian Medical Association code of ethics it states:
    21. Provide your patients with the information they need to make informed decisions about their medical care, and answer their questions to the best of your ability.
    24. Respect the right of a competent patient to accept or reject any medical care recommended.

    But when it comes to paps and women’s health care in general those ethics are ignored.
    It didn’t occur me that I could reject paps and the well woman exam and eventually mammograms. That shows how effective the propaganda has been and that the medical profession doesn’t respect informed decision making when it comes to women’s health care. Information provided to women about these exams use the words should and must. Look at the Canadian Cancer Societies website where it states: “Women who are sexually active should have regular Pap tests by the time they are 21 years of age, Pap test is done every 1–3 years, depending on the screening guidelines in their province or territory, women who stop having sex should continue to have regular Pap tests, When a woman has a Pap test, a pelvic examination may also be done to make sure the pelvic organs are normal and to check for infections.”
    Compare that to the information about prostate cancer: “Men over the age of 50 should talk with their doctor about whether they should have testing for early detection of prostate cancer, research currently shows that the risks of testing for prostate cancer may outweigh the benefits of screening men at average risk of developing prostate cancer. It is important for men to talk with their doctor about their personal risk of developing prostate cancer and about the benefits and risks of testing.”
    It is estimated that in 2013 23,600 men would be diagnosed with prostate cancer and 3,900 men would die while 1,450 Canadian women would be diagnosed with cervical cancer and 380 would die. But men are given a choice and informed consent while women are not. The difference in the language is powerful and it shows how women have come to think they don’t have a choice in their health care. We’re just expected to comply and to go along with all recommendations. If we don’t comply we’re lectured in appointments and hounded with letters and our other health care needs ignored (I remember reading one story of a woman whose Dr declined to prescribe asthma meds because she wouldn’t have a pap smear) or in some cases denied access to health care all together with Dr’s dismissing women as patients who don’t have pap smears. That is also unethical as quoted above and also the CMA code of ethics states: “19. Having accepted professional responsibility for a patient, continue to provide services until they are no longer required or wanted; until another suitable physician has assumed responsibility for the patient; or until the patient has been given reasonable notice that you intend to terminate the relationship.”

    • Hmm I posted something hours ago and it’s not here ….too bad it had a link in it. Oh well. Basically, I’m on a mission now. I want people’s perceptions to change. I also don’t want people thinking they have a -1 % chance of getting cc…they have 99+ % of living a healthy normal life.
      I also discovered that of the hpv+ women 40+ out there 85-95% will also go on to live normal healthy lives without the worry of cc. The other women do have ‘abnormal’ cells but as well all know that doesn’t mean cancer. The body could possibly get rid of them if given a chance or they could just sit there being weird and that’s it. Incredible.

      • Always like to hear from another informed woman on a mission, on the bandwagon, on her soapbox, anywhere actually…keep reading and talking!

        Many women spend years climbing into the stirrups having more and more of their cervix removed until finally some are happy to get rid of the lot and have a hysterectomy. (600,000 are performed in the States every year) On some American health forums I’ve heard women say they’re sick of all the gyn stuff and just want it to stop, so they’re considering/having a hysterectomy. Of course, many of these women still go on to have 6 or 12 monthly pelvic exams and pap tests even AFTER the hysterectomy because they have a history of “dysplasia” or “abnormal” pap tests. There is no escape for these poor women who live in fear their entire lives.

        The misery this must cause is hard for me to fathom, someone who has never had a pelvic exam or pap test. There is no doubt in my mind this is no life at all and I know many women end up carrying permanent damage, physically and emotionally. There are threads on forums dedicated to cervical scarring and the problems it causes – infertility, the need for c-sections, it can interfere with menstruation and lead to infections and possibly endometriosis etc. It illustrates how common it is for women to have cervical damage, often after early treatments. (when the risk of a false positive is at it’s highest)
        I know there have been at least two suicides after a false positive mammogram.
        It makes me wonder just how many women go down that path as a result of these “life-saving” tests and exams.

