353 comments

1. 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

2. 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??

3. 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.

4. 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.

5. 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.

6. 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.

7. 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.

8. 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.

9. 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!

10. 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.

11. 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.

12. 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!

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

14. 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.)

15. 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.

16. 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.

17. 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

18. 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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