353 comments

1. This latest study by the IARC strongly supporting breast screening..well the IARC has had an interesting history and has a lot of critics, they’re accused of bowing to industry influence and pressure and for having a distinct lack of transparency.
   Yes, that sounds about right.

2. http://www.usnews.com/news/articles/2015/06/09/on-capitol-hill-a-push-to-get-the-birth-control-pill-over-the-counter
   Things seem to be moving in the States. interesting that once America had the most onerous requirements for the Pill, yet they’ll beat us to on-going OTC access to the Pill. I can’t see it happening here anytime soon, the AMA are dead against it, IMO, nothing to do with healthcare, they’re protecting their own interests. The reasons put forward by the AMA are sounding increasingly ridiculous…counseling (?) breast checks (haven’t been recommended in years) pap tests. (of course!) If the AMA can’t move with the times, they should be ignored, they should not be permitted to stand in the way of easy access to the Pill. (they’ve done that for far too long)
   Disgraceful that decades after its introduction, women are still fighting for easy access.

3. This looks like an interesting read…it must be concerning that some doctors are breaking away and speaking honestly to women, let’s face it the coercion and deception has been so effective because all or most doctors played the game.

   • I read a few pages of this book that I found online and I don’t agree with some of his opinions, he says that the Pill increases the risk of cervical cancer. I don’t agree, it’s not the Pill that leads to cc in rare cases, but HPV. He also, doesn’t think HPV testing should be left until age 30…well, I do, and it’s a move backed by the evidence. (assuming women want to test)
     He does say some good things though…true virgins should not have pap tests at age 21 or ever. Women in lifetime mutually monogamous relationships do not need pap testing, speculum exams etc. He’s also, keen on natural family planning, but it’s a method that doesn’t suit everyone. It suited me, but I only know a handful of women who’ve used the method long term. Of course, that’s partly because many GPs don’t mention natural methods or promote it as unreliable. Some GPs are horrified you’re taking such a risk, an unplanned pregnancy is not far away. In fact, it can work very well indeed if you’re committed to the Method, have a supportive partner, and don’t break the rules….ever!

4. http://www.dailymail.co.uk/health/article-79313/NHS-breast-cancer-screening-waste-time.html?

   It never ceases to amaze me how the cancer charities back screening and continue to urge women to screen. I get the feeling if they were buried in evidence of harm for no or little benefit, they’d continue to ignore it. Some seem to say if one woman is saved by screening, you can’t place a value on her life…but what about the women harmed in the process? Surely they have rights too.
   I wonder who funds their work? Are they protecting those with a vested interest in screening? Or, is it ignorance and a lack of respect for women? Perhaps, it’s both…
   I’d have more time for these groups if they expressed concern and urged women to look at all the evidence and make up their own minds. Instead I’m left with the feeling they’re protecting screening, not women.

5. Thanks for this article. It is cervical cancer awareness week this week, so I’ll be avoiding shopping at Sainsbury’s my local supermarket, who are supporting the “Josef Goebbels Cervical Trust” with their sales of knickers this week. If you are in the UK ladies, beware where you go this week.
   I think the charities are in damage limitation mode. I contacted the Eve Appeal and asked them if their campaign would involve evidence based honest information. “Absolutely” came the reply, “screening saves lives”. I think they’ll fight tooth and nail to hang onto their programmes.

   • What, another campaign week? I was sure we’d already had one earlier this year. Maybe the “Josef Goebbels smear test appreciation society” is aiming to get a whole month dedicated to their cause, like Black October (as Professor Baum calls it) for breast cancer.
     Just spotted an article in my daily rag which states that some ‘experts’ want the cervical screening age raised above 64 because – shock horror – the disease occurs in older women too! Well, that’s nothing new, but they’re implying that this is due to the participation rates falling among older women.
     And of course a study by the Goebbels trust is implying that older women are failing to comply due to ignorance… same tired old propaganda.

     • The one in January is Cervical Cancer “Prevention” Week, the one in June is Cervical Cancer “Awareness” Week. WTF!

       Yes, I too read that they want to raise the age to 70. Actually, at the moment it already does extend to above 65 if any of your last 3 tests are abnormal. Clearly the over 50’s are quitting the programme and assuming they won’t hear anymore after 65 anyway as they’ve had years of normal tests, so this is the next big threat: “if you haven’t bothered with them in your 50’s we’ll pester you until you’re 70”.

     • Two whole weeks for campaigns and a LOT of money to fight a fairly rare cancer…now that makes sense. 60, 65….we can better that, our current program stops at 70 and the new program is likely to stop at 72 or even 74. I kid you not…and we’re extending breast screening, of course, why not? More over-diagnosis, brilliant!
       I suspect with the screening numbers falling, to get the quota through the door, they have to cast a wide net, this is after all about numbers and profits. IMO, it has little to do with cervical cancer and protecting women. If it did, we wouldn’t be screening in a way that misses some of these cases in the muddle of excess and harms a lot of healthy women. We also, don’t really have a start date, it’s roughly 18 or 2 years after you first have sex, but in reality, GPs can do as they please.
       When we were doing research on our HPV vaccinated women (ssshh, don’t mention this to women) they compared this “cohort” to the pap test registry. It came out then, in the research, that some “doctors” were pap testing teenagers under the age of 17. It was stated in the study that these girls should not have been tested, but…what have they done about it? Nothing.
       I can’t believe how flippantly and recklessly this test is used, if a young woman has pain with her periods or they’re irregular, the GP might do a pap test. Why? Is it just to help with the screening target or pure ignorance? This testing can lead to some ugly places so I find it unacceptable that some use this test inappropriately, yet nothing seems to be done to protect women.

6. http://www.bmj.com/content/bmj/299/6708/1153.full.pdf?ijkey=6f74f3b5263eeb1374db7c33ebffcd97046365b2&keytype2=tf_ipsecsha

   This article was written in 1989, interesting that many were questioning mammography way back then, some were directly involved in screening. This account was written by Dr M. Maureen Roberts (clinical director of the Edinburgh Breast Screening Project) shortly before her death from breast cancer.

   You’re right Ada, they’ll fight tooth and nail – on point:
   http://bmjopen.bmj.com/content/5/5/e006333.full
   “Values in breast cancer screening: an empirical study with Australian experts”

   “Breast cancer consumers’ view of screening: Consumer advocates in this study presented a very particular view of breast screening. They emphasized morbidity benefits including reassurance; tended to suggest that harms were minimal; and argued that the best way to respect women’s autonomy was to provide them with, and promote, screening services, as this allowed them to access information about their personal breast cancer risk. It seems possible that these ways of thinking about screening may risk generating ‘too much medicine’10 for women. We were only able to interview three consumer advocates, and as such our findings may not be indicative of the entire range of opinion in the breast cancer consumer movement. However, the experts that we spoke to were in senior consumer advocacy roles, and expressed remarkably consistent positions on each of these three important values. Further research is needed to explore the range of values held by consumer advocates. If our findings are transferable to breast cancer consumer advocacy more generally, it seems possible that these values may promote and protect screening activity, but provide little avenue for adjustment or improvement in line with new evidence and technologies.”

   No surprises there…

7. http://www.newstatesman.com/lifestyle/2015/04/martha-hadn-t-let-anyone-touch-her-years-and-she-wasn-t-about-start-now notice because it is the New Statesman, not the Daily Fail, the usual no smear test cervical cancer sob story has a twist- she is a survivor of sexual abuse!

   • “It is readily preventable by smear tests but the psychological sequelae of the abuse were such that Martha could never contemplate being screened.”
     We read that a lot, it’s not right, false negatives occur as well as false positives. Adenocarcinoma of the cervix is often missed by smear/pap testing, these women tend to get a false negative result, which can falsely reassure and lead to a later diagnosis and poorer prognosis. So I’d say cc MAY be prevented by cervical screening, a fairly small number of women are helped by screening.

     Also, can’t help but think of all the abused women out there, abused by this program and the medical profession. Those pressured or coerced into unwanted pap testing, the women ambushed in the consult room, misled and scared into testing, driven into testing after receiving letter after letter, phone calls, perhaps, even a home visit. Those who avoid all medical care as a result of the abuse. The women who’ve gone through excess biopsies and over-treatment…all of this abuse has been caused by the screening program. Why don’t they put something together on that subject, on the huge number of women left worse off by this program? I could get 6 women together in 5 minutes, just walking around the office.

   • I think it’s a bit odd that nothing was mentioned about her making her choice even if it killed her or about her having surgery & that being that- no tests or anything, but only having the surgery & leaving it at that.

     A commendation for her following her decision instead of worrying about dying a bit later should have been included.

8. http://www.pcc2015.org.au/presentations.html
   Presentations On Changes to our cervical screening program

   “Volume and Changes

   Pap tests 2.4M down to 0 (new program will be HPV primary testing)
   HPV testing 55,000 to 1.3M+
   Colposcopy 82,000 to 102,000” (and usually a biopsy)

   Note we’ll be doing HPV primary testing on women aged 25 to 29 AGAINST the evidence, this means about 40% WILL be HPV+…transient and harmless infections that would clear naturally in a year or two. It sounds like these poor women will be put through a colposcopy and biopsy.
   So vested interests have been well looked after, yet another program that’s not focused on the evidence. (or focused on what’s best for women) We have excess, harmful excess, we’ll start testing too early, test too often and for too long, and no self-testing unless you reject the invasive HPV test for 6 years. We’ll also, screen until an absurd 74 so these older women will be expected to have an invasive test as well, incredibly painful at that age for most/many women, way beyond cruel and unethical – almost all of these women are HPV-, they could be offered HPV self testing (if they want to screen)
   Finland and the Dutch have never tested women older than 60 and the new Dutch HPV testing program stops at 60 – although I assume if you’re HPV+ at 60 they’d suggest a pap test and possibly a further HPV test in 2, 3 or 5 years time.
   I fear for our young women who’ll continue to be worried and harmed by this program, all so unnecessary….and older women…and all women who’ll continue to be put through too many invasive tests and procedures. Vested interests win again, women lose again…

   • Thanks for all this info, even if it did make me choke on my coffee. I noted that the overhaul of the Aussie Program is to “ensure the continued success of the screening program”. I thought it was something to do with cancer myself…

     I also noticed that there was emphasis that the self testing would be only available for low/never screeners. I’m intrigued to see how this will pan out. I envisage that they will do everything they can to prevent women finding out about them, but I think that once word gets around, more women will want them, and will try to postpone their visits in order to get one. How successful they will be remains to be seen. I also noted that the colposcopies are set to rise. Simply dreadful to put these young women through this. The 25-30 age group in the UK has the lowest attendance rate, so I hope many women will delay going until they are 30 and then insist on the self test.

     We still haven’t heard anything in the UK at all about the future of our screening programme. I contacted someone on twitter the other day about figures from a conference on HPV prevalence in 16 and 17 year olds, male and female, and asked them how these results were obtained in such young people. A: urine tests were used on those who’d done chlamydia tests (another opportunitistic test sprung on young people who go to their GP). I asked why these couldn’t be used to replace paps, and she said it wasn’t her research, but that of Dr Goebbels himself, Robert Music of Jo’s Fucking Trust.
     He never replied. He never replies to my tweets. I wonder why?

