References and Education

This page provides links to the references and resources found on *forwomenseyesonly*.  The references are sorted by post and are presented from newest to oldest.  Many of the links have been provided by contributors to this blog.  Some posts and links have been excluded where context is important/to avoid repetition.

What Pap Testing Should Look Like in 2013:

A comparison of pap testing in the Netherlands (begins at age 30) with the United States:

Balancing benefits and risks:–cervix-scarred-shut/show/479102

Why doctor does not have pap smears:

Common misconceptions:

Should we abandon pap testing:

Urine test for HPV:

HPV testing for cervical cancer:

Sexual Abuse Under Guise of Health Care Presents Barriers:

Incidence of sexual abuse within health care:

Unnecessary exams under guise of care: Dr. Stanley Chung

Click to access 10051301.pdf

Doctors operate unchecked:,0,2850650.storygallery

Many complaints filed to no avail:

Tips to prevent sexual abuse in medical settings:

Forced rectal exam:

The White Wall of Silence:

The Love Surgeon:

Dangers of Versed and Conscious Sedation:

Same Gender Maternity Care:

Why women should avoid male doctors for intimate health procedures:

Pelvic exams without consent:

Sexual abuse by gynecologist:

Gynecologists duke it out with task force over pap testing young women:

Cervical Cancer Screening in the United States and the Netherlands: A Tale of Two Countries:

Cervical Cancer and Older Women:

Ob-gyn groups nix cervical cancer screening guidelines:

Recommendations on screening for cervical cancer:

Women boycott unnecessary pelvic exams by buying birth control pills online:

Birth Control Pills Linked to Abnormal Pap Smear Results:

Committee Opinion – over the counter access:

Women seeking birth control get unneeded exams:

Choosing a Birth Control Method:

Over the counter access to birth control pills backed by ACOG:

Websites for online purchase of birth control:February 18, 2013 at 4:04 pm

Tips for trustworthy online pharmacies:

Drop the paternalism and sell the pill over the counter:

Patient’s bill of rights:

Code of ethics:

Pelvic exam necessary for contraception?:

Managing contraception questions:

Map of birth control pills available without prescription:

Over the counter birth control access – working group:

Yaz birth control pills suspected in deaths:

Sex and the law:

New HPV test for men:

Click to access Student%20Presentation%20Paper%20-%20HPV-%20Melody%20Wainscott.pdf

Moving oral contraceptives over the counter:

Honesty in screening best policy:

Naturopath doctors:

Balancing hormones naturally:

Cancer incidence for common cancers:

Top ten cancers:

Marketing of Pap Tests Can be Misleading:

Scotland Raises Cervical Screening Age:

Stop Pap Tests in Women Under 25:

Video of Conization (Cone Biopsy) WARNING may be disturbing:

Colposcopy – Why did my cervical biopsy hurt so much?:

Fewer women screening:


Complications of LEEP and biopsies:

Patient Sex Abuse Problem Makes its Way Into Mainstream Media:

Patient Sex Abuse Still a Challenge in Ontario:

Doctors Disciplined for Sex Abuse But Keep Working:

Posted Notices Confusing:

Sexual Misconduct by Doctors:

Modesty Violations:

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

How accurate are pap smear results?:

Cervical Cancer is Rare:

More Money for GPs for Tests:

Bimanual Exam Unjustified:

Screening Harms:

Cancer Facts and Figures:

Lifetime Risk of Cancer:

Cervista HPV Screen Without Pelvic Exam:

Study Questions Reasons for Routine Pelvic Exam:

A Critical Evaluation of the Pap Test:

The annual pap test – A dubious policy success:


Informed Consent:

Outcomes of screening to prevent cancer:

Stop pap tests in women under 25:

How did he get away with it for so long?:

Pressure on laboratories to produce abnormal pap smear results:

Informed Consent for Pap Tests/Pelvic Exams Still Not Offered to Women:

Patients Rights:

Informed Consent Missing:

