This is a guest post written by Diane, a valued contributor to this blog:
I have this health plan. My doctor was very nice when I told her that I did not want a Pap or pelvic exam, and she hasn’t hassled me about it. The health care plan, on the other hand, seems perturbed that I haven’t toed the line and agreed to have a Pap. A few weeks ago I received this “invitation” in the mail. It offers a bribe of a $50 Target gift card if I go for a Pap before the end of 2014.
I think it is VERY important to note, at this point, that TARGET HAS NOTHING TO DO WITH THIS. They are NOT sponsoring this, donating the gift cards or participating in this ruse in any direct way. The bribe just happens to be a gift card from their store. There’s a disclaimer on the purple page about that. Apparently the health plan is buying these cards themselves.
This promotion is very, very clever, and very, very insidious. To point out the most glaring issues with it:
1. The card is covered with photos of smiling women. What’s the message there? “Getting your Pap is fun, ladies!”
2. “You still need a cervical cancer screening.” Not “you should talk to your doctor and make an informed decision” here, no siree. You NEED that Pap. The language here is clearly designed to make women think that the Pap is mandatory or essential to their continued good health. It takes away women’s agency and choice in the matter.
3. “You could have cervical cancer and not know it.” Fear-mongering, much? You could also have heart disease, ovarian cancer, a brain tumor, or melanoma – and the odds of having any of those things is way higher than your risk of cervical cancer — but your insurance company isn’t going to aggressively insist on screening you for those, are they? And no, they’re not going to mention that your risk of cervical cancer is highly dependent on a number of factors, or that the average incidence of cervical cancer in Los Angeles County is something like 10 women out of 100,000 (“Health Indicators for Women in LA County,” LA County Department of Public Health. Page 14, “Health Conditions – Incidence and Prevalence.”) Nor will they mention that cervical cancer isn’t even one of the top ten most-diagnosed cancers in California (http://ccrcal.org/pdf/Factsheets/Ten_Most%20Common_Types_Cancer_California,_2009.pdf).
4. “…the whole process takes only a few seconds” …and we won’t mention it’s an internal exam in which a doctor or nurse practitioner shoves a large instrument in your vagina, pokes around your cervix, possibly does physical damage, causes you pain, humiliation or PTSD, and performs a test that has a high rate of false positives! Shhhh!
5. “Do it for yourself and for your family.” C’mon, ladies. Take one for the team. The language here makes it seem as though women are neglecting their families if they refuse a Pap.
6. “Find out how to stay healthy…” More misleading language here, eh? There isn’t any information on how to stay healthy in this flyer. I don’t see anything that talks about women’s risks for heart disease or diabetes. I don’t see a list of warning signs for ovarian cancer or a guide to self-examining one’s skin for melanoma. I don’t see good exercise guidelines or nutrition information. Hell, I don’t even see anything about safe sex or preventing STDs here. Nope, apparently the magic key to staying healthy is just getting a Pap, ladies!
7. I suppose it’s Captain Obvious to mention that this entire flyer is written in a very paternalistic, condescending tone of voice, at about a third-grade reading level. They’re clearly assuming that any woman who refuses Pap testing is uneducated, illiterate or too stupid or ignorant to make informed choices about her medical care.
And if that isn’t insidious enough:
This insurance company is one of the two major managed care systems that handles Medi-Cal, California’s version of Medicaid. Thus, it’s safe to assume that a majority of the women who received this notice were low-income Medi-Cal recipients. This “promotion” dangles a $50 gift card in front of women who are living around or below the poverty line. $50 is a lot of money, especially to those who are financially struggling. A gift card to Target is a perfect bribe, too, since one can buy just about anything from groceries to personal care products to clothing there.
In addition, this “promotion” was sent out in the middle of the summer. If you look closely on the flyer, you see a 7/14 date right there in the corner. Why is that significant? The school year in California starts sometime between early August and early September, depending on one’s district. It’s the time of year when many parents stress out over the cost of school expenses…particularly those who are poor.
How many women who received this card were desperate to pay for their kids’ school clothes or supplies? How many were short on grocery money? How many looked at this promotion and decided that they really, really needed that $50 and went for a Pap even though they didn’t want to do it, they were not giving fully informed consent and the test had absolutely zero benefit to them? How many thought that declining the Pap would be “throwing money away” because of that gift card?
This isn’t informed consent. It’s coercion. It’s a pack of lies targeted to a vulnerable population.
forwomenseyesonly 
Reblogged this on the risky body and commented:
Amazing post on insurance company efforts to make women get unnecessary pelvic exams, in this case Pap smears.