   • Thank you for posting the link to the presentations. I had time to look through a few.

     What strikes me: no mention of urine HPV tests maybe because none are widely available except Trovagene. Under new plan colposcopy projected spending will be increased to $120 million. Self HPV tests are dismissed as not useful as they want to keep the swab for cytology (pap) for reading if the HPV test is positive. They want the doctor done exams.

     One graphic shows high levels of cervical cancer in regions of subSahara Africa and South American but another graphic shows that these regions have unreliable or no reporting of cervical cancer incidents. So all their data is extrapolated and inaccurate or made up. Of course these regions also have high poverty and high birth rates which they would like to control mostly by reducing birth rates. Cervical cancer screening registries (also vaccination registries) are an excellent method of monitoring and controlling birth rates.

9. “Cervical Cancer Screening in Average-Risk Women: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians”
   By George F. Sawaya, MD; Shalini Kulasingam, PhD; Thomas D. Denberg, MD, PhD; and Amir Qaseem, MD, PhD, MHA for the Clinical Guidelines Committee of the American College of Physicians, Ann Intern Med. 2015;162:851-859. (a download)

   “Clinicians have poor adherence to cervical cancer screening guidelines and begin screening too early, perform screening too often and do not end screening in women who are at low risk on the basis of age criteria or because they have had hysterectomy. Moreover, nonadherence to guidelines for the management of women with mild screening test abnormalities—
   specifically, more intensive surveillance than is deemed necessary—has also been reported. There is much room for improvement. Recent self reported estimates suggest that approximately 60% of women have been screened by age 21 years and approximately 53% of women aged 75 to 79 years and 38% of those aged 80 years or older.”

   “Although recent reports have suggested that the age of screening initiation is increasing and cervical cancer screening visits for women aged 65 years or older are decreasing, it is unclear whether these changes are due to clinician adherence to guidelines, evolving patient acceptance of less screening, or changes in reimbursement for services that are not endorsed by guidelines.”

   60% of women have been screened by age 21, about 53% of women aged 75 to 79 and 38% of women aged 80 and older…(shaking my head, I have no words)

10. https://www.ucsf.edu/news/2015/07/131011/vaginal-douches-may-expose-women-harmful-phthalate-chemicals

    I’ve known douching is not a good idea for many years, not sure how many Australian women would douch on a regular basis, I get the impression it’s more a European thing.
    I’ve always hated the hotel rooms in Paris and elsewhere with a bidet in the bedroom, especially when many foreigners assume it’s a toilet!

    • The whole paper is just wrong in its assumptions. Many women who douche do not use the commercial preparation that has the scented chemical solution in the plastic bottle. Many women mix their own douche soution with vinegar or hydrogen peroxide or herbal teas or just plain tap water. Bulb syringes are usually either plastic or latex rubber. It the commercial plastic bulb type of reused then that is better since the solution has not been sitting around or processed to absorb more “plastic”. Other types of fountain syringes might be used that are latex rubber or plastic tubing and metal (waterworks). Again these are used with home prepared solutions of tap water. A commercial douche preparation that has been sitting around in a warehouse and store in plastic is worse than bottled water.

      The discussion of race does have some people with darker skin tend to have vitamin D deficiency which affects their immune system functions. Other studies i have read have discussed that the vaginal flora of “African” heritage women is much different with even different strains of HPV being predominate. Hence it might be that women with more vsginal infections tends to douche more and those infections and their biofilms tend to cause cancer rather than douching or “taking bubble baths” or “using tampons”. When menstrual blood seems foul and women do not have access to a shower (poverty and housing problems) or medical attention.

      All these useless tupes of studies do is add to the list of behaviours that doctors can question women on to evaluate their “risk” of cervical cancer and push paps at them. The one that assumes me the most is asking women if they wear “white cotton panties” (as apposed to what? black lace thongs?). Wearing white underwear is supposed make a woman notice abnormal (or normal) discharge so they run to the doctor for medication rather than self treat with a douche or boric acid capsule, garlic clove or herbs. Women who seem to have frequent vaginal infections also tend to have more abnormal pap results and maybe even more cervical cancer. How safe are these yeast treatment medications anyway? The reason why “black” women wear black underwear is so that it does not show through when they are wearing light colour clothing. I doubt the “dyes” from dark coloured underwear cause cancer anymore than any other type of clothing.

      Safer douching (homemade solutions) is no more harmful than taking a bath (no bubble bath detergent) or swimming in a clean natural body of water. Bubble bath has detergents and fragrances that could be carcinogenic. A safer bath idea would be to use sea salt or epsom salts and some herbal oils. I often wonder how harmful chemical swimming pool are. Coming out of a pool with red and irritated eyes.

      • Moo, I’ve always accepted the vagina is self-cleansing, because that seemed right to me, that was my experience. I suppose that’s why I’ve never thought of douching.
        What would be the main reasons for regular douching? I know some women feel cleaner carrying out the practice, I suppose menstruation might be another reason, but showering helps there. I’ve never felt the need to go further than that. I know some women douche before and after sex, but it doesn’t seem popular here. I believe in leaving well enough alone, but if it works for some and doesn’t lead to issues, then…so be it. We know our own bodies best.
        You’re right though, if you’re going to douch, make sure you’re using something that won’t irritate or interfere with the natural process/environment. I certainly know women who treat thrush with home remedies. I’m a fan of some home remedies, especially the poultice.
        I know some women also, feel cleaner having their pubic hair waxed off…although I suspect that trend has been partly fueled by online porn, all of the female participants are hair-free. Over the years I’ve heard of women getting all sorts of nasty things from brazilian waxing, ingrown hairs, infected hair follicles, cysts, blisters, rashes, burns etc. I hope these women are doing it for themselves, and don’t feel pressured by a partner, I sense a double standard may be in place with waxing, I doubt many men go to the same trouble.

11. https://theconversation.com/celebrity-campaigns-are-a-distraction-from-the-real-risks-of-cancer-screening-44257
    We’re a long way behind the UK and the States when it comes to this discussion, but we’re starting to see this sort of article every few months. Of course, the authorities and vested interests always have the last word…and tellingly, never address the evidence.

    • Rarely with this breast cancer screening campaigns are the signs and symptoms of breast cancer ever discussed. Signs such as redness, swelling, nipple that becomes inverted, orange peel like skin, dimpling, hard painful lump.

      From the article is DCIS cannot be distinguished under a micrscope from deadly cancer then the bet is that slow growing cancers that will not kill a person in their life time cannot be distinguished between fast growing ones. I have heard this from other sources. So everyone gets the same treatment. I still do not buy that a small lesion found in screening mammogram will only result in a lumpectomy. I would like some more statistics on that. But it also might depend on where a woman lives.

      • “There are women who have come to think of their breasts as the enemy.
        —Dr. Kenneth Offit”

        Surely they understand why, decades of scare campaigns and misinformation.
        http://www.wsj.com/articles/defying-doctors-more-women-with-breast-cancer-choose-double-mastectomies-1436545322
        “An analysis of the National Cancer Data Base revealed that 12% of women who received surgery for Stages 0-to-3 breast cancer in 2012 underwent a double mastectomy, up from 2% in 1998. Nearly 30% of women under age 45 opted to have both breasts removed in the most recent year, according to the analysis by Dr. Katharine Yao, director of breast surgery at NorthShore University HealthSystem near Chicago.”

        This is the madness that surrounds the healthy symptom-free female body, BOTH BREASTS OFF for 0 Stage cancer, 0! I assume they mean DCIS or lobular carcinoma. Perhaps, we should have our cervix removed at say 18 and then our breasts off at 21 just in case, but then, I doubt the system would approve of that, the huge money is made testing and “treating” the cervix over many years, here from 18 until 70.
        Amazing that women are so spooked and misled they’d agree to have their breasts removed for STAGE 0 “cancer”…stage 0, there is a clue there, NO CANCER.
        I think the concept of pre-cancer or something that “might” increase the risk of cancer has been great for vested interests, you don’t have to confine your treatments to those with an issue AT ALL, women with no breast cancer agreeing to having their breasts off.
        The names need to change too, women hear carcinoma and think “cancer”…no, it’s not cancer and is most unlikely to ever be an issue, we didn’t know about or worry about these conditions until we started screening women. Now with ever more sophisticated mammograms, I fear even more women will end up losing perfectly healthy breasts.

12. http://www.qmul.ac.uk/media/news/items/smd/148932.html

    “Gardasil 9 offers the potential to increase overall cervical cancer prevention from 70 to 90 per cent, nearly eliminating this cancer among vaccinated women. However, it’s crucial to remember that vaccination must be done before exposure to the virus. Our focus for prevention must be on girls aged 12-13, as the current UK vaccine programme is doing, but the vaccine may also be appropriate for women 25-45 as part of a screening appointment.”

    “Following these important findings, this vaccine has been licenced in the USA and approval is currently being sought in the UK and other countries.”

    I recently found this about Gardasil9. The new version of the Gardasil vaccine which includes many more types of the HPV virus. I wonder how long they are going to keep the speculum test going with HPV 90% eradicated? What are all those gynes going to do for a living? Become window cleaners?

    Very interesting that “the vaccine may also be appropriate for women 25-45 as part of a screening appointment.” I recently read that there is a simple test which can detect whether you have had the HPV virus in the past at all. They may insist that women turn up for a speculum test, and then this sample is used to find out if the woman has ever had the HPV virus, and what type it was. The vaccine may then only be offered to those, who have never been exposed to it. That’s just my guess.

    • I do not trust vaccines in general. The HPV vaccine needs to be done three times at first in children. Studies have only been done to show that the immune effect lasts to 8-10 years. Studies have not been done further. But I would like to see the exact data. So really does it make sense to vaccinate a 12 year old girl and have her be immune to HPV until she is 22 years old? If after age 22 she does not get a booster vaccine and she gets HPV will her infection be worse? A naturally occuring immunity might be better because when does that wear off? Has there been any studies done? All we know is that most HPV infections are cleared within two years. Can a person be infected with the same strain of virus again? There has never been any proof that the HPV virus can become dormant and reactivate. This was only a hypothesis brought up in one paper and never proven.

      There are some reported very bad reactions to the vaccines even deaths. The risk of an adverse reaction to the vaccine is one in one million. This is lower than the risk of cervical cancer but tell that to the family of those children who die.

      I am not going to anyone’s guinea pig.

      • Moo, I am sure that is why they are still pushing everyone to undergo screening, even if you’ve been vaccinated. All the young women today are guinea pigs for them to assess the efficacy and duration of the vaccine.
        I’m just hoping many women will stand up for themselves and say they’ve done enough and want nothing more to do with it.