What Some Male Doctors Do When Women Say “No”:

Why Doctor Does Not Have Smears:

Why I’ll Never Have Another Smear Test:

GPs Bully Women Into Smears for Cash:

Violet to Blue:

Battle Brewing Over Pointless Pelvic Exams:

Do New Guidelines and Technology Make the Routine Pelvic Examination Obsolete?:

Questioning the Pelvic Exam:

A Pelvic Exam is Not Necessary to Test for Sexually Transmitted Diseases:

STD testing without exam:

Procedures for STD testing:

Which tests you should get:

Tests done without swab:

Is there a herpes blood test?:

The Other Side of the Speculum: A Male Doctor’s Point of View:

Original Comment: July 16, 2013 at 7:42 am

A Pelvic Exam is Rape:

I’m Taking Back My Pussy:

Why Does a Man Become a Gynecologist:

From Both Ends of the Speculum:

Hysterectomy Alternatives and Aftereffects:

Hysterectomy Consequences:

Inappropriate Touching in the Doctor’s Office:

UK Policy Database:

Patient Modesty – Student convictions:

Birth Trauma:

Sexual Misconduct by Doctors – Chaperones:

Doctor Attempts Rape on 14 year old Girl:

Patient Modesty – Reasons to Avoid Male Doctors:

What is your opinion on the pelvic exam?:

Gynecologist Degradation of Women Disguised as Humor:

Sensitive Examinations and Your Right to Say “No Thank You”:

British Columbia College of Physicians and Surgeons’ Guidelines:Sensitive-Examinations.pdf (application/pdf Object).

Our feel-good war on breast cancer:

Is a pap test necessary every year?:

Precautionary with Pap Smears:

Is the Routine Pelvic Examination Obsolete:

Miscarriage after pap smears:

Cancer Screening – Benefits and Harms:

Diagnosis – Insufficient Outrage:

The Overtested American:

Corporate Crime in the Pharmaceutical Industry:

Women and doctors:

New Study Backs Less Frequent Pap Smears:

Outdated practice of annual cervical cancer screenings may cause more harm than good:

Scientists Seek to Rein in Diagnoses of Cancer:

Growing uncertainty about breast cancer screening:

8,398 Comments and Counting on Blog Regarding Unnecessary Pap Smears:

Recovered Comments:

Breast Cancer Screening Fails to Cut Deaths:

Researchers are saying unnecessary pelvic exams are “Worrisome”:

You might not need that pelvic exam:

The harms of overtreatment:

Cervical Cancer is . . . RARE??:

Statistics (Canadian, 2008):

Reaching Targets – are current practices unethical:

Honesty about Screening Programmes is Best Policy:

Comparison of Screening in Netherlands versus the United States:


Me and Pap Tests Don’t Get Along:

Birth Control Pills Without Prescription:

Holding Birth Control Hostage:

SoloPap Test Kit:

Five Real Reasons Physicians Want to Examine Your Pelvis:

Physician Sexual Misconduct:

Prevention of Sexual Misconduct by Doctors:

Cervical Cancer Screening Using HPV Testing:

Thank you to Elizabeth for suggesting a method to keep references and education in one place.


  1. Hi Sue, regarding your above comment that there was only 1 research article about HPV contaminated specula and no further research done. It sounds to me that that article confirmed without a doubt, that the old metal ones did indeed spread the virus, so that is why no further research was done, and the metal ones have since been replaced by disposable plastic ones. In the UK now, the transparent plastic disposable ones are used and these are sealed up and only broken open just before use. Proof, if ever there was, that the virus was being spread by unclean specula.

  2. You might recall I attended the Evidence Live Conference in March 2013 (Oxford, UK)
    I must have looked like a giddy middle-aged fan in that company, my medical heroes. (although Prof Baum was missing)
    This year it was held at Dartmouth in the US, you can listen to some of the speakers on this site.
    Dr Iona Heath, ex President of the UK College of GPs, her close to parting statement is spot-on, “I just wish they’d leave well people alone”….so do I.