You know what the person who wrote this invitation has and doesn’t know it? No writing skills or grammar appreciation whatsoever. This is so poorly written. “You can have cervical cancer and not even know it.” The correct word to use would be may or might – not can. Can implies that you can do something on your own free will or are capable of it. In this context, it would mean that you are capable of having cervical cancer if you so choose. Can always implies a choice. Nobody would choose to have cancer. “Often cervical cancer causes no symptoms or pain.” I don’t even no where to begin critiquing this. It isn’t even an actual sentence. It should be changed to “often times”, or “cervical cancer often…” Furthermore, there is no evidence to back up that claim, so it once again it should read “Often times cervical cancer may…” “A pap test can find cervical cancer or other problems that can turn into cervical cancer.” There we go again with improper use of the word can. That sentence is still a bit “iffy” anyway. It seems a bit incoherent. I can’t place what else is wrong with it, but it reads very poorly. “These are easier to cure when they are found early.” Was the writer not taught to site their sources and facts? I want to see actual statistics and proof. Otherwise, those words are meaningless to me. That sentence seems a bit off as well. This whole thing was just a mess to read. I didn’t even want to start on the second paragraph. (Also, I would like to note that I don’t actually go around critiquing everyone’s grammar, but if someone’s going to have a dictatorial, paternalistic attitude I will do as please and call them out on everything I find fault with.)
Anyway, it’s terrible that they’re doing this. I said this fairly recently in another comment, but the number of informed women must be steadily increasing. They’re continually grasping tighter and tighter trying to get women to participate. It’s just disgusting and awful (and other foul words I won’t use) that they’re targeting low income families this way by dangling money in front of women. You know what I think? I think that every woman who writes a strongly-worded letter to this company should get a gift card. I think that every woman who asks for unbiased information and will only give informed consent (this includes declining) should get a gift card. I think that we, as a human race, should focus more on helping people in need so that no woman – or person – would EVER feel they have to compromise of themselves in this way or do something they aren’t comfortable with to provide for themselves or their families.
Also, I was so angry and typing so quickly that I typed “know” as “no” and now look like a hypocrite LOL.
Actually you’re quite right about the vegetarian diet, it’s not necessarily healthier, they may eat more sugar. The vegan bakehouse here is amazing, all sorts of donuts, cakes, pastries, many are gluten and dairy free, but most have sugar.
The low fat thing confused a lot of people, I did some personal training a few years ago and worked out I needed a new trainer fairly quickly, I was told to snack on jelly snakes during the day, that might be okay for elite athletes who need the energy, but the rest of us are just taking in extra sugar, the choice was justified to me, “they’re fat free”. Yes. but…some low fat yogurt had added sugar. So the low fat diet can pile on the kilos and may not be great for your health if you’re getting more sugar.
I agree we have to know more about our food, I choose not to eat red meat these days, but still eat chicken and turkey, so buy the best on the market and just eat less of it, real free ranging chicken, sometimes corn fed, and I buy the same quality for my husband. He prefers to eat something that had parents and loves pork, I’ve been buying free ranging pork that’s allowed to snuffle around in an orchard.
I work in Japan now and then and I know many are concerned there about food being contaminated with radiation. My interpreter goes to great lengths to ensure the food she buys is “clean” for herself and her family.
My aunts (my father’s sisters were a lot older than him) used to say everything in moderation and they lived into advanced old age, but they also, lived in the country, grew their own vegetables, kept chickens “the girls”, did their own cooking, baking, bottling/preserving. I always come back to basics, that’s partly why screening is not a good idea, it shifts the focus and can lead to false reassurance.
Two of my aunts were vocal critics of screening, they considered it pure insanity to put your breasts between two plates, have them squeezed flat and irradiated. How right they were…and they certainly didn’t have pap tests. Any doctor who mentioned pap testing to them…well, let’s just say it was never mentioned again. “Is there something wrong with you, young man?” and THAT stare, that steely resolve…that kind of thing. They died long ago, but pap testing was around here in the 1960s, (perhaps even earlier) the screening program arrived later, so I guess they would have been in their early 50’s at the time.
Breast exams and screening were loudly dismissed as utter madness. These women were great role models for me, they’d have snorted at the suggestion they were feminists, but certainly they were well ahead of their time when it came to women’s rights. I can recall feeling a bit anxious about women’s “healthcare” in my late teens, but then I remembered my great non-screening aunts, it was comforting when it felt like I was the only one who had a problem with the way women were being viewed and treated.
I totally agree that the change in tact that these “campaigners” are now employing is a result of more women challenging the system.
In the UK, there’s been a decisive shift in campaigning tactics over the past five years too. Campaigners are loudly protesting that UK screening rates are at an all time low – a third of under 35s are now refusing to screen and that figure is rising. These same campaigners have been saying women are too busy due to the pressures of modern life (yeah right) to attend their screening appointments orthey are too scared, so the tactics have changed over the past five years from telling women they “must” screen, to emotional blackmail, about the dangers of contracting the disease and leaving their children behind. It’s equally appalling, but also a telling sign that the tide has started to turn. Contrary to being “scared” or “too busy”, I’ve heard in other outlets a growing number of women state they have made informed decisions to opt out of screening in an unapologetic and matter of fact way so I think it is clear evidence that women are challenging the system.
Out of interest, does anyone have any statistics on the percentages of those declining pap screening in the US, Australia, NZ and Canada?