13. Also further news from the UK. I saw this advert for a new screening service being pushed.
    https://www.gynaehealthuk.com/cervical-cancer-screening-services/gynaecheck

    It has long been clear that the present UK government wants to privatise our NHS and the screening programmes are no exception. I’ve often seen that they fit the “American style private business model” rather than the “socialist public health service” we have in the UK, so it was no surprise to see this. This company is offering an HPV screening service to those who don’t like the speculum test. They are charging a staggering £129 for a bi-annual HPV test. Whatever happened to Tampap and testme.co.uk, who were offering HPV tests at £50 a go, and the result was supposed to be reliable for 5 years?

    The gadget looks just like the Delphi Screener to me.

    They want to keep women locked into a programme of some kind or another. Gynaehealth also offers corporate screening through your workplace, where it is paid for by a salary sacrifice scheme a bit like our pensions are. I think they want to get rid of the wealthy worried well, who take up most of the screening budget yet have the least risk of cervical cancer, and put them on a private scheme they can pay for themselves.

    This article is also full of muddled news:
    This woman sounds over treated to me. I was out of hospital the next day, and could have gone back to work after 2 weeks after a total hysterectomy…
    http://www.telegraph.co.uk/lifestyle/11685923/Why-are-older-women-not-having-regular-smear-tests.html

14. http://www.forbes.com/sites/elaineschattner/2015/07/16/how-to-avoid-overdiagnosis-and-overtreatment-of-breast-cancer-improve-mammography-screening-quality/

    I get the impression this woman is protecting screening, not women.
    I think the only approach these days, knowing what we know, is to present all of the evidence and leave the decision to individual women.
    If an author doesn’t say that…well, I’m suspicious…do they have a vested interest in screening? Is it scientific ego? Is it a closed mind? Do they view women as second class citizens?

    I see a comment has been made by Laszlo Tabar (the Swedish study)…oh, yes, I’m going to take the advice from someone with a clear vested interest/conflict of interest.
    Others too have an issue with this man’s comments. If he likes mammograms so much, he can have them!
    http://www.bmj.com/content/348/bmj.g366/rr/687427

15. http://www.bmj.com/rapid-response/2011/11/02/stephen-duffys-claims-benefits-and-harms-breast-screening-are-seriously-wr

    More on Stephen Duffy and Laszlo Tabar.
    It’s important to have a close look at the person or group promoting breast or any sort of screening – it can tell you a lot. I trust the NCI because they’re independent, not for profit and they’re a highly regarded medical research group. I’ve noticed vested interests and others who defend screening often try to scare or confuse women, don’t respect informed consent (or consent itself) and are quite happy to make simplistic screening statements, get screened! (and they’re quick to refute anything that might threaten screening, often very aggressively, defensively or rudely)

16. Quite so, Elizabeth. I’ve often wondered (apologies to any men out there reading this post) why a man’s private parts can’t be screened in the same way as a breast mammogram. The man could stand on a chair, and have his parts crushed between 2 glass plates and it would save inventing another kind of machine. Maybe it is something Laszlo Tabar could consider if he’s worried about his empire collapsing…

    On another note, you mention about your SIL having X-rays for Hodgkin’s disease when she was young. I noticed from national stats that breast cancer has peaked and is on the decline. This has been put down to the drastic drop in HRT use following its link with breast cancer in the past decade. But something I also noticed on the Cancer Research UK website is that a woman is at higher risk of breast cancer if she had a chest X-ray as a child for TB screening.
    I was one of those children who tested positive to the Heaf test for TB, and was duly taken off to be X-rayed. I think that as our cohort moves into old age we can expect to see the numbers drop still further. This practice of screening for TB has now been stopped in the UK, but is another example of overtreatment causing harm later.

    • That’s interesting Ada about HRT and decrease in breast. Cancer.
      I’m not an expert but was dismayed at my recent medication review ( for. Migraine I might add) doc was very eager to prescribe HRT even though I only have very mild symptoms.
      I was given no advice about self help or herbal remedies, and I thought it was appalling! I don’t know where I stand on HRT but I do know I’d have to be a lot worse than I am now before I even consider it.
      Next point can anyone recommend any good sites to read more on HRT??

      • http://www.theoneclickgroup.co.uk/news.php?id=7020

        I’ve been getting my info from Jim Thornton postings. He’s Professor in Obstetrics at Nottingham Uni UK. He posts a lot on social media and on a site called Ripe Tomato:
        http://ripe-tomato.org/2015/05/25/conflicted-hrt-experts/

        When I first started reading about HRT I was put off from the start by finding out that it is made from oestrogen from horse urine. Premarin, the brand name is from Pregnant Mare’s Urine. That was enough for me to decide very quickly…

      • Thanks adawells!! Put like that.. Actually my symptoms aren’t severe and I’m coping well. It was just the daft doctor trying to rail road me into it made me curious…

      • I’m a firm believer if you don’t need to take something, don’t…my symptoms were bothersome for 2-3 years. I had trouble sleeping, which makes life more difficult, and the mad and constant fluctuations in body temperature.
        Sweating was also, unpleasant…and sometimes, embarrassing. I might be in an air-conditioned office, but could feel sweat running down my back. I also, had flushing on and off for a few months, bright red face for no reason. Rashes on my neck and chest…and joint soreness – I suspected both were linked to my hormones, oh, and some acne to top it off.
        I was determined though…no HRT unless I’m sure it’s safe and I REALLY need it. I was prepared to put up with a lot though, my initial reading about HRT was worrying. Pleased I managed without, my issues have almost cleared now.
        You never know, we’re all different..my mother had no issues at all, none that she can recall, certainly no sweating, flushing etc. I’m very grateful that I didn’t have flooding, that can be very difficult.

17. Incredible too that some women take HRT because they believe it will slow down the aging process, so thicker hair and better skin…not terribly helpful if it leads to something nasty and life-threatening!

    • Thanks Elizabeth!! Like you I don’t like taking anything unless I have to and I’d try self help or herbal first. I think the HRT hard sell was maybe a ploy to get me to smear!! I’m not flooding either in fact I’m getting lighter.

18. “Our study demonstrates an increased risk of preterm delivery and PPROM following LLETZ treatment compared with a matched control group. We did not, however, elucidate a relationship between the volume of cervical tissue excised and the subsequent gestational age at delivery. This further emphasises that reduction in cervical length is unlikely to be the sole contributing factor to the risk of preterm birth, rather complex interactions between the cervix, infectious agents and pro-inflammatory mediators may be of greater significance. Further work in this area is required to elucidate the underlying mechanisms behind preterm birth in order to generate potential treatments. Our data should provide some reassurance to clinicians who should continue to perform LLETZ with adequate tissue margins to ensure complete resection of disease in line with current UK guidance”
    http://obstetricsgynecology.eu/articles/selected-ejog-papers/predictive-value-volume-cervical-tissue-removed-during-lletz/fulltext

    Surely this also, means doctors should take care not to over-screen and over-treat women, if LLETZ (even performed conservatively) increases the risk of pre-term delivery. The levels of over-treatment we see in this country is way beyond scandalous. (and mostly avoidable)
    I’d like to know how many premature babies we have compared to say The Netherlands.

19. Elizabeth, the Castanon group who maintain their research showed very little difference to preterm births are based at Queen Mary Uni London, and they are very pro-screening, and always doing research to promote screening adherence. Judging from their twitter accounts they seem to be friendly with Jo’s Cervical Trust. A few months ago, I saw Thornton (Prof of Obst at Nottingham) query their research saying that he felt sure from his personal experience that LLETZ was causing a lot more preterm births than their research admitted. QMUL replied in the negative.

    I noted that the article compares LLETZ with punch biopsies and not with women who have never had any “treatment” at all. It also says that preterm birth with ruptured membranes may also be due to other factors such as infections.
    My first baby was born at 37 weeks after my membranes broke at 36 weeks. I told no-one and delivered at home as I had planned. It all went OK but my daughter was only 6lb in weight. I’ve often thought that a pap test forced on me by my GP might have been to blame, as she was brutal and made me bleed at 12 weeks gestation, which worried me a great deal. The sample was useless of course because of the bleeding, so a big waste of time. At my second pregnancy, my baby was very large, well over 9lb, and he went a couple of days over full term, with a normal delivery at home. Clearly my cervix had no problems holding in a much bigger, later baby 3 years later. At about 2005 the NHS ruled out doing paps at prenatal visits and at postnatal assessments. Guidelines now stipulate they should not be carried out at these appointments. I wonder why? The examples used in this article are pre-2005, when these women would have been having regular paps during pregnancy, especially if they had had “suspicious cells” in the past.

    • I did write a long piece at women against stirrups about pap tests during pregnancy. I found several “user information pamphlets” for doctors for the media that the scraping from pap tests are out in the go to the lab or that the endocervical brush is put into. All of them say “do not use the endocervical brush after 8 weeks of pregnancy”. You have to wonder how many doctors even have bothered to read this. Also sometimes a pregnancy really cannot be dated accurately unless an ultrasound is done. At the “first prenatal” visit in Canada and US when they are doing these paps a woman might estimate that she is around 6 weeks from her last menstruation but she could be more. So is it safe at 7 or 71/2 weeks and not at 8 1/2 or 9 weeks? Even for that 8 week warning to be on the pamphlets there must have been some unpublished study done. I cannot find a study about correlating pap tests during pregnancy and miscarriages or premature births.m so is this all a big secret or a way to reduce births among the poor or those deemed insufficiently medicalized?

      The pap tests are purely opportunistic as the rates of pregnant women with cervical cancer are really rare and the same as rates of non-pregnant women. One paper had urged doctors on “because this could be a time when a woman might ever have a pap test”.

      The other issues are that the pap cytology is difficult to interpret with a pregnant woman and nothing really can be done in terms of treatment for cancer except “advise the women that terminating the pregnancy”…… Not an option for many families. Plus why put a woman through the stress and risk of a colposcopy while pregnant? There is this cancer prejudice that seems to permeate through all doctor/patient relationships. The smallest risk that someone could die of cancer pushes all respect and trust away.

      The cervix does have a function. The mucus glands provide an environment that filters sperm to the uterus and limits pathogenic organism in the cervix and blocks them from entering the uterus. Women who have had procedures on their cervix including dilations for IVF and abortions also have problems with preterm births, infertility, etc. For IVF when the sperm is injected directly into the uterus it has to be processed first otherwise it causes cramping. They cannot use fresh sperm from the donor for that. Other methods of artificial insemination will put a tube a small distance into the cervical os and then fresh sperm can be used while letting the cervix do its job. Many women will do this at home rather than pay a $1500 fee to have it done in a doctor’s office.

    • Hi Ada
      That’s very interesting, vested interests run deep and can take on many different forms. I know there are a couple of American medical journals that are seriously biased in favour of screening. I couldn’t understand why there were so many articles desperately supporting mammograms…decided to dig a bit deeper and there were all the usual suspects. Talk about rats in the wood heap. (no offence to rats) Propaganda and business promotion pretending to be medical research.

      The NHS wouldn’t have made that ruling on a whim, they want the coverage. Here we have RANZCOG favouring coverage and healthy profits.

      “Cervical cytology
      A cervical (Pap) smear should be recommended at the first antenatal visit if this would fall due during the pregnancy, according to cervical screening guidelines. There is no evidence to suggest that a Pap smear in pregnancy is harmful.”