  3. Sue
    Add this to your breast screening homework list: the speech made by Peter Gotzsche, head of the NCI, at the Evidence Live Conference in Oxford in 2013.

    I was lucky enough to be present for this speech, music to my ears!

  4. Sorry Sue, I posted the wrong link.
    Mind you all of the lectures are informative and worrying….thank goodness, we know what’s going on and don’t form part of the trusting and compliant herd.

  5. Sue, sorry, I see what’s happening, if you scroll down Playlist, you’ll find the lecture I’m talking about with lots of extras.

    • Awesome, thanks Elizabeth. I won’t be able to get to it for a while, so if you think of more references in the meantime please pass them on (not that you haven’t already provided enough). I do like Peter Gotzsche, yes music to the ears!

  6. Sue, I’ve been having a problem with hitting the Like icon & it goes up, but then it goes right back down again. Also, I think one of my comments didn’t load (that or got removed, but I figure you’d have told me if I offended). Just thought I’d let you know.

    • Hi Alex, thanks for letting me know. There was an issue with spam a few days ago, when comments were being held by WP for moderation that were not spam and shouldn’t have been held. This site gets hundreds of spam comments every week, but WP has a way to hold them back from the site so maybe your comment got lost in the spam queue. I would not purposely hold back any of your comments. The ‘like’ buttons have been glitchy for me too, I’m not sure what can be done about it though as they are from Polldaddy and not a WP feature. Thanks again Alex, I think the spam issue has been sorted out and it should be smooth sailing now but please let me know if there are issues with comments.

      • Okay, thanks. I just figured maybe I was being offensive (but I figured what I had said wasn’t really above anything else I’d said). I don’t exactly remember what it was, it had something to do with all the “Anglo” countries acting alike when it comes to this sort of thing (being medically dictatorial, I mean- with special emphasis on general pervyness). It seems the German-esque countries do, too (Germany, itself- but also sometimes the Scandanavian & Baltic countries). Don’t know what the deal is with that.

  7. A couple of articles here from the Lancet in 1986 about catching the HPV virus from unclean specula. Only sections of these articles have been typed.

    Viruses, specula, and cervical cancer, The Lancet April 5, 1986, D. C. G. Skegg & C. Paul
    In New Zealand, as in other countries, we have been concerned about the rising incidence of cervical cancer. … Recently we heard that one large clinic was reusing plastic disposable vaginal specula after cleaning in tap water and immersion in “Savlon”. This might not kill papillomaviruses. GPs tell us that their practices for disinfecting specula vary widely, and some doctors were not fully aware of the risk of transmitting viral infections in this way. … Most practitioners do not have the facilities for sterilising instruments that are usual in hospitals.

    Risk of transmission of HPV by vaginal specula, The Lancet October 4, 1986, McCance, Campion, Baram, Singer.
    In response to Skegg and Paul’s warning, we investigated the risk of iatrogenic transmission of HPV via specula inserted into the vaginal vault of women with subclinical HPV infection. We investigated the possibility that HPV could be detected in cells adhering to specula after colposcopic examination of women with pre-malignant disease of the cervix (CIN grades 1-3), associated with HPV infection. Many of these women also have HPV infection in other areas of the lower genital tract. The specula, after colposcopic examination and removal from the vaginal vault, were rinsed briefly in an aqueous solution of chlorhexidine to remove excess mucus and then washed thoroughly in phosphate buffered saline to remove adherent cells which were collected in a clean sterile container. … 29 specula from different women were examined and HPV16 DNA sequences were detected in 4 cases with 3 other equivocal results. This HPV type is associated with most of premalignant and malignant disease of the cervix.
    To confirm these findings cells from a further 16 specula were examined by Southern Blotting. Total DNA was extracted from the restriction enzyme Pst1. HPV16 DNA sequences were detected in 1 instance: 5-20 copies per cell were detected. This small study shows that HPV infected cells can be found on instruments inserted into the vagina of women with HPV infection, and if these instruments are not cleaned and sterilised properly they will be a potential source of infection for subsequent patients.