What’s it called again? When someone, male or female, tries to give someone $50 to let them “play doctor” on them?
Ro: I think what’s tripping you out about all this is that there’s a contradiction between description & situation. It’s a bit worse when it’s put in a more science-y kind of way & it IS getting portrayed in a very direct & blatant way. There’s no disclosure about risks, inaccuracies, or alternatives & the presentation is conveying things that are, at best, half-truths.
This is all about a serious subject & done in a very deliberate manner. It’s interesting how they’ll go to extreme lengths to prevent people from smoking, that they’ll go on & on about alcohol, and they’ll on a nearly constant basis demonize basically all food that is actually nourishing & sustaining- yet they’ll advertise, champion, and frequently impose things on people that do cause detriment or simply is a problem on its own.
They’re enemies, plain & simple. Maybe not each & every one of them, but there’s obviously some kind of orchestration & group activity. However it goes on, these efforts DO get launched.
One more thing: Some people make excuses & arguments for other people when they do something, as if they don’t do things like that. Like doing something is not evidence THAT they do things like that!
I don’t see how someone’s actions are NOT indicators of what someone’s behavior is. It’s like the argument is “Well, that’s what they did- but you can presume that this is not something they would do.” They already did it! It’s not a guess!
It’s disgusting, is what it is. You know what I just realized? They’re giving out TARGET gift cards. The irony of that has not escaped me. I wonder if it was a Freudian slip on their part or just a random choice?
I think you’re right. Nothing seemed to fit together and the wording was way off. It was contradictory beyond belief. In relevance to this situation, I was minding my own business going to the store yesterday and I saw a billboard advertising pap tests! I was shocked and dismayed. There was also something underneath that about women having STDs and not knowing it (why do they always claim we’re probably dying from something we don’t know we have?) (Another side note, it’s interesting that we live in a culture which simultaneously tells women they should be overtly sexual and that those who choose abstinence until marriage or a celibate life are bitter and frigid, but at the same time, tells them sex will be what kills them.), but I’m not sure why that was tacked on as the pap test doesn’t test for STDs, only changes in the cervix which may or may not actually be of any concern. There was something they were giving away for “new patients” as well. They just have bribes coming out of their ears these days. I really do think it’s a good sign though. If they’re having to reach that far, it must mean that women are becoming informed, making the right decision for themselves personally, and standing their ground. We aren’t buying into the population screening propaganda any more.
In regards to demonizing good food, I read a study a few days ago claiming that vegetarians are more likely to end up with cancer, diabetes, depression, and anxiety. The percentages from the “study” showed vegetarians at a MUCH higher risk for all of those. I think it was 4x the risk for cancer and diabetes and 2x the risk for anxiety and depression. I’ve been a vegetarian essentially my whole life simply because I just don’t like meat. It’s never tasted good to me. Reading that study freaked me out a bit, but I realized these are also the same people promoting GMOs as being safe and healthy, so it’s probably meant to be taken with a grain of salt. (Also, that isn’t to say that I think meat is a bad thing because I don’t. I just don’t necessarily buy in to the notion that vegetarians are any less healthy.)
Someone’s actions most certainly ARE an indicator of their behavior. On a basic level, aren’t the actions of others how we decide who we want in our lives and who we’d rather stay away from? I think a lot of it has to do with the fact that people think doctors are far more intelligent and superior than they are and society turns around and enforces those ideals. So that’s why people don’t assume their actions define their behavior.
Maybe only the vegetarians that eat GMOs as their general diet get cancer? Seems like a stupid way to advertise, but it could have been “Oh, the regular vegetables are going to kill you- but the genetically modified ones will be fine.”
The idea of intelligence equaling superiority IS fostered in this society. There’s no concept that these people should be humble- they’re basically allowed to act like spoiled brats! That’s blatant stupidity to do, since know there’s an asshole with whatever expetise they have.
The problem with a lot of studies is that they forget that correlation does not equal causation. And one needs details…”vegetarian diet” is very broad. Even without meat a person could eat an unhealthy diet. A person who chooses to eat meat can be healthy…are they eating lean poultry or fatty steaks, for instance. And how are they prepared? What else is the person eating? Et al.
I’m also vegetarian and the big bogey I’ve heard is about people who rely on soy for their protein. Bad idea, since it is a natural estrogen and could disrupt a persons endocrine system in no time at all. But that isn’t tlling me anything about their diet specifically, what they take in terms of medicines, their exercise habits, their genetic factors, etc.
Alex – Even people who don’t eat a strictly vegetarian diet could be regularly ingesting GMOs and other harmful chemicals. Are the animals being used for meat being fed GMO produce? Are they being injected with hormones? So I don’t necessarily know if there’s any correlation there. In both groups I figure people would have the same risk from GMOs and chemicals on average, it would just come from different sources. I liken what you said in the last paragraph to the typical bully scenario in films. The guy is always the captain of the football team, and the principal and whoever else was in charge would turn the other cheek because, “Hey, he’s a superstar at this school!” That’s sort of how society views people who are perceived to be exceptionally intelligent. Personally, I believe every single person is exceptionally intelligent in at least one area, but there are only two areas of intelligence which seem to matter to society: scientific and medical.