      It’s even MORE unreliable during pregnancy and CAN end up harming you, and lead to a pregnancy full of worry and fear. (and possibly more…a biopsy etc.)

      I also, know lots of women who were tested or a pap test was strongly recommended (but refused) shortly after they gave birth…6 or 8 weeks…again, more likely to be a false positive. It’s so transparently about coverage and profits.

      How could you ever trust these groups? Well, we can’t, simple as that.

      It makes me see bright red, I cannot believe women are treated so badly by the medical profession. Here in Australia there is an increased focus on domestic violence and we have a Royal Commission working on child sexual abuse…we need one on abuse of women by the medical profession!

      “she was brutal and made me bleed at 12 weeks gestation”…this sort of treatment is bound to lead to harm, physical and emotional, and I’m sure it does lead to premature babies, infections/inflammation and perhaps, even miscarriages. It stands to reason, I wouldn’t trust them to tell us, but the cervix is there for a reason, treating it roughly, making it bleed, doing punch biopsies, cutting bits off…well, it seems like a no-brainer to me.
      I’m sure it must lead to issues, my inner voice is shouting at me…

20. Hi. There is no shadow of a doubt pap caused mine. I will go to my grave believing i flushed my baby down the toilet. I was young and didn’t know what it was until i went to the doctors later on. It was within two days of a pap done by nurse G who swore it wouldn’t do any harm. For the sake of their pap targets they murdered my baby. I will never forgrt it. To help me i called by baby ‘Richard’ as that is my favourite name. She could have been a girl but i chose to gi e ghat name anyway.

21. Click to access cerv23-pregnancy.pdf

    “Pregnancy and a request for antenatal care
    may be the only reason a woman presents
    to a health professional, and thus at the
    time of booking, or a later visit, may be the
    only occasion on which she can be offered
    cervical screening. In line with the practice of
    opportunistic screening Pap smears should be
    offered to all women presenting for antenatal
    care who have not had a previous Pap smear
    or have not had a Pap smear in accordance
    with national guidelines.”

    So clearly it’s about coverage and the precious program, and again, an “offer”…for many years it was “required” at the first pre-natal visit or women were seriously pressured. Of course, they go on to say: “In general, pregnancy is not a contraindication
    to performing a Pap smear. ”

    Linda, that’s so sad, I’m so sorry, no wonder you’re so angry at the system, perfectly understandable.
    We should not be doing pap testing during pregnancy, they may argue the test doesn’t cause a miscarriage, but they can’t deny the results are even more unreliable, so what’s the point?
    Oh, that’s right, it might be the only opportunity to “offer” screening to a woman. I don’t agree with opportunistic screening, it violates informed consent and even consent itself. I’ve also, read that opportunistic screening can lead to the avoidance of medical care and cause psychological issues…being cornered to have a pap test when you’re there with an eye ache is plain wrong. We might be happy to see anyone for an earache, but if we choose to have a pap test, might choose to see someone else. It should be our call, not them plotting…how do we capture more women?

    • Wise words!! I know however many times I’m offered or invited to smear I won’t, but at every appointment I have I’m wondering if it’ll be brought up even though I’ve opted out. I’ve an appointment next week with the nurse for my bloods and I’m wondering… I haven’t seen any nurses at the practiceyet in six years so I’m really curious…

22. To all of you down under, Dr Iona Heath is giving talks on overdiagnosis in Sydney right now. She is an outspoken critic of breast screening and has decided not to screen.
    http://t.co/lvfhgcw3rX.

23. Hi Ada
    That sort of lecture is fairly rare here and it seems never promoted to the public, “it might put women off screening and threaten the program” would be the official thinking.
    I was shocked at some of the media coverage of Prof Gotzsche’s visit, “A Danish professor with controversial views….”
    I won’t be able to make it, but I’ve passed on the information to my younger sister and a few friends who live in Sydney.
    I called the Uni and they’ll produce a podcast, available about 4 weeks after the lecture, so that’s something.
    Thanks for letting me/us know…

24. http://www.theguardian.com/science/2015/aug/05/regularly-taking-pill-helps-prevent-two-forms-cancer-decades-after-use have you seen this? Seems suspicious to me, esp with the timing, as more and more women are going off the pill, and getting away from the medical meddling. Might reduce risk of rare cancers, but what about all the other side effects?

    • Both ovarian and endo cancer are oestrogen dependent cancers, caused by “out-of-control” unopposed oestrogen, so any method of hitting back your oestrogen levels will reduce your risk of these cancers: pregnancy, and OC’ s with progestogen in them will counteract the oestrogen and reduce the cancer risk. Incidentally, cigarette smoking also has a protective effect against high oestrogen in the body. When I was in my 20’s I tried the pill on 2 separate occasions, and was made so ill by it, I could never complete a single packet. I’m convinced this “allergy” to the progestogen element in the triphasic pill I took was a sign I might be a candidate for endometrial cancer later on, but when I put this to my consultant he denied a connection. I had endometrial cancer at age 51, despite spending 4 years of my life being pregnant and breastfeeding, and being a normal weight person. On the very rare occasions that these cancers strike premenopausal women, the Mirena IUD is offered to these women to “progestogenize” their wombs and flush out the proliferating oestrogen in there. That way they can keep their wombs until the menopause. When faced with my diagnosis I asked why older women couldn’t have this to save themselves a hysterectomy, but I was told that it wasn’t an option. As I’d been made so ill by my attempts at the pill years earlier, I didn’t think I could last with this anyway.
      I have gone over and over, what I could have done to keep my womb, and I honestly can’t see what I could have done any differently. If you don’t want to have children, it might seem a wise option to take the pill long term, but if you want to have children it’s not an option.

      • Certain herbal compounds also promote the balance of hormones in the favour of progesterone such as Vitex, wild yam and maybe some Indian herbs such as shatavari and ashwanganda. Certain nutrients are important such as iodine, zinc, vitamin K, folic acid, vitamin D. Estrogen overload seems to be a factor in many cancers developing. Estrogen levels in premenopausal woman can be high. I just do not understand why HRT is pushed by so many doctors.

        I also think anti cholesterol medications are dangerous. Cholesterol is the base block for many important hormones including the sex ones in male and female. It is also the basis of cortisol the stress hormone. Dietary cholesterol is not the problem as we have been misled. The body produces cholesterol in response to certain feedback mechanisms.

        I was reading a paper that had some information about why latency of HPV in older women might have been theorized but my opinion is that it did not prove it. Sorry I cannot find the reference to the paper. When HPV infect the basal layer of cells of the epithelium they will do what they naturally do, shed upwards. IF a cell transforms into a cancer cell (in the presence of certain factors such as carcinogens from tobacco) then sometimes those cells grow laterally in the basal layer rather naturally upward. If the cells are not detected and dealt with by the immune system they will make a tumor eventually. The normal cells will heal over the top and the pap will never detect them until the tumour grows larger. Of course the cancer progress in people with immune suppression such as HIV or cancer treated patients is very fast. Of course not mentioning the damage that pap tests do scraping up the epithelium to the basal layer. And the cell cultures used for many studies of viruses are derived from cervical cancer cell. Confuses the research somewhat?

        A paper on HPV in relation to male infertility. HPV in sperm. Can also infect the ovaries and embryo. http://www.hindawi.com/journals/bmri/2014/230263/. I have also read that there are studies in Italy about the relationship between HPV and Peyronie’s disease (Induratio penis plastica). However because it seems the costs of HPV and cervical cancer is mostly for women nothing will change. Testing men and vaccinating them for fertility is not cost effective. Maybe the pure males will be locked up in puberty and keep for sperm banks. But if a link between penal or prostate cancer and HPV is found then no doubt vaccines and better treatments will happen.

        Dear Ada I do not think your idea of the pill progesterone as being protective against cancer is quite right. It falls into the medicalization of women from puberty to post menopause protocol to me.

25. Thanks for your reply, Moo. I think I got this cancer through sheer bad genetic luck, and I wouldn’t want anyone to go on the pill and medicalize their life in this way. It’s just not right.

    • I’ve never taken the Pill and have no children, would I have taken the Pill for years to cover the risk of uterine and ovarian cancer? (assuming I could get the Pill)
      No.

      • If you did take the Pill to reduce the risk of ovarian and uterine cancer, you’d then read that the Pill increases the risk of other cancers (breast?) and can cause other health issues.
        I still read that the Pill increases the risk of cervical cancer…a bit misleading, your HPV status is all that matters there.
        I don’t agree with medicalizing the asymptomatic female body, if I’m well, then leave me alone. Meddling with the female body has left a lot of women worse off…

26. But the medics adore the pill!! Back in the day I had agonising periods when I’d literally be rolling in agony for three days. The gynaecologist said “pill”. I didn’t want to take the pill and said so several times but was told, the pill is the option and you’ll take it. So what happened was I’d take it for a few months then stop, endure the agony a few months and so on. Til I finally cried at my GP who suggested something non pill I’d not had before and it worked!!
    I’m also wondering the pill is contra indicated in women with severe migraine which of course I suffer…

    • Kat, my older sister has suffered from debilitating migraines for most of her adult life. I suspect a genetic link, our maternal grandmother also, suffered from them. Some women find they ease after menopause, but no, my sister is 60 later this year and she still takes preventative medication and feels lousy for 3 or so days every month.

      Fortunately, her last severe migraine was a few months ago, but that knocked her about, 2 days off work. (nausea/vomiting, splitting head, aura, dizziness, extreme sensitivity to noise etc.)
      I do wonder whether some of these medications fight, whether she gets rebound headaches. She’s found doctors to be totally disinterested in her migraines over the years, but she’s had to fight off pap test and mammogram pressure.

      • Elizabeth you are right I think, there’s several in my family with migraine including my 19 year old daughter.
        I can identify and sympathise with your sister!!
        My GP does try to help but I’ve had to field off offers of smears and HRT. When I’ve gone for a review of meds.
        It’s truly awful what we have to put up with still maybe now the tide is turning..

27. And I wasn’t even sexually active at the time and said so but still I had to take the pill and suffer the indignity of being tested for sti I knew I never had. When I went for a refill of it the practice nurse asked me if I practice safe sex which was really the straw the broke the camels back!

28. This is gonna be a long rant off topic.
    Had appointment today to discuss treatment options for my anaemia. Bearing in mind only symptoms chronic exhaustion.. I don’t take aspirin or anything like that, no charge in bowel habit, I don’t pass or vomit blood, no gut pain…
    He wanted to refer me to have tubes and cameras shoved down my throat and up my bum because it could be something serious??
    No way am I agreeing to that I said.
    Do you understand it could be sinister??
    It could also be overwork and lack of iron I said.
    What do you want he said
    Iron tablets and see how it goes I said
    Would I accept a,second opinion he said
    Not at this point I said
    I accept they don’t want to be sued but why suggest all this?? He felt my belly and didn’t feel any mass.. It’s like cracking a nut with a sledgehammer.
    I got an iron prescription and agree to more blood test in 6 weeks.
    I’m even more determined to avoid doctor unless I’m dying
    Sorry for the rant ladies n gents

    • If I was passing blood or having pains I’d maybe consider it but I’m asymptomatic apart from the exhaustion?? Or am I just being stupid here?
      Thanks god he didn’t mention smear testing or I’d be locked up by now after hitting him with my handbag..