        There have been some tragic posts over the years, women who’ve suffered badly as a result of over-treatment – from unnecessary hysterectomies, women who’ve lost premature babies (born early after the cervix failed, damaged by an early “treatment”) women who almost died, one woman had an emergency hysterectomy after she almost bled to death after a cone biopsy, others end up with cervical stenosis or incompetence etc…the list is long.
        We’re told these things are rare outcomes, BUT the cancer we’re trying to prevent is RARE. Why is the rare event of invasive cervical cancer the only thing they see, is it a success to harm so many in an attempt to help a few? I say NO.
        NO screening test or exam is risk-free and as you’ve found, the risks with these tests and exams are usually far greater than the thing they’re trying to prevent.
        I’ve lost count of the accounts over the years, and it’s been hard…when you KNOW almost all of this damage was/is avoidable.

      • Good luck and be prepared to argue because you’re going to encounter resistance. The need for constant monitoring of the female sexual organs has been engrained into our culture. Many women do not realize they can decline screening but it is also deeply believed that to go for your yearly well woman exam and pap is part of living a healthy life style and being responsible with your health. To not screen is viewed as being reckless and a bad wife/partner/parent and if you don’t screen and get cancer it’s your fault and you deserve it. Because of the propaganda women overestimate their risk of developing cancer and most assume that someday they will get cancer and believe that if they catch it early then their life will be saved. Most people do not realize that the deadly cancers that kill usually grow quickly and show up between screenings and that screening is more likely to catch the small cancers that were probably never life threatening but lead to invasive treatments that in themselves could be life threatening. Most women also don’t realize that heart disease is a greater threat to their health. Overall a culture of fear has been created around cancer particularly of the female sex organs with no truthful information being discussed about the risk factors of getting cancer and of screening. What it also comes down to is that even if CC was a real threat to our life we still have the right to say no to screening.

    • I’m not trying to be insulting, but women seem “check for permission” (when it’s not up to someone else to grant or deny) whereas0 men just form a situation to their liking. If someone attacks them, they don’t check if there’s an enemy-supported option to counter this situation or retaliate to it).

      This doesn’t mean that someone should categorically be unconcerned about things like this, but someone shouldn’t outsource the ability to protect themselves to the ones they are trying to protect themselves from. This is a major conflict of interest & an ineffective strategy to do things of this nature. Again, it doesn’t matter if they don’t want to lose.

  73. For the lady with the abnormal Pap test, google folic acid and abnormal pap. You get many results about vitamin supplements helping clear abnormal cells on a pap. Folic acid, vitamin B12 and others are suggested along with dosages. I am I not surprised your doctor did not suggest this? Even some medications such as ones for GERD, epilepsy deplete the body of folic acid or vitamin B12 .

    Also proper nutrition or vitamin supplements can also help for colon polyps. Yet doctors never seem to mention this as they are pushing colonoscopies. Not much risk to take a good multivitamin per day. More risk for all these tests.

    Prostate cancer treatment results in impotence and urinary incontinence. This is why men are not pushed for testing or screening. Apparently womens sexual pleasure, fertility or hormone levels are not important.

  74. Clare, contact Delphi Bioscience, they might be able to mail the Delphi Screener to you. I know a few Australian women who’ve used it, I don’t think it’s that expensive.
    If you’re HPV- they recommend you re-test in 5 or 10 years time and pap tests are unhelpful for HPV- women. Also, if you’re HPV- and confidently monogamous or no longer sexually active, you might choose to forget all future testing.
    So if a woman wants to test, sounds like a good deal to me, far better than numerous pap tests with the high risk of an excess biopsy or over-treatment.
    (Note: HPV testing is recommended for women aged 30 to 60…and pap tests are of no benefit to those under 30…and now we know can’t help the vast majority of women (age 30+) who’d be HPV-)

    Also, Tampap is another HPV self test, currently available in the UK.

    • Hi Clare, I have tried emailing the Delphi and they still haven’t gotten back to me. I have found that the test is around 30 dollars but I don’t know where you live so that may not be accurate. I’ve done TONS of reading about HPV and hope you know that even if you are HPV + it doesn’t mean you have cervical cancer or that you will get cervical cancer.
      I just read this article about the benefits and risks of HPV testing if you’d care to read it…
      The women in this blog are amazing and I encourage you to post here any questions or comments you may have.

      • mgpr, Are you American? Sorry, I’ve forgotten…
        I’ve contacted Delphi Bioscience in Singapore a couple of times, I could send them an enquiry and check access in your country. (or one close by, save those frequent flyer points or $$$s, for those women who want to test, it’s definitely worth the effort)

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