Diane – I agree. I read a comment on the article where someone complained about that, actually. They suggested that because people had been diagnosed with those things, they switched to a vegetarian diet to help combat those illnesses. Which I would consider a great possibility since it was never touched on and I know that people with diabetes typically do veer towards vegetarian diets. So it makes sense that, that would have been the case. And as you said, we still would know nothing about their medications, soy intake, protein sources, or what else they eat. People could consider themselves vegetarians and eat a diet of some healthy food, but lots of potato chips, sugar, and unhealthy foods. There was no clarity about any contributing factors whatsoever.
You know, as far as food goes, it seems that going lean actually causes some problems- namely lack of “fuel” & that there ARE vitamins & such in the fat (so “nutrient content,” I suppose). A point is that any food is going to be a problem if it’s contaminated & that’s a very common thing in this country.
Historical Tid-Bit: There was this guy Ancel Keys that thought that read meat caused heart problems (actually called the “diet-heart hypothesis”). He went to a Catholic area of Europe during Lent (when people wouldn’t generally have been eating meat) & right after World War II had ended (when there wasn’t much to eat in the first place), then he said “They don’t eat red meat & they don’t have heart attacks.” This got added into medical information & that snowballed into all kinds of initiatives- that apparently cause a shitload of problems. Looking this up will give at least two interesting articles.
Side-Note: It seems that this guy actually said in 2002 that they’d known all along that this was bullshit! Well, maybe he just found something to latch himself onto (at the time, heart attacks were a new epidemic), that he could use to further his career by providing a false answer to the problem with, and just kept insisting & insisting that this was the case.
Maybe he knew it would cause problems. Cholesterol is used to make hormones & not just reproductive ones, cortisol for regulating blood sugar & defending against infection, vitamin D production, bile for digesting food & absorbing vitamin A, D, E, and K (which seems to be what you need to absorb calcium & phosphorous for bones & teeth). It seems some type of it actually keeps your blood vessels from being clogged!
I don’t think there is enough money in the world to pay me to undergo that. So effectively, they’re asking women to perform a version of prostitution, or am I being too radical? And we still don’t know what they’re doing with all this “vital information,” do we?
No, not at all. It’s getting a Target card that amounts to $50 worth of purchases in exchange for letting someone probe you. It’s not being radical to describe things for what they are. Just like it’s not stupid, immature, or crazy to think compositionally (“a situation is what it consists” of thinking- not a real common term, so I thought I’d elaborate). It’s not defective to have bodily autonomy or self-protectiveness, either.
It’s like when people get mad that you say something like this being imposed is an attack. If it’s an interface with a sexual area (particularly a penetrative one) as a product of someone else’s decision-making, it’s an attack. What’s someone going to argue? That a situation is NOT what it consists of? No, what happens is what occurs & reality doesn’t take a break for doctors.
I guess $50 is a lot of money when the piggy bank’s empty. Some women are driven to prostitution through desperation too, so I see the comparison. But then bribing women in the name of ‘good health’ is nothing new. One healthcare trust in the UK decided to award girls around $70 worth of shopping vouchers for getting all their HPV shots.
But then I think of the way we’re treated by the NHS. We’re automatically enrolled into a government system without our permission, often coerced into having a penetrative exam against our wishes (for our own good, yo!) the perpetrators of what is tantamount to sexual assault are rewarded for coercing us into and conducting the assault and WE are the ones paying for it all through our taxes. Don’t know what you’d call that. I did accuse one particular obnoxious GP of acting like a pimp. Except they get ALL the money.
How’s that for radical?
a gift card to get a pap test what bull. thry mostly like get cards for a few cents. isn’t someone’s health more important than a gift card.
Why is it men aren’t being offered gift cards to Home Depot if they get a prostate exam? Fewer men even get a prostate exam once in their life compared to the many times the average woman has a pap. So why are they pursing women?
It’s outrageous, but this is the way they’ve always treated women. These measures are unlikely to affect male behaviour, but I’ve read this sort of tactic is fairly effective with women. I’m speaking generally about coercive and unethical tactics used to get women screened, not gift cards, this is a new low. Few women complain about this treatment, in fact, the propaganda has been so good for so long, most will probably feel guilty, afraid, silly etc. Our member was outraged but she’s in the minority, an informed woman.
It’s appalling conduct, but nothing surprises me about this testing, once you think they’ve hit rock bottom when it comes to the law and ethical standards, someone manages to think up another coercive and offensive tactic.
I’m tempted to email them, I’m Australian and not directly affected by this tactic, but it offends me across the ocean to see an organization who thinks this is an appropriate was to “offer” screening and obtain informed consent. Of course, any woman harmed by this coercive tactic would have an open and shut case against them, but then they probably figure most women will never get to the evidence, they’ll remain unaware or even grateful after an excess biopsy, it “might” have been cancer.