      • Kat – I found myself being exhausted and now take Vitamin D and calcium supplements, they are working wonders, may be worth a try. The VitD is by Vitabiotics 1000iu and I take 3 per day which is 3000iu. I do this for a couple of weeks then have a break and then start again. Sometimes I take B12 & Folic acid too.
        I have also had an abnormal screen (CIN1) back in 2009 but refused to continue on the roller coaster ride, I can tell you I got nothing but grief from them but at least all my organs are intact. Tried to opt off the recall programme to no avail as received another “offer” (LOL) in July 7 months after the last one and after asking my GP to remove me, verbally and by letter. Good luck!

29. Sorry! More rant. Doctor just rang me to tell me he’d got second opinion, which I said he could, but I said I didn’t want to hear what it was. He told me anyway that the colleague was happy to leave it (like they had a choice)
    Then he hassled me about smear testing I said no way I signed a disclaimer.
    I was on public transport at this time!!
    Why don’t you want a smear test?
    I repeated I’d signed a disclaimer and wouldn’t be having the test.
    He’s not happy.
    I now have a severe migraine and I’m fuming. Tomorrow a very strongly worded complaint will be written because of course my cervix could be be causing the exhaustion!! Oh am seriously going away to cry now!

    • Kat I think this doctor is the reason you have migraines. It’s terrible that he phones you like this. I’ve never been phoned by my GP at home. If you have signed the letter to not have anymore screening he’s breaking the law to keep bringing the subject up. I’m sure the stress of the smear programme can’t be helping your migraines. Good luck with your complaint.

      • And chas UK a big thank you as well, I’ll pick up the vit do and folic acid tomorrow.. I hope you find a way to stop the smear “invitations “!!
        I will write a strongly worded complaint tomorrow, it’s pathetic. Why would I need a smear for exhaustion especially when I said my periods aren’t heavy, no discharge ect??
        Again, thanks xx

      • Thanks adawells x will sure put the law break bit in its probably all they’ll understand!!

30. I feel restrained in answering any medical questions. Some women experience heavy menstruation nearing menopause or when they are having an early miscarriage. This can cause anemia especially if they do not eat red meat. Take some vitamins with iron in them. Please try to see an alternative practitioner such as herbalist, Ayurvedic, Traditional Chinese. There are herbs that can help get the hormonal balance. The pill can cause migraines in some women. There are different types of migraines so you need to read up on the triggers and types. Some are due to chronic sinus infections which will never clear from taking antibiotics.

    • Hi moo.. Or any ladies out there, I’m doing my research while I’m on leave and..
      Moo?? What you said about sinus problems and migraine?? Do you have any more info or links I could check out please? Because I’ve issues with sinus at times and it’s worth a shot!
      The advice and support I’ve got on this site has been amazing and makes a lot more sense than what my doctor says!! Thanks x

31. Moo, thanks to you as well. You have given me a few more ideas as well as much needed support.
    I just drank hot chocolate made with milk to boost vitamin levels, and will buy more supplements tomorrow.
    I’ll research Chinese and ayurveda and see what appeals or jumps out at me most.
    I’d like to say a big thank you to sue for this site, as well as a big thank you to all of you for your support and advice. What I’ve read on here makes much more sense than swallowing cameras or speculum testing. Thanks again!! X

32. I do not know where you live but I buy the Costco Kirkland prenatal vitamins. This is a huge bottle of 300 and it costs me $10. Even though I am not pregnant this gives me all I need at a low cost. I supplement with extra vitamins and minerals sometimes but that can be expensive. Curcumin and green tea extract, both available as capsules kill HPV infected cells. There have been many studies on these two. Some women even mix the contents of an green tea extract capsule with coconut oil (1 tbsp) and make a suppostitory they put into their vagina to kill HPV. Other people have had success with mixing the green tea extract with petroleum jelly to make a salve for genital warts.

    If you can google migrain and natural remedies you will find much information.

33. http://blog.medivizor.com/2013/05/09/30-percent-for-30-percent/
    http://www.quora.com/Are-some-cancers-more-neglected-in-research-and-awareness-raising-efforts-than-others-What-can-be-done-to-improve-the-status-quo
    http://www.metavivor.org/awareness/

    Did you know?

    -100% of people with metastatic breast cancer will die from the disease.
    – about 30% of people with breast cancer will go on to metastatic breast cancer.
    – only 2% of breast cancer donations goes into research for metastatic breast cancer.

    “CJ found that most of the funding from donations and taxes has gone to early detection and prevention… But it has made little difference. The same numbers are still metastasizing and dying. “Prevention continues to elude us and early detection has failed to make a difference for many cancers. Only lung and colon cancer have seen improvement,” CJ explains. “In the US only 2% of research funds go to Stage IV cancer research. One study showed the American Cancer Society gave ALL stage IV cancers only 2.3% of its research budget in 2010. The Federal government gave 0.5% to stage IV cancers in 2005. “The same is true for other organizations. ACS, Komen, Avon, NBCC ALL focus their funding on prevention and they NEVER defined CURE.”

    So much money is wasted on screening and so many end up worse off, not to mention the reduced quality of life that is often the result of being “called” for screening – the test itself, false positives, over-treatment etc. These programs should not be untouchable, if we can spend our health dollar better, we should do that…every program should be subject to regular and independent review.

    I don’t like politicians making grand gestures with screening either, there should be no new screening programs or extensions of current programs until they’ve been approved by someone like the NCI. Screening should not be used as a political tool – our health and lives are at stake. The extension of our breast screening program is an example of politics at work. (and a great move for vested interests) Q: where is the evidence that breast screening will benefit those aged 71 to 74?
    (that there IS a benefit and it exceeds the risks with screening)
    We should funnel more money into research for better treatments and palliative care – most people would like to die at home, but most end up dying in hospital, now hospital care is very expensive, it’s better to focus on palliative home-based care – we’d save a lot of money and provide better end of life outcomes. My sister-in-law died in a private hospice, but without private health insurance, she would have died in hospital.
    Mental health care needs way more funding too, this area has always been woefully underfunded and remains so. We waste a lot of money…we could do SO much better.

    • Hi Eliz. I did not know any of this about funding. It is not only a waste of money but it seems criminal.
      I have already discussed the situation of cancer with john. We have decided to live our lives as best we can and if we get cancer we are not going down the ‘cure’ route. Chemo snd radio killed my friend dashing back to clatterbridge everyday which is miles away. She spent the last few months clawing at life. For what? Better to just go for coffee and cake, shopping, glass or two of wine, instead of all those sessions. There is no cure for cancer and even if these aggressive treatments appear to work in the short run they or the cancer kills you in the end.
      As you may gave guessed i have some mental health problems and there was never any funding for help of any kind. It was just pills and see you in two weeks, oh and i see you’ve no had a smear test for five years!
      I’ve stalled with my book tho i’m half way through. Will havd a brwak and get back to it soon.
      X

      • Linda, I can certainly understand where you’re coming from, for me, it would depend on what sort of cancer I had, uterine cancer is worth treating, so is testicular cancer – not that I’m likely to get that, although some moderators might disagree with me! One accused me of being strident and male-like in my views, that made me laugh, I suppose women are supposed to react differently when they’re being fed absolute rubbish.
        I’d also, treat thyroid cancer and a few more.
        I probably wouldn’t treat Stage 2 or more pancreatic or oesophageal cancer – the prognosis is poor. I lost a sister-in-law to oesophageal cancer about 8 years ago, this aggressive cancer that took her life in 9 months. I didn’t realize at the time, but the huge surgery she had to remove part of her oesophagus and reconnect it to her stomach was actually palliative surgery. It took her some time to get over the surgery, then the chemo started, it didn’t touch the cancer, she died shortly thereafter. It didn’t give her more time, but made those last 9 months an absolute misery.
        As you know, I recently watched another SIL suffer through chemo treatments and palliative surgery, this time for pancreatic cancer, she had zero quality of life over the 14 months from diagnosis to death.
        I wouldn’t want to go through all of that…
        I think some people feel like they should try, they might be the lucky one who survives, some do it for their partner, children etc. I think some people need time to get used to the idea of dying, their loved ones have to reach that place as well, some want the time to sort out their affairs and say their goodbyes. Others are terrified of death and the dying process and will do everything and anything to keep living, even if it’s not really living. I think fear of pain also keeps some going with treatments, I know my SIL was fearful of uncontrollable pain at the end, that sometimes happens with pancreatic cancer.
        I really can’t say what I’d do, but as well as coping with all of the unpleasantness of the treatments I’d also, have to cope with hospitals, doctors, nurses, technicians etc. (and loss of control)
        I hope we allow assisted suicide in the future, I think people should have the option of a swift and painless end when it all gets too much for them or they choose not to have chemo/surgery etc. The process has not been abused in the Netherlands. (that country again…) It can be properly managed, let the Dutch show us the way, they can sort out our cervical screening program while they’re here too. (vested interests would be horrified!)

      • Hi Linda, there are loads of different types of cancer and the treatment is different for each one. I think this needs to be made much clearer to the public. Not all cancer is a death sentence, and I hate seeing people post on the web about themselves being cancer survivors, when they’ve had a few dodgy cells removed. It was only when I got womb cancer last year that I realised some cancers really can be cured never to appear again. There are several different types of womb cancer and about 20 different types of breast cancer and they vary very much in the treatment you can have. Some, like me, get surgery alone with no further treatment or follow up, others have more aggressive types with a high recurrence rate, and get a different treatment pathway which might be surgery followed by radiotherapy, but that’s it. No chemo. It’s not always “slash, burn, poison” as I discovered last year. I feel great, and my risk of recurrence is about 5%. Haven’t all of us over 50 got a 5% risk of any cancer? I don’t feel any more at risk than the next person, since the odds are still much greater I’ll die of something else later on.
        It makes me cringe to see some people crowing about how they’ve survived cancer, when they’ve had something very treatable.

34. Elizabeth,

    In the US there are actually number of states that have passed “death with dignity” acts. Oregon’s was enacted by the people of the state in 1997 and has worked well. Washington’s law was enacted in 2009 and Vermont’s in 2013. In addition, a supreme court ruling in Montana stated that there is no Montana law that prevents a physician from prescribing a lethal dose of medication for a dying patient. In all, 25 states have considered some form of “death with diginoty legislation over the past few years.

    Hex

    • And I need to watch my spelling closer….it’s late……

    • I’ll bet New York & California aren’t on the list of places that don’t interfere with things like that. It seems it’s usually the “trendy” places like New York & California that are very dictatorial in a lot of things. Has anyone else noticed that? For all the people there seem to think everyone else is annexing & pushy with most things, it actually seems to be the other way around.

    • Thanks gang. Obviously if cancer happens i will have to do my research. Ada i hope my comments didn’t offend as i didn’t intend to dismiss your experience. I’m so glad you went down the treatment route and recovered. The future is an unknown entity and i had no right predicting what i would do. I’m still shocked at my best friends death. Its coming up to a year in a few days time.