  8. Please be informed that I had previously posted up several articles about this topic of sterilizing or high level disinfection of instruments used for colposcopy. One Canadian hospital even admitted that they were not processing equipment properly and patients were at risk of contracting HIV, hepatitis etc although they did not mention HPV contamination.

    Even reviewing standard practices of colposcopy, it seemed to suggest that equipment was only sterilized by steam autoclaving once per day. Particularly the instruments used for cervical biopsy (cutting into flesh) were reused all day after high level chemical disinfection. The biopsy punch costs several hundred dollars each and they might only have a few of them. Steam autoclaving reduces sharpness of surgical instruments. Are you horrified yet? Other types of surgeries have higher standards and even dental practices. However because whatever instruments (colposcopy, colonoscopy) is going into the body that is covered by a mucus membrane is not considered as important is what is cutting into the tissue. Sorry did I mention that biopsies might happen during these procedures and there is cutting and micro-abrasions formed? Also isn’t that how HPV infects through micro-abrasions caused by sexual activity? Why is all the reusable equipment going into our mouths at the dentist sterilized (not those xray cards, gloves, resins)? I really doubt that those private colonoscopy clinics are really cleaning properly and chemically “sterilizing” their reusable scopes the full time needed with their high volume of procedures per day. At all they need to make money. Any healthy person infected with HPV from contaminated equipment will take years to develop cancer. Who would ever know?

    How many times do I have to repeat asking this?

    Typing the HPV strains every time a colposcopy or pap is done might actually give someone a clue but it is not happening. No study ever published?

  9. “The TGA has received proposals for several oral contraceptives to be re-scheduled as pharmacist only.
    Among the proposals, which have drawn condemnation from the AMA, are to move oestradiol, levonorgestrel and dropsirenone to Schedule 3.”

    The AMA want the Pill to remain on script and we all know why…

    “It will lead to fragmentation of care and a lack of continuity of care, he says.
    “You will end up with the patient never coming to see the doctor and [missing out on] mammograms, breast self-examination, Pap smears, blood pressure checks. All those things related to lifestyle won’t be checked.”
    (from the 6 Minutes site, sadly, I can’t link the article, it’s a site for doctors only, not sure how I got access)

    Of course, we don’t hear this argument about things that might force men into the consult room.

    Requirements for the Pill: medical history and a blood pressure, this could be handled by a pharmacist or by the woman herself. No privacy in the pharmacy is another argument used by the AMA, I’m sure pharmacists would sort out that issue if this opportunity presents itself. I think we need to do more with our highly trained pharmacists. The AMA seem to view them as a threat, when they should be working with them to achieve the best outcome for women. (all of us for that matter) No, it’s a turf war as far as they’re concerned, they’re not doctors!

    Basically, they’ve always used the Pill to force women into cancer screening and pure excess, (routine breast and pelvic exams) and they want that to continue, so they must stay in control of the profitable herd.
    Breast self-examination has been out for ages, yet they throw that in as well.
    They are so transparent, this has nothing to do with health and everything to do with the medical profession and others wanting to control women, maintain market share and maximize profits.

    I get the feeling more are waking up the AMA couldn’t care less about women, IMO, they have given women bad medical advice for years, urging them into early pap testing and serious over-screening and IMO, they’ve never respected consent/informed consent for women. When it comes to the risks of screening etc. the AMA is silent.

    • Well, doctors seeing the pharmacists as a threat isn’t really all that hard of a leap to make- it’s someone OTHER than them handling things, more & more of their job can be done by false labeling, and ultimately they wouldn’t be imposing these kinds of things on people.

