Recent recommendations by the Canadian Task Force to stop pap testing women under the age of 25 have not been sitting well with the Society of Obstetricians and Gynecologists. The numbers of women undergoing cervical cancer screening have been steadily declining in recent years, and the numbers are poised to drop even further given the new recommendations to stop screening women under 25. Ob-gyns are beginning to fight back by claiming young women are being placed at risk by not screening, but the evidence gathered by the task force strongly suggests otherwise.
The task force has utilized research revealing that more harm than good is being caused by screening women under the age of 25. Cervical cancer is extremely rare in young women, while at the same time the pap test used to screen for cervical cancer has a high rate of inaccuracy – especially in young women. When a young woman receives a positive pap test result, and in most cases this is a false alarm, she is often sent for colposcopy/biopsy and this is where damage to her cervix can occur. Young women with damaged cervix’s due to colposcopy/biopsy often have difficulty with pregnancy and are at greater risk of giving birth to premature/stillborn babies.
The task force has also compared cervical cancer mortality trends amongst young women in other countries that screen women less frequently, such as Finland. In Finland women are not screened for cervical cancer until age 30, and then afterwards are only screened once every 5 years. In spite of far less frequent screening beginning at a later age, rates of cervical cancer in Finland are comparable to other countries which screen far more often and at younger ages. For example, research from the Netherlands states that “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.” http://onlinelibrary.wiley.com/doi/10.1111/j.1468-0009.2011.00652.x/abstract The conclusion from the research study was that the majority of countries are needlessly over screening.
The battle between the ob-gyns and the task force is all well and good, but there is still a lack of informed consent being offered to women in regards to pap tests/vaginal exams. Each individual should be offered truthful information and be given a choice to screen/what age to screen for cervical cancer – and this would render moot any battle over age of screening.
Also worth noting here is the fact that there has been an absence of complaints made in regards to the task force’s recommendation to cease and desist screening women over the age of 70 – even though cervical cancer, while still rare, is far more common amongst older women than it is amongst young women. “Women ages 65 and older have a cervical cancer incidence rate of 16.8 per 100,000, compared to 7.4 for women younger than 65.” http://seniorhealth.about.com/cs/womenshealth/a/cerv_cancer.htm
The reasons for the lack of concern related to the task force’s recommendation to stop screening older women with greater risk of cervical cancer are unclear.
References:
http://www2.macleans.ca/tag/cervical-cancer/
http://www.cmaj.ca/content/185/1/35
http://www.webmd.com/cancer/cervical-cancer/news/20110308/study-older-women-need-pap-smears-too
forwomenseyesonly 
I’m new to this website. I used to be of the mind that gynecology is the profession for the delusional , male doctor that just, vaguely… hides the fact that he only got into this profession for the pure simple fact that attractive women can be convinced that their vaginas have to be tested annually by a male god sorry….[I mean doctor], I mean a male human being.
Am I right?
Ladies, if your doctor has a penis. NEVER see him for genital exams. got it??
Male gynecologists… go to hell.
there I said it.
“Male gynecologists… go to hell.”
LMFAO!!!!
Yeah, I don’t understand which one is more weird:
The fact that men want to examine boobs and vag’s all day or the fact that women think it’s okay for men to want to examine boobs and vag’s all day.
What an enigma.
I dont care what gender they are the exam is uneceptable to me and I refuse to have a pelvic.
I agree, Anonymous. Ever since I was a little girl, my skin has crawled knowing men are gynecologists. They have no right poking around women’s genitals when they all hate women, think badly of us, and are all perverts KNOWING these exams are NOT beneficial in any way.
Pap tests in young women are even more inaccurate than a coin toss, or not even that. If you toss a coin, you do have at least 50% chance of accuracy.
And it has the humiliating, nasty and dehumanizing aspect on top of that. No, men have no business in gynaecology, but women are no better either. I no longer believe the women that say they’re embarrassed by these exams. If they were, they wouldn’t tolerate them again. Then again, some women are so worried that they cannot let go. It is amazing what people can do when they’re afraid of disease. Just because something is done in the name of health doesn’t mean it’s right
I think there is a degree of truth in what you are saying. Most people who would challenge on my decision to opt out of screening are indeed other women, and they are almost fanatical about the situation. Try explaining the words “false positives” and “informed consent” and they shut down. They seem to have been brainwashed at a young age – from school nurses, the media, female relatives and friends – that they MUST accept this when they are older, no if’s or but’s. I found the total compliance mentality very bizarre when I was younger. Of course, men would not be subject to this because generally speaking, I don’t think they’d put up with it. They’re perceived as being far more individualistic, meaning, they’d say, it’s upto the individual whether they have a test done. Maybe they’re less susceptible to discussing it with friends hence women are far more susceptible to this type of brainwashing IMO. You are right – for this to stop, it needs to start and stop with women. If screening figures were no longer making the enterprise profitable, it’d eventually stop. But while there is still buy in, the practice will continue for the short term at least.
I’m not surprised that they’re resisting the task force recommendations. In Ontario Dr’s get incentive payments for cancer screening and with pap smears if they reach an 80% target rate it’s a bonus of $2200. Taking out patients under the age of 25 cuts into reaching that target and getting that bonus. This puts those letter I was receiving from my Dr’s office reminding me that I was “overdue” for my pap into a whole new light. It’s also adds to the issue that informed consent is missing because the Dr’s interest is not with the patients health but on money.
So glad I found this site, thanx again for a great article.
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Not all the scientific research and statistical data in the world can stop the old school medical community to relax on the unnecessary probing/testing. I have no idea how they manage to give dated and unreliable testing with all the info to prove otherwise, but millions of women will get their annual pap smear next year. Ugh. P
So I have to ask if any woman hear have heard or seen the new US tv show called “Jane the virgin”? Its about a virgin that goes for a pap smear and the gyn impregnants her instead of giving her a pap smear. I am sick of American tv shows pushing gyn exams at woman. Its sad bc most American virgins are told they need gyn and pap smears.