They probably wouldn’t have an open & shut case, since the court would likely figure “Well, you took the money.” They sure as shit don’t pursue things like doctors backing teen girls into corners the way they do with the same teen girls drinking or smoking.
Excellent post about the usual insanity… btw the model looks like Beyonce!
Didn’t catch that one! You’re right, it could be an angle for advertising- at the very least, to black women. Ironic, considering that this branch of medicine came from a guy that used to experiment on female slaves.
Ahh yes Alex……the kind, considerate Dr. J. Marion Sims (1813-1884) who has been called The Father of Gynecology, and was the first physician to have a statue erected in his honor in the United States.
The bastard conducted his experiments on women WITHOUT sedation, causing his victims agony. The statue should be DEMOLISHED and his ass should be burning in hell.
Maybe some women might like to follow the unshowered smell tennis shoe and plastic spider trick but use some lube and get their free grocery card from their Pap test. The lube should be the kind that clogs up the liquid Pap test processing so they get an unsatisfactory result. Then they will get called back and get their $50 card again in three months.
I really do not like the reference to sex workers. Those girls are getting paid for their services making much more even for only a “few minutes”. If a women is getting a useless pelvic exam she is not prostituting herself. She is being abused or exploited even is she is getting a gift card.
Well, yeah- except when she does know the score on everything & just figures “Oh, I’ll get $50 & it won’t “really” be hooking- because it’s a medical thing.” Like she found some loophole to reality, you know?
AS a women who has survived Ovarian and BC and now in my first recurrence for ovarian, I am not offend by this marketing strategy. If it gets one woman to the Dr to get a Pap and at the same time the Dr is able to screen for Breast and other Gynecological Cancers it is worth it. Cervical Cancer is the ONLY CANCER that has a screening. Death from Cervical Cancer fell something like 80% after the discovery of the screening. I wish there were one for Ovarian. I will die from this disease and i will leave behind a 18,16 and 12 yo along with my loving husband. My odds are very bad and the treatment is hell. Go to the Dr get the screening and LIVE.
” Let’s build that future where we hold our loved ones’ hands, watch them grow old as it should be after a long life fully lived” Pierce Brosnan at Stand Up 2 Cancer as he announced the Ovarian Cancer Dream Team..
As someone who has lost relatives to cancer…i AM offended by it. First off, cervical cancer is NOT the only cancer that can be screened or tested for. Secondly, the Pap is notoriously unreliable, has a huge rate of false positives and can result in women getting biopsies and coloscopies they don’t need. Third, cervical cancer is rare. In the article it mentions that this isn’t even one of the top ten cancers in the state of California. Fourth, no, a Pap cannot screen for any other cancer, and it can’t even screen for adenocarcinoma, which is the one form of cervical cancer that is worrisome. Fifth, and this is the most important part, cancer screening is a choice. Women shouldn’t be misled the way this flyer is misleading them. Men are told to talk to their doctors and make an informed choice about getting prostate cancer screening…something that is far more common than cervical cancer. Why shouldn’t women have the same choice, instead of being psychologically and emotionally manipulated?
Well, maybe that’s the idea? It’s being this way on purpose.
An interesting thing is that when this “discovery” about HPV came out, it’s like a new product to market. Even though the percentages were low, whatever it was caused by, now that this new information is floating around it’s like it’s something more likely than it was before.
I figure if it were to be said aloud it would be “Oh, it’s actually caused by this?” “Yeah, so since there’s more information about it, there’s more of it to worry about.” “That’s bullshit, it’s not going to be less rare because the causes are known.” “Well, are you a doctor?” “No, I’m not.” “Then you’re wrong about this.” “So a doctor’s right no matter what they say?” “No, of course not- but functionally I’ll act like that is the case.”
The end could also go: “So you’ll only believe something if the doctor says so? That creates a pretty be conflict of interest if they decide to lie or they’re wrong about something.” “Well, they wouldn’t do that.” “Why not?” “Because they’re trained & certified.” “Making it impossible for them to lie or be wrong?” “No, of course not (or dead silence).”
You rang…yes having more pap testing is more risk, over-testing leads to more false positives and we know where they can lead…gulp.
Also, there are certain times in a woman’s life when a false positive is more likely anyway, during pregnancy, up to 6 months or so after childbirth, during menopause, post-menopause and being under 30, and especially under 25.
Also, so many things can contribute to a false positive, infections, inflammation, trauma, hormones etc.
Now factor in the cancer is rare, hardly surprising few can benefit from this testing, but huge numbers can be harmed, not that anyone is counting or cares.
Quality of life is a factor too, constantly having an invasive test is quite stressful for some women. I’ve spoken to women online and in the real world who start to dread their Due Date, some have trouble sleeping, start to feel anxious and sick in the stomach, this is no way to live and you can imagine 2 years comes around quickly when you live in dread of the next test.
I can never forgive these programs for all they’ve taken away from so many women, the list is huge. No one cared about harming the masses, except the Dutch and Finns, who made some attempt to reduce the number of tests, false positives and over-treatment.