35. Has anyone seen this yet: http://www.sciencedaily.com/releases/2015/09/150917135302.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fhealth_medicine%2Fcervical_cancer+%28Cervical+Cancer+News+–+ScienceDaily%29

    • This is very importwnt news. Here is the company’s website. http://www.inovio.com/products/cancer-vaccines/hpv/cervical-cancer/ They are currently conducting an international clinical trial.

      The treatment for cervical cancer and other cancers caused by HPV involves a vaccine (injected into a limb ?). The study would still involve colposcopy exams and cervicla biopsies to see if it was working. However some patients get the real vaccine and other get a placebo. So in particpating in such clinical trials there is no choice because who gets the real treatment and fake treatment is supposed to be random.

      What I would like for the future to be is have Trovagene urine test for HPV. If a woman over 35 has HPV then she could get the Inovio vaccine in case she has some lesions. I think hell might freeze over before these doctors give up their invasive exams and pap tests. I might also wonder if the vaccine would get rid of those pesky foot warts as well.

36. July 2014, I had my pap results come back abnormal with HPV. I received the call from Dr. L*** telling me that it was imperative that I come in to get a colposcopy. I told her I would make an appt. for it soon. Being so scared to get it done, I waited to make the appt., but was bradded with phone calls by the nurses and receptionist telling me that I NEED to get it done…ASAP.
    A year later, I saw another doctor, Dr. S*** (at the same clinic), for my annual. I explained to her that I was so scared to get the colposcopy and that I am worried about getting cancer or something. She was very kind and said “Well, let’s look at your file.” She looks at it and said “Oh no sweetie, you never had the strain that you would need to get a colposcopy. You never had anything to worry about, dear. Nonetheless, we will test you to make sure it hasn’t developed into the higher strains.” A FULL MONTH later, I receive a phone call from a nurse at the clinic telling me that my pap came back abnormal (high risk HPV) and that I needed to schedule an appt to get a colposcopy done with Dr. L***. Me – “well, first Dr. L*** is not my doctor it is Dr. Sm***, and could you please tell me what is wrong with my pap? Dr. S*** told me I never had the strain that required me to get a colposcopy.” Nurse – “let me pull up your file. Yes, you do have high-risk now…you did before and “the doctor” would like you to get a colposcopy now.” I was extremely skeptical about this vague information that I was receiving, so I ordered a print out of all of my lab results.

    7/28/2014 – Mild dysplasia/CIN 1; HPV High-Risk (Positive); HPV 16/18 (Negative) 9/01/2015 – ASC-US Atypical Squamous Cells of Undetermined Significance; HPV High Risk (Positive); NOTHING ABOUT HPV 16/18!!! And they are STILL calling me to get a colpo

    So, I called the Lab directly and they sent over my lab results which matched those I got from the clinic. When I asked if there was any further information on 16/18 for 2015 labs, they told me “I just took a look at that 9/1/15 pap- it looks like while HPV was ordered and run, the 16/18 typing was not ordered (it is a separate test). That is something we can definitely still provide if your doctor requests it.”

    Why in the world are they telling me, I don’t need a colpo if it doesn’t show positive for 16/18, redo the pap, don’t even test for 16/18, and STILL telling me to get snippets of my cervix taken out for biopsy.

    I’ll be honest, it sounds fishy to me. I’ve read on some articles on women leaving their nursing jobs because they think it is immoral for SO many women having to get colpo’s. Not to mention, this article……. http://www.cbsnews.com/news/fda-panel-recommends-hpv-test-as-replacement-for-pap-smear/

    Clinics get so much money for each PAP done, so reading stuff like that article makes me wonder what other incentives are being given for each colpo? Why was I called SO many times by so many different people to get this procedure done?
    My gut is telling me there is something wrong with the women’s health care system….and truthfully, I don’t care to have my cervix snipped for their financial gain.

37. I’m thirty one and don’t go for well woman/ pap smears. You will be OK with out them. Its bezar to me that healthy sysmtopm free woman are told to subject them self’s to such intrusive invasive exams .

38. Why was it acceptable to so many to “offer” cervical screening in the way we’ve observed over the decades? This article makes some interesting points…that perhaps, partly explain why women are viewed and treated very differently by the medical profession and others.

    “It is clear that the approach to consent in the Australian National Cervical Screening Program was influenced by gendered presumptions about women, as well as by conceptions of science and medicine as rational and overriding interests. Even privileging of rationality itself is related to patriarchal norms.Where women do not comply with role presumptions, the Act replicates rape society tropes about the (lack of) necessity for women’s consent. The consent question in the legislation is ultimately “did she say no, sufficiently clearly and every time?” rather than “did she say yes?”
    As well as being influenced by dominant patriarchal tropes about women and their bodies, the Act reinforces and replicates those tropes, repeating them back to women, health care professionals and researchers. It reinforces the active, dominant role of science and medicine and that women are the object of that process, but that women do not get to decide the boundaries of their care and rights. By imposing no penalty for ignoring a
    “no” (an opt-out) the Act reinforces the lack of importance accorded to women’s autonomy, consent and rights. None of this is necessary. Functional, successful cervical cancer screening can be run without a register that reinforces gender tropes. Women’s health can and should be promoted without creating and reinforcing toxic gendered identities. An opt-in register would serve many of the same needs without reinforcing toxic tropes about the irrelevance of women’s consent and should be preferred to the current Australian model”

    http://www.academia.edu/4464126/No_need_for_yes_Australian_Pap_Smear_Registers_consent_and_the_re-_creation_of_gendered_identities

    • A great article, Elizabeth! This quote simply sums it up, what all those Pap-registers and eHealth systems are about:

      “Record keeping technologies can have wider social ramifications as methods of surveillance. …Medical technology is inevitably politics by other means. Medical and state surveillance may act as a Panopticonic method of disciplinary power. That power is internalised by the inmate of the medical Panopticon so that they comply with rules and expectations in the assumption that non-compliance will be observed and disciplined.”

      I only hope that we will see the day in our life time when these tax-money-wasting, privacy-invading systems of government and medical surveillance and dictatorship will be either dismantled or at least made explicitly voluntary.

39. http://blogs.scientificamerican.com/cross-check/questioning-mammograms-versus-torturing-the-data/
    “Yet another major study has challenged the efficacy of mammograms. The study examined the claim that mammography has helped reduce breast-cancer mortality in North America and Europe by 15 percent or more over the past two decades.”
    Carried out by Archie Bleyer of the Knight Cancer Institute in Oregon, the study found little correlation between screening and the decline in breast-cancer deaths.
    The authors attribute the decline in breast-cancer mortality to advances in treatment, with screening playing a “minor role.” But they cite other studies that raise doubts about even a “minor” benefit; when all causes of mortality are considered rather than just breast-cancer mortality, women who are screened do not live longer than unscreened women.”

    “At the end of their paper, Bleyer and his colleagues imply that not all analyzes of mammography are carried out in good faith. Quoting another health-care analyst, they note that some researchers “torture the data to make it confess to what one knows to be the real truth!”

    “This quote came to mind when I read “Early Detection of Breast Cancer Backed by U.K. Study” by Melinda Beck of The Wall Street Journal. Beck reports on a study, published in the Lancet, on screened British women diagnosed with abnormal milk duct cells, also called ductal carcinoma in situ or DCIS.
    “Some experts argue that DCIS shouldn’t be labeled cancer at all, since it’s unclear whether it will spread outside the milk ducts,” Beck states. But the British study found that “in 90% of the local screening areas, for every three cases of DCIS detected and treated, one fewer case of invasive cancer was diagnosed in the following three years than would have been without early intervention.”
    The study provided no evidence that early diagnosis of DCIS extended women’s lives, and it implied that some women diagnosed with DCIS might have been treated unnecessarily.

    NOTE: “Stephen Duffy, the study’s lead author, nonetheless tells Beck that the findings “suggest that a substantial proportion of DCIS will become invasive if untreated, and it is therefore worth detecting and treating early.
    That sounds like torturing the data, especially in light of Bleyer’s study; or the 2013 analysis by the Cochrane Group, which is renowned for its impartial assessments of health-care practices; or other studies on which I have reported.”

    Couldn’t agree more…

40. Response received: I complained about the inappropriate UK campaigns to scare women into screening, especially, “My Mum missed her smear, now I miss my Mum”.

    “Dear Elizabeth,

    Thank you for taking the time to post such a detailed and considered response to the PHE Screening blog about cervical screening.

    We agree that informed choice is essential in screening. The cervical screening programme fully supports and promotes informed choice for women. Following extensive consultation with women, health and communication experts, and screening providers, we have reviewed our materials and will soon be introducing new letters and information leaflets which strengthen this message. We are aware that a minority of GPs have been accused of pressuring women into attending for cervical screening, and this practice is not something that we condone. Whilst we do not have jurisdiction over GP practice, we do have avenues by which we can disseminate information to GPs about the NHS Screening Programmes. The issue around informed choice and cervical screening is one that we intend to address on a regular basis, to try and ensure that the message is getting out there.

    Self-screening kits are not currently approved for use within the English cervical screening programme, however, we intend to explore the evidence around HPV self-screening to consider a future proposal in the programme. The UK National Screening Committee (UK NSC) has just recommended that primary screening using HPV testing is introduced into the programme. This does use the same technique to collect cells from the cervix, however, it means that only women who have an HPV positive result and abnormal cells found will be referred for colposcopy. In addition to reducing the numbers of women being referred for colposcopy, it is anticipated that the use of HPV primary screening will mean that women won’t need to be invited to attend screening as often as at present.

    The screening campaign you refer to was one that was put together by a local health promotion team, not the cervical screening programme. We very strongly advised that they withdraw it as soon as we were told about it. We agree that it in no way respected informed choice about screening.

    Thank you again for reading our blog, and taking the time to comment on the content.

    Best wishes,
    TJ
    Ms TJ Day MSc MA
    Publications and Information Manager
    PHE Screening”

    • Hi Elizabeth. Thanks for sharing this response from Ms Day. You are being taken seriously, as evidenced by the lengthy, detailed, polite response. However, as you’ve no doubt noted, there are a number of carefully worded sentences that indicate they intend to change very little, if anything at all.

      For example, she states that in relation to informed choice they “will soon be introducing new letters and information leaflets which strengthen this message”. The words “soon” and “strengthen” are vague, and could mean 20 years in the future with added emphasis to a word or two.

      She downplays the vast numbers and role of drs in withholding choice by stating “We are aware that a minority of GPs have been accused of pressuring women into attending for cervical screening” – Minority?! What planet is she living on? And by “pressure” does she mean the withholding of health care and/or medications? She then goes on to state that they do not have “jurisdiction” over GPs, but that they will “disseminate” information to them – okay . . . that will be really really helpful. GPs will surely just stop coercing and bullying women once they get the information disseminated to them.

      Then in relation to HPV screening she states “we intend to explore the evidence around HPV self-screening to consider a future proposal in the programme. The UK National Screening Committee (UK NSC) has just recommended that primary screening using HPV testing is introduced into the programme. This does use the same technique to collect cells from the cervix . . .” So, no intention to allow women to self-collect. The “same technique” will be used.