As for the frequent insertion of the speculum…you’re right, some women find it painful, even intolerable, some bleed and feel sore for a few days after the test, I also, wonder whether this testing could lead to infections or UTIs, of course, there is very little on the harms of testing.
They’ve been telling the same story for so long…it’s a reliable, safe, easy and painless test. That’s become a fact, no one bothered to ask women whether that was their experience. I think more women are sick to death of being told what something feels like or should feel like…that’s our call. The strategy is…if you have an issue with this test, it’s about YOU, not the test.
Interesting that one of the rules for an acceptable population screening test is the test itself must be acceptable “to the population”. They got that men didn’t accept the routine rectal exam, but are deaf when it comes to the pap test.
i am a small women 5’1 100 lbs. the speculum can’t fit inside me. i have asked for a young girls one. i am treated like a freak because i can’t have an exam , and i get anxious.
i have spent yrs with no diagnosis or help. wasted time $$$ to have an anxiety attack.
i do have a consultation with a dr scheduled. if she gives me the crap i need an exam . i am finished for good. not going to touture myself anymore.
i ave suffered enough being denied intimacy. i am sure many other women have suffered too.
And ovarian cancer and breast cancer are entirely different animals. One can test for the BRCA gene and go from there. Going to the doctor for regular Paps and pelvics won’t do a damn thing for diagnosing or stopping either disease.
i wonder if having constant pap test does more harm than good. it can’t be healthly to constantly have a spectulm inserted. I can’t even have on inserted it hurts like hell,
Diane S, someone else here (paging Elizabeth!) can probably speak more on this but there are definitely hazards to the Pap…both physically and emotionally. There’s also the point that a majority of women end up being referred for biopsies etc. for completely harmless changes, or for false positives, and that damages their cervixes and gives them issues later on. If they’ve punched out half your cervix in a cone biopsy you’re going to have more trouble carrying a fetus, for instance.
Debbie: As a woman who has been harmed by enforced pap testing, I can only say that your view is incredibly ill-informed. This primitive test was invented way back in the 1930’s and has never been subjected to any proper evaluation. American doctors continue to brag about how the incidence rate of CC has dramatically declined since the test was created, yet there are many countries – UK included – where the incidence rate of the disease began to drop long before the test even made it to their shores. The cancer was never as common as the ‘experts’ tell us, and when you use an unreliable test to detect an uncommon cancer you have to screen vast numbers to make any kind of impact. Mass testing didn’t begin in the USA until several decades later – it’s plainly obvious to those of us who’ve done a little research that pap testing is NOT solely responsible for the reduction in incidence.
Plus, you contradict yourself – you say that the Dr is able to screen for breast and other gynaecological cancers and subsequently state that cervical cancer is the only cancer which has a screening!
Screening is the search for potential signs of disease in people with no symptoms. If you go the doctor for help with an injury, for instance, and he insists you *need* a blood test to check your cholesterol, that’s a screening test.
If the whole point of the routine pelvic exam is to check for abnormalities, why is ovarian cancer such a problem? When your doctor jams his/her fingers into your womb and prods your ovaries, they’re screening for abnormalities, right? So there IS a screening test for ovarian cancer – it just doesn’t work. Many countries gave up on routine pelvics years ago because they’re useless on asymptomatic women, and not very helpful even if you DO have symptoms. Unreliable testing – whatever that test may be – only benefits the medical profession due to the huge number of false alarms produced.
I put it to you, Debbie, that the enormous faith women like you place in these antiquated and unreliable tests and you god-like doctors is the reason that women’s healthcare remains in the dark ages. If you want improvements, you have to demand progress, not simply prescribe more of the same tired old methods.
And your ‘dream team’ will achieve nothing. There was a PLCO cancer screening trial conducted from 1993 – 2001 which tested, among other things, the value of the transvaginal ultrasound or CA125 test as screening tools for ovarian cancer. The study concluded that although more cancers were detected there was no decline in the death rate, which is the ultimate goal of cancer screening.
This ‘dream team’ is simply conducting another trial using the CA125, transvaginal, and pelvic exams. We KNOW pelvic exams don’t work as a screening method. So much for *cutting edge* research!
When you have something non-invasive and accurate to offer, maybe I’ll be interested.
So well said.
Another part of the whole “rates of death from cervical cancer have gone down since the pap was introduced…” that I was just thinking of: OF COURSE the rates of cancer deaths have gone down since the 1940s! That’s true across the board, because of all the treatment options that are available now, and if you looked at the survival rates for ANY cancer – leukemia, brain cancer, pancreatic cancer, ANYTHING – you’d find the same thing to be true. They’re better than they were in the 1940s.
It’s another case where people confuse – or deliberately conflate – correlation and causation. They say that because cc death rates have gone down since introduction of the Pap, it means that the Pap is responsible. But it’s truly distorting the issue since we’re better at treating cancer in general these days; people survive longer because we have more and better treatment options.
Also, hysterectomy rates have skyrocketed over the years, and most are performed for benign conditions. This may have played a part in that *remarkable* decline in cervical cancer. The USA has the highest rate in the developed world, and I’m sure those routine pelvic exams are partly responsible for that. Although the rate is pretty high in the UK too, so doctors obviously don’t understand the workings of the female body at all.
Another thing is that it’s pretty stupid to worry about dying if you’re being eroded out of your own life. Suppose there was some disease that went around that caused all the problems that arise from the risks & inaccuracies of all these procedures? Suppose it happened more frequently than actually dying of a different ailment & could still die of this one (about in the same frequency of fatal hospital-bourne illnesses & surgical complications- adding in a deliberate iatrogenic murder or two, of course)?
You make it sound as though a woman will just die if she doesn’t get these procedures done on her. If someone put a gun to a woman’s head & said to her “Let me play doctor or I’ll kill you”- do you think that’s no issue because she LIVES? Staying alive isn’t all there is to the story & even if you were immortal, quality of life would be a major point. I think someone might do better to listen to William Wallace’s speech than Pierce Brosnan’s.
Especially since people that actually have worked in these various agencies have said it was the most crooked thing they ever saw & that all kinds of potentially helpful things would get dismissed without even reviewing it further. If you’re most likely not going to get anything helpful when you have a problem, it may as well not be made worse.
Debbie – Cervical cancer rates were already declining before cervical screening was introduced. What’s more, there has NEVER been any randomised controlled studies of cervical screening plus the disease is and always has been RARE. So, there is no way whatsoever to attribute the 80% decline in cervical cancer rates to screening alone – especially given the fact that the numbers of false positives are extremely high. Here’s some perspectives for you – ONLY 12 – 30% of those diagnosed with high grade dysplasia (CIN III) will develop cervical cancer, yet 100% of people receiving this diagnosis are at risk of harmful biopsies and LEEP treatments. Another statistic – average lifetime risk of receiving a colposcopy is 65% compared to a lifetime average risk of developing cervical cancer is less than 1%. Given the fact that back in the 80s, the average chance of developing cervical cancer was 16 in 100,000 and given the fact that around 80% of women are on average, screened, the rates of those diagnosed with cervical cancer ought in theory be much, much less than 8.5 in 100,000, if screening is as indeed as effective as you state because in accordance with natural decline rates, it might have reached 12 in 100,000 incidence rates by now anyway (I calculate that as being just 3.5 out of 100,000 benefitting from screening).
The message that screening is just like any other medical procedure with risks and benefits seems to be lost in translation with certain groups. It is time women be given all the information and be allowed to make informed decisions for themselves without all the propaganda getting in the way of that.
I’m not sure if I should start a new post for this or not. But today a friend of mine posted a link to this on Facebook
http://itsmylife.cancer.ca/index-en.html#!page=0
I went through the first part of it and it start by saying that because I’m femail and 44 I have a 41% of getting cancer in my lifetime. This kind of fear mongering infuriates me. It’s disgusting. It’s done up all pretty and nice like but…to me it is fear mongering by big pharma in the worst kind of way.
That’s not fear mongering, that’s the actual Canadian statistic. No money from big pharma. None of the risk factors addressed in the application require pharmaceutical intervention – they are all lifestyle factors that individuals can change themselves.
They asked me two questions – my age and sex – then told me I have a 41 % chance of getting cancer. I think that is an awful way to start something and makes me, and I’m sure a lot of others, scared.
Just for a laugh, why not try telling them that you’re a man in your mid-20s or mid-30s. If you can type it in or do a convincing voice, of course.
I wonder if they’re capable of saying “You have a 0% chance of getting this form of cancer”? I’m sure they don’t like the words & the idea is fairly rough for them to express.
I just tried that. Even worse at 45%. However, they were not encouraging any screening programs or vaccines at the end, as opposed to when I said I was a woman. They just suggested I share my results on social networking websites. So make of that what you will. Apparently, guys have a higher risk of all cancers, but yet they’re being told to only fight those off naturally whereas women are being told to fight them off naturally AND screen AND get vaccinated.
It gave me the same percentage, and I’m 21. I definitely think it’s rigged. It probably just tells all women that their risk is 41%. I finished answering all of the questions and gave them all the answers I thought they wanted (yes I use sunscreen, yes I’m up to date on vaccines, etc). At the end, it was telling me about all of my screening options that I should take advantage of (read: use these programs or get cancer) and talking-up vaccinations (particularly for HPV) that I should consider getting (specifically, it said, “ask your doctor about…” which would end in getting vaccinations). Anyway, it’s essentially free advertisement for screening programs and vaccinations. It encourages you to “share” this-or-that on social networking websites and have your friends get involved. Just more propaganda. Everyone has a different risk for a different illness. I don’t trust some silly online test to sort that out (and it’s RIDICULOUS that people are being encouraged to do so).