      She finishes up by stating the screening campaign you referred to was not something they put together, and they will strongly “advise” the local health promotion team withdraw the campaign. Okay, that will likely not do much, for this campaign or future ones. Just what do they have responsibility for? They don’t have sway over GP’s (not their jurisdiction), and they don’t have control over the local health promotion team. They still intend to send letters. They are “reviewing” HPV testing, and even if introduced will still need to collect with speculum exam. Wonderful, thanks Ms Day.

      At least they are taking a great deal of care and thought in their responses to you, and that really is some progress.

      • Sue, I have to agree with you, also, they’ve obviously decided not to allow my comment to stay on the thread, it’s still with the moderators. So they’re still using censorship to keep informed and potentially damaging comments off the website.
        It must worry them though that more and more women know exactly what’s going on…none of the dirty tactics work with informed women.
        They know it’s medical abuse, but calling it healthcare was enough for many years, that doesn’t wash now with more and more informed women rocking the boat.

      • Hi
        You are right about them not allowing the comnents to stay.
        Here is my private email from her. It came late yesterday evening. This is the first time anyone has taken the right to reply.  I also read between the lines.

        Also regarding my complaint to the Eu court of rights – section 2 the right to a private life and the right to decide who sees and touches my body. I have been allocated a number now, this only means I have got past past the first post – one of many now ahead of me

        Dear Linda

        Thank you for taking the time to post such a detailed and considered response to the PHE Screening blog about statistics for cervical screening. We wanted to reply to you personally considering the private nature of some of your comments, so I hope you understand the decision to contact you via email.  We are very sorry to hear about how your experiences of cervical screening have affected you.

         You are quite right that cervical cancer is a comparatively rare disease. The cervical screening programme significantly contributes to this by finding and treating abnormal cells before they have a chance to develop into cancer.

         The screening programme fully supports and promotes informed choice for women. Following extensive consultation with women, health and communication experts, and screening providers, we have reviewed our materials and will soon be introducing new letters and information leaflets which strengthen this message. We are aware that a minority of GPs have been accused of pressuring women into attending for cervical screening, and this practice is not something that we condone. Whilst we do not have jurisdiction over GP practice, we do have avenues by which we can disseminate information to GPs about the NHS Screening Programmes. The issue around informed choice and cervical screening is one that we intend to address on a regular basis, to try and ensure that the message is getting out there.

         Self-screening kits are not currently approved for use within the English cervical screening programme however we intend to explore the evidence around HPV self-screening in order to consider a future proposal in the programme. The UK National Screening Committee (UK NSC) has just recommended that primary screening using HPV testing is introduced into the programme. This does use the same technique to collect cells from the cervix, however it means that only women who have an HPV positive result and abnormal cells found will be referred for colposcopy. In addition to reducing the numbers of women being referred for colposcopy, it is anticipated that the use of HPV primary screening will mean that women won’t need to be invited to attend screening as often as at present.

         Thank you again for reading our blog, and taking the time to comment on the content.
        Best wishes,

        Ms TJ Day MSc MA
        Publications and Information Manager

41. Correct me if I’m wrong but aren’t the two replies virtually identically worded??

    • Hi Kat. Yes they are. I’ve only just noticed. Looks like a cheap cut and paste job to me. X

      • Linda I’m so sorry u must feel disrespected all over again x

42. Hi Kat. A bit annoyed. I hadn’t realised it was identical to Elizs i just thought we were getting somewhere.

    I downloaded the applicatipn pack last week from the euro court of h’rights. I filled it in and sent it off. I am climing ‘victim status’ i have given the reason for not sending any documents because the nhs is refusing to give me my records. I have sited the resson for not providing any details of other complaints to uk governing bodies to the fact they are ignoring me. When u dowload it they give you a bar code and no. to keep up to date with the process. Apparently it can take several months before they even look at it. And then It has to go through a process before they will consider action or not . I don’t suppose anything will come of it but it gave me a laugh filling it in. The thought of someone like me going to the court of human rights – its just not going to happen is it?
    I know i am way over the top but i just can’t help it! X

    • Linda your not. Going too far. Good on you! Kicking off is the only way we’ll get anywhere and who knows more women might do the same!

    • You should have sent a copy to your GP practice!! Have you heard back from these people??

43. http://www.nejm.org/doi/full/10.1056/NEJMclde1512213#t=article
    “CLINICAL DECISIONS
    Breast DCIS — Is Surgery Still the Answer?
    A.L. Merrill, L. Esserman, and M. Morrow”

    This article makes clear if you have a mammogram and they find DCIS you need to get a few opinions before making any decisions. In fact, IMO, women should consider thinking about this situation before they have mammograms. After the discovery it can be hard to put emotion and fear aside, how do I want to “treat” my Stage 0 cancer? Do I want to “treat” it at all?
    I heard an insightful comment at the Evidence Live conference a couple of years ago, “State 0 cancer is NO cancer = you do not have cancer…why would you agree to surgery and radiation when you don’t have cancer?
    Exactly…

    • You are right. There is NO point having any type of screening unless you understand what the result may mean, the “treatment” involved and the odds involved, and more importantly; whether you will choose to have the treatment upon receiving an adverse result.

    • Imagine if they had mammograms for other organs, and you could get (or heavily encouraged/blackmailed) a “liver mammogram” to detect stage 0 liver cancer, or a “kidney mammogram” to find a “kidney DCIS”, I bet they would try to milk this as much as they could, and would quietly acknowledge that these non-cancers appear and disappear from time to time and never cause any problem, but better treat it right now with all the heavy artillery just in case! I think breasts are just very conveniently located for them, there’s no screening for more dangerous cancers because they just can’t squeeze your liver or your brain between 2 plates and x-ray it.

44. http://www.academia.edu/4464126/No_need_for_yes_Australian_Pap_Smear_Registers_consent_and_the_re-_creation_of_gendered_identities

    This is an interesting paper, while I was reading it I couldn’t help but think you could take out the word “register” and just make it cervical screening. It’s not surprising that consent is not really a concern with the register when it’s not really a concern for the testing!
    It’s surprising there are still relatively few critical articles on cervical screening when you consider how badly the program/system and medical profession have treated women – you couldn’t find anything further away from ethical, legal and evidence-based screening.

    ” Cervical testing itself partakes of stereotyped gendered heterosexual intercourse roles. The woman lies on her back, stationary, and is penetrated. The doctor is active, performing the test and penetrating the woman. The doctor’s role reflects heteronormative assumption of penetrators as active and rational, while the woman’s role reflects patriarchal, heteronormative assumptions about women’s role in heterosexual sex acts. The woman is positioned as passive, done-to, merely unresisting, not the active subject of the process. It becomes even easier to ascribe gendered assumptions about intentionality, capability and rationality, where the very testing invokes gendered tropes. This in turn, informs gendered social identities of both doctors and Pap smear patients, which, as detailed below, inform and are reinforced by the legislation surrounding cervical cancer screening in Australia.”

    “Furthermore, because bodily boundary is an essential pre-requisite to dignity, the
    unbounded subject is reduced in status”
    (Savell, 2001)

    “Woman, penetrated with a speculum is cast as both a medical object and sex object, with her status accordingly reduced under patriarchal conceptions of woman as penetratee (Mackinnon, 1982). By allowing herself to be penetrated, she has demonstrated that her rights, her autonomy may be violated, compared to the bounded body of a rational man.
    Objectification makes sexuality a material reality of women’s lives, not just a psychological, attitudinal or ideological one made to appear a quality of the object itself
    (Mackinnon, 1982). Thus, following Mackinnon’s logic, patriarchal discourses mean that woman is for sex,fordoing-to,not a rational actor, but an object to be penetrated.”

    Very interesting comments, certainly the program uses pap testing and childbirth to dismiss privacy and dignity issues, “women have to get used to it” etc. Basically we’re expected to assume the position when we’re ordered to do so, if we don’t there must be something wrong with us!
    So I certainly believe there is a denial of basic human and legal rights.
    Given this test, many consider unacceptable, was basically forced onto most of the female population it says a lot about the way women are viewed by those in power. Even today I hear grossly inappropriate comments but because it’s about cervical or breast screening, no one says a word, yet, IMO, they’d be jumped on if the same comments were made about men or prostate screening.

    • I’ve always had these thoughts about cervical screening. I am stunned that a lot of women do not question the motives of male doctors.

      I also think the chdbirth issue has been hijacked by male doctors and female doctors due to notions of gender perceptions and convenience.
      As women, I am sure I have read that it is far more beneficial for women to give birth while upright or on all fours – a certainly more active, dignified position which also supposedly facilitates labour and reduces pain.
      Yet, the male fraternity within the medical profession and their female accomplices have never liked this as it gives the woman more control over her own body. I’m not sure how open they are to women exercising this “right” even in this day and age, but the NHS have been forced – kicking and screaming – to accept choice in this matter, thanks to a litany of informed women and medical experts forcing their hand over the last few decades, just as with screening.

45. http://www.nejm.org/doi/full/10.1056/NEJMoa1600249?query=TOC

    Another article by Gilbert Welch and others – wait a few days and the usual names will appear madly and aggressively defending breast screening.

46. I was just taking a look at Preventing Over-diagnosis Conference 2016 from here: http://www.preventingoverdiagnosis.net/?page_id=1180 – a very good read if you have the time. Then came across this list of open delegates with names/organisations/email address/country:

    Click to access PODC2016_OpenDelegateList.pdf

    Just thought I would share on this section, you never know one of us may want to use it in the future.

47. http://www.medscape.com/viewarticle/857100#vp_2
    “The most important action that all of us (patients, nurses, doctors, and healthcare writers) should take is to learn from this revelation. There’s nothing bad about the fact that current-day screening tests don’t save lives. Cancer is a tough disease, and in some ways, it may be the natural order of cell biology. What’s bad about this medical reversal has been our blindness to the evidence.

    We let what we believe become what we know. In clinical medicine, that should be a never event”

    I believe vested interests have fuelled this fire as well, and they’re keeping it stoked, they make a fortune from screening and it’s aftermath. Also, certainly in women’s cancer screening, it was always a highly emotive topic, the pap test became a feminist icon.
    I felt it was irrational and quite frightening, it felt like women had lost control of their body, while we were being told the test was empowering. The climate silenced dissenters and turned something that should have been elective into mandatory testing.
    How many women actually reviewed all the evidence (provided to them) and made an informed decision to screen? NONE, would be my guess…
    I had to hunt for the evidence and that wasn’t easy pre-internet, it’s still not easy with most real information locked behind a medical pay wall.

    • That’s because the “-ist” in “feminist” is like the “-ist” in “motorist.” I never got why people think that there’s some kind of exemption from reality for medical personnel- it’s as if they think a doctor’s office is “out of bounds” or something.

      I get that someone might do something as a means to an end, but that doesn’t mean that these situations cease to exist. I say this because everyone would say something to the effect of “It’s not like that” & I have to wonder: “Not like what- reality?”

    • You are right about the feminist icon thing. They were spectacularly stupid, naive and short-sighted – even more surprising, given that men dominated the medical profession at the time of the introduction of screening.

      A prime example of how women can often be their own worst enemies.

48. I’m sorry if I am going off topic and I am sincerely sorry if I unintentionally upset anyone with this, but a while ago, we discussed how cervical screening could be actively used against women and I mentioned rape trials. We know that some defence lawyers will actively try to use a complainant’s medical history to use as ammunition against a victim, such as mental health issues, despite the safeguards created by the Youth and Criminal Evidence Act 1999. It begs the question, what medical history could be seized as “evidence” by a salacious defence team? A litany of “abnormal results”, to imply that the victim has been sexually active and promiscuous?? Is anyone aware of anything like this having occurred? Yet another example of cervical screening being used to punish women by men.

    • Canadian law. Yes the defense can subpeona therapy notes, medical records, and other documents but the judge must allow it for a reason.

      http://www.collectionscanada.gc.ca/eppp-archive/100/201/300/cdn_medical_association/cmaj/vol-153/issue-10/1502.htm

      So this does concern me because the cervical screenings registry records include marital status, number of sexual partners, is she had any pregnancies, abortions, miscarriages, what age that sex started. So what this has to do with one person sexually assaulting a woman in one particular case? She might have seen many doctors in different countries but they can only get certain records they know about but the registrynhas them all in one place. These facts can be used to discredit a woman’s testimony because there is bias about women who are not virgins.

      In other words ladies do not give the registry any information that could be used against you.

      • I have read that Canada has one of the most stringent laws in the world with regard to what “evidence” can be admitted into a rape trial. So much so, that the UK legislators will apparently consider adopting some of it, following a high profile case at the weekend. Perhaps not that stringent after all then?

        You’re right to be worried about that register. Why are they recording information about women’s sexual histories and marital status on that register? The word needs to get out there – this is Big Brother and they are using the info to create an Orwellian society!

        I’ve had a brief read on this topic. Seems like the US has “rape shield laws” to prevent sexual history being used against a victim. Seems that some of the strictest interpretation of these laws are in republican states like Arizona. Who knew? There is also an example of a similar law, though less stringent and slightly more relaxed in more liberal states such as California. This depends on the discretion of a judge and a closed hearing in the first instance, so all in all, more encouraging than what I was expecting.

        A general google search turned up very little but I will continue to research.

49. http://www.smh.com.au/national/health/little-benefit-to-pap-smears-for-women-under-25-study-shows-20161012-gs0wrz.html
    Gee like how many years have we been saying this now for? Especially Elizabeth.
    How may women are going to put two and two together and realise they were overdiagnosed? No they will be outraged and say they wouldn’t be here today if they didn’t have their pap smear at 19 which was highly dysplastic.

    • I know, we must be the thickest people in the world, the Finns and Dutch knew screening those under 30 was risk for no benefit back in the 1960s! I’d say our program and vested interests have been deliberately looking the other way, while it was safe to do so….now with more informed women, they’re forced to make some changes.
      In 30 years time, they’ll probably come out and say, “we now know it’s not a good idea to do HPV testing on those under 30″…

    • They’ve been careful with this “new” research, I can’t find a single site that allows comments, this seems to be the trick these days, they can’t trust us, we might actually challenge the misinformation and lies. “New” research…hardly!

50. Yet another study telling us what we already know, but note:
    “Experience with cervical abnormalities substantially increases screening adherence”
    http://www.sciencedirect.com/science/article/pii/S0091743516303735

    I’m convinced this is one of the reasons why nothing was done about our over-screening program resulting in high false positive, over-treatment and excess biopsy rates. It was probably viewed as a plus by the protectors and promoters of the program.
    Many of these women were scared to death or considered themselves survivors and were vigilant going forward with their screening, no doubt warning their friends and family to, “get screened, it saved my life”…
    Here in Australia, it’s a very large group, about 77% of women who take part in screening end up having something done to their cervix.

    We know this program needed huge numbers to make any difference at all to the already low incidence rate for cervical cancer. The high screening target meant these women played an important role, they were “used” by the program.

    So there was no value placed on the healthy cervix.
    There was also no value placed on the health and well-being of the majority of women who could never benefit from screening.
    There was no respect for our legal rights or bodily autonomy.

    It also “looked” like they were saving lives so that PR helped keep the program in place, make it “look” like a sound use of health resources, and it kept women deceived – making it “look” like cervical cancer was a huge threat and screening was, therefore…an absolute must.
    The fudged statistics, again, to make the program “look” good, on and on…

    All smoke and mirrors…

    I don’t believe RCTs would have backed the formation of these programs. This is why politics, vested interests, pressure groups etc. should be kept well away from screening decisions – you just waste a fortune and harm and even kill a lot of healthy people.
    Can’t help but think….
    If this vast amount of money had gone into mental health, (always poorly funded) how many lives might have been saved? How many might have had a better quality of life? Better family life? Live more independently? There are many other examples, mental health is only one seriously under-funded area.

51. Yes Elizabeth. I have a friend who told me the other day that she is going for a pap smear. I urged her to wait until May and have an HPV test. But she was ‘overdue’ by a year and was worried because she had cin 3 many years ago. I could not convince her that she probably had a false positive and the merry go round she went on was a result of a poor test not because she almost got cancer. it’s so hard when all the medical professionals she dealt with were scaring her. And why would she listen to the one dissenting voice? They really have fooled a lot of women.

52. Cervical Stenosis (CS) caused by large loop excision of the transformation zone (LLETZ): http://www.gponline.com/case-study-amenorrhoea-cervical-stenosis/obstetrics/article/587405
    Cervical stenosis is a recognised complication following treatments for cervical dyskariosis. It is defined either as cervical os narrowing preventing the insertion of a cotton swab or as difficulty or inability to perform a cervical brush smear.

    Most treatments for abnormal cervix cells are for no benefit at all, but quite a number of women experience CS and need further treatment to help the issue that they will most likely have for life! This is a painful condition that they caused by the LLETZ treatment – wow they don’t highlight this to the women who are consenting to it, truly shocking!

53. http://www.nhs.uk/news/2017/01January/Pages/MRI-scans-could-spare-25-per-cent-of-men-from-prostate-biopsies.aspx

54. Click to access Board%2014_McCaffery%20Kirsten.pdf

    The program has gone out of its way to scare and mislead women, so many women assume cervical cancer is a serious threat, only being contained by pap testing and “treatments”.
    Look at all the women who’ve been “saved”…of course, we know almost all of these women were simply over-treated and left with the impression they were saved, “you’re lucky, we got it in time” etc. That was said to a workmate who had treatment for CIN 2 about 7 years ago, no mention was made that most CIN 2 resolves with no treatment at all or it doesn’t progress to cervical cancer.
    When I spoke to her, she also told me that HPV had not been mentioned, but interesting she’d had a baby a few months before the pap test, so my guess…it was a false positive and I’ll bet she was also HPV- (Another interesting point: she’d had years of normal smears until the CIN 2 shortly after childbirth…)
    The option of re-testing was mentioned, but she was afraid when she heard the next progression was CIN 3 or carcinoma in situ. The latter sounds like cancer, but as we know, it’s actually pre-cancer.
    So, could she make an informed decision with that selective “information”? Hardly.
    A simple HPV self-test could have cleared up the issue, but no mention was made of HPV or HPV testing.

    Most CIN 2 does not progress, she was most likely to have a false positive result because of her pap smear history and recent delivery.
    So the “information” provided to her was very one-sided so hardly surprising she opted for treatment. (an ordeal, especially with a young baby at home)
    It’s not only what they say to women, it’s also what they choose not to say…all carefully designed to keep us in the dark.
    It’s the perfect deception really but women (and men) make bad decisions when they’ve been misled, decisions that could have a major negative effect. I’ve looked at studies where women put the risk of cc ahead of bowel cancer, after all, we hear so much about cc and cervical screening, not as much about bowel cancer, nowhere near as much…
    BUT bowel cancer is far more likely – so misleading women over the risk of cc might be viewed as a clever trick, but it’s culpable. So many women would never miss a pap test, but don’t fear the real threats out there. I’ve heard heavy smokers scoff at lung cancer, but are full of concern about cervical cancer. I even spoke to a woman online who gave up smoking because her doctor said it increased the risk of cervical cancer! (no mention of lung, throat, mouth and other cancers, respiratory disease etc.)

55. https://www.drmcdougall.com/2016/10/17/dr-h-gilbert-welch-publishes-large-study-showing-mammography-does-more-harm-than-good/ (Interview with Gilbert Welch about his latest research findings on the value of mammograms)
    The Study: https://www.ncbi.nlm.nih.gov/pubmed/27732805 (published Oct, 2016)
    Findings: “Although the rate of detection of large tumors fell after the introduction of screening mammography, the more favorable size distribution was primarily the result of the additional detection of small tumors. Women were more likely to have breast cancer that was overdiagnosed than to have earlier detection of a tumor that was destined to become large. The reduction in breast cancer mortality after the implementation of screening mammography was predominantly the result of improved systemic therapy”
    Thank you, Gilbert Welch – in my medical hall of fame.

56. This is something women need to see, a good read:
    http://www.healthnewsreview.org/2017/04/news-race-report-cdcs-numbers-hpv-infection-rates-important-context-missing/
    2. Most infections clear up quickly. Most coverage downplayed the key fact that HPV has a very high “clearance rate” compared with other sexually transmitted diseases. In other words, 90% of HPV infections, including those linked to cancer, go away on their own within a couple of years and most cause no symptoms. Out of nine news stories we looked at, three didn’t report that information. The remainder reported it in the fourth, sixth or eighth paragraph.
    3. Only a tiny fraction of infections turn into cancer. A minority of news outlets informed readers of the actual number of U.S. cancers estimated to be caused by HPV — 30,700 annually. That figure is far lower than the number of people infected with HPV strains linked to cancer, which is somewhere on the order of 50 million at any given time. By our very rough calculation, 1 in 1,600 people infected with a “high risk” HPV strain will actually develop a related cancer.

57. http://onlinelibrary.wiley.com/doi/10.3322/caac.21392/full
    An overview of cancer screening in the States, lots of “should” for women’s cancer screening, and a lot of emphasis on risks and benefits and informed consent for prostate screening. We have a lot of research now about the risks with breast screening, that risks may exceed any benefit – yet we still get a “should”…it seems like the medical profession and others simply don’t want to hear, especially when it’s women’s cancer screening. At this point, surely it’s culpable to just say “should” – the evidence that it’s a very close call is now long-standing, and all decent research says the same thing, over and over again.
    Latest review by the NCI (2017)

    Click to access mammography_screening_leads_to_substantial_overdiagnosis.pdf_letterhead.pdf

58. https://www.harding-center.mpg.de/en/health-information/fact-boxes/early-detection-of-cancer/breast-cancer-early-detection

    A brilliant infographic at the bottom of this item from the Harding Center for Risk Literacy. If anyone is pro-breast screening, just send them this link and ask them which group they’d like to be in.

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