“Find out how to stay healthy” — stay away from lying quacks and the whole deceiving medical enterprise that for some reason is called call “heath care system”!
i agree i rarely go to the dr. i finally found a dr that is the old fashion type. does the basic chck up and blood work. guyd him ge screwed with the insurance bs ( us). medical system here caree
more about paper work and money.
i do stay away, the anxiety they caus me isn’t worth it!
The ritual of the humiliating Pelvic Exam and Breast exam, etc were all invented by MEN after they took over gynecology from the midwives. These exams are NOT needed. The stirrup chair was also invented by a perverted man. It used to be a common joke amongst men to ask one another, “Hey, how many Tubes have you notched up?” Tubes = totally unnecessary breast examination. All part of the toxic patriarchy. We don’t see mass marketing towards men for their “Well Man Exam” do we? Nor do we see mass marketing that notes that men “must get a yearly penis exam.”
I nurse angry that I wasn’t getting Pap smears told me “ that’s not good. Are woman’s bodies are so complex.” The nurse was offended that I was not getting them and she let it be known even tho it wasn’t her business. I’m assuming by the way she acted she had never seen a woman my age that didn’t have them. I was 24. She looked a little older than me. It must be taught in school that the female bodie is more complex and she mentioned because we have menstral cycles. What does that have to do with needing Paps. Really I think they aren’t even taught what a Pap smear screens for just that all woman have to.
Ironically, the field of OB/GYN has largely transitioned back to women, with the majority of residents being female in programs in US teaching hospitals. However, the patriarchy and oppression are alive and well. Besides the concept that women’s bodies are inherently “flawed,” “more complex,” and in need of “special care” being taught from one generation to the next, I believe it is largely economics that drives all the unnecessary invasive exams, procedures and follow ups. An entire industry has sprung up in support of all of this, with “women’s imaging centers,” “breast care centers” and the like all needing, as our UK friends would put it, “bums in seats.” Add to this these newly minted young women doctors finishing their programs with sometimes hundreds of thousands of dollars worth of medical school debt and their desire to perform the surgeries and procedures they were trained in, they have every incentive for the “more is better” mindset when it comes to their patients.
Here in Australia, our dental and medical clinics (and vet clinics) are being bought up by larger companies, some listed on the ASX, so there’s more pressure to reach profit targets and to up-sell. I’m currently looking for yet another dentist, my current dentist retired and sold out to the large company…like day and night…now we have pressure to have x-rays every year, recommendations to replace older fillings, (that are fine, just old) pushing crowns, zoom whitening, veneers, all sorts of cosmetic dentistry.
I heard we have a dentist in the next suburb who’s still resisting the urge to sell out to the large company…I just made an appointment. Soon we won’t have owner operated clinics, they’ll all be employees in a huge commercial machine.
The only thing I’ve noticed with my GP…you now need an appointment to get blood test results…even when they’re normal. Annoying…a waste of money and Medicare funding.
On the up side, the clinic now has every service you could possibly need, podiatry, pathology, dentists etc. all under the same roof. (you’d have to watch the upselling though) A friend used the podiatrist, an excellent service but she left with two creams she didn’t really want, an extra $35.
Thankfully, we have vets and veterinary specialists in the family…a dentist too, but he’s now retired and off travelling, always handy to run things past him though.
Over time, it seems that only a few stand-alone medical clinics are around, and more and more of the chain dentists – where you’re pressured for all sorts of expensive and cosmetic dentistry, and being very reluctant to do basic dentistry (amalgram fillings or extractions). They want to put on white crowns (and replace them every few years), or put in an implant. Partials or bridges aren’t done much, so it seems. I had one, who I reported, where I insisted to *just* fill the tooth – they drilled it out, said, “appointment time is up”, and had me walk out with the drilled-out cavity OPEN. Yes, I reported that one to the State, and I found a stand-alone dentist who could take me as an emergency… with a WTF when he saw what was what there.
The doctors seem to have their offices in hospitals, with lots of labs and imaging right there and available – making for too many tests. And, screening tests of any kind tend toward overutilization – overdiagnosis, overtreatment… Just at a time when the cost of medical care has skyrocketed and various groups in the US are trying to make it somewhat affordable and available to (nearly) everyone.
Also with so many doctors offices being taken over by hospital systems in the US, the doctors are under pressure to adhere to the system’s “standard of care” which involve goals that a certain percentage of their patients undergo cancer screenings. I believe pressure to meet these goals hinders the providers ability to give balanced information about these screenings similar to the way incentive payments do for doctors in countries with national healthcare.
You are spot on Elizabeth! Exactly same thing is happening around my current area: dentists, optometrists and doctors are bought by large, money-churning chains, which turn those places into sausage factories for overdiagnosis, time- and money-wasting, excessive testing, and screening peddling.
This hasn’t affected me directly yet, as I avoid doctors like a plague, but my neighbour told me that her doctor was purchsed by the SmarClinics chain, which resulted in prices going up and her starting getting loads of spam, reminders and recalls saying that she is “due” for all sorts of screening and tests that she never wanted.
Correction: the name of the chain is “SmartClinics”. It apparently already swallowed quite a few medical centres around Queensland and Tasmania.