      I don’t think things like this are really about money, or at least not entirely. I think it’s got a lot to do with malice- whether that’s pervyness, causing problems in itself, lying in itself, general dictatorial conduct, whatever. It seems to me that they are looking to INFLICT things on people, whatever the dynamics happen to be.

  10. OMG, read this:
    “I guess the “Private Consulting” area could easily accommodate the pharmacist doing a quick PAP test, just shove the pill bottles and potions aside, and hop up on the table. While your up there just unbutton the blouse and we’ll do a breast check. It is my experience that many women go to great lengths to avoid a PAP test, like going to bulk billing clinics where doctors being rushed for time due to patient number pressure easily circumvents the test. My practice is to insist on the PAP test when due or no pill prescription, or proof of result from another practice.”

    I’m about to email this comment to the Medical Board, this is one of the most concerning emails I’ve read in some time. It is also, hugely disrespectful of women, it says a lot about the attitude at work here. He appears to be a GP in a major country town.

  11. I haven’t seen this article amongst the references and education section, and it is one of the very few that criticises the pressure and bullying that British women have been put under due to the payment targets British GP’s have to meet.

    Reaching targets in the National cervical screening programme: are current practices unethical?
    Peggy Foster & C. Mary Anderson, Jnl of Medical Ethics, 1998, 24, pp151-7.
    It seems to be freely available online.

    Click to access jmedeth00314-0008.pdf

  12. Interesting article on the effect of unbalanced information in the German HPV vaccination brochure.

    I think unbalanced (it could also, be called biased, incorrect or misleading) information is the norm in women’s healthcare, it amazes me that “stories” are provided to women, men get the evidence and a choice. (that’s certainly the case with prostate screening)
    It’s a scandal when this testing carries risk, even serious risk.

    “German HPV vaccination leaflets do not provided balanced information.
    Unbalanced reporting reduced people’s understanding of the HPV vaccination.
    By contrast, balanced reporting was found to increase their understanding.
    The differences in reporting did not affect people’s actual HPV vaccination uptake.
    However, only balanced reporting induced an intention that reliably predicted the vaccination decision.”

    This is an excellent book review of Professor Linda Bryder’s book on the National Women’s Hospital incident: Women’s bodies and medical science: an inquiry into cervical cancer.
    It shows how irrationality took over to ruin a centre of excellence devoted to sparing women mutilating surgery and widespread screening. So depressing to read how misguided and blinded women have become to screening.


    This group are based in Boston, they have their work ahead of them with many American women still facing medical coercion to force them into screening. (holding the Pill and other meds or sacking you as a patient) There is certainly more talk about the harms of screening and informed consent, I wonder if your doctors are listening or is it business as usual at the surgery level, for most of your doctors anyway?

    • “We’ve seen a seismic shift in the last 25 years. And although the road is long, I’m very hopeful and confident that in the next 25 years, it will be second nature to engage patients in conversations about these important health care decisions”, says the lady in the article.

      Elizabeth, we could be dead by then.

      • Ada, yes, I know….
        I used to think that I’d be talking to myself about the outrageous treatment of women by these programs and the medical profession for the rest of my life, but things are changing…it’s been painfully slow progress, but I can see the light at the end of the tunnel.
        I’m still amazed that most of my posts sit uncensored on all sorts of websites, that was not the case a decade ago…and many women agree with my comments, that wouldn’t have happened either, it would have been a barrage of outrage and abuse.
        No one has accused me of killing women for sometime now.

        There is no doubt in my mind though that the ONLY reason they are finally changing our program is because more women are refusing to follow our program, they can no longer get the numbers, (it’s harder to deceive, pressure and trap informed women) and it’s the ONLY reason our GPs now provide the Delphi Screener. (I doubt it’s ever mentioned to women, but there in case an informed woman asks for it, they want to keep their claws in as many women as possible)
        The evidence is getting to more women and it’s comforting to know when we go…there are at least more informed women around to continue warning/educating and supporting women.
        So the ignorant and compliant pool of women is getting smaller all the time, that spells trouble for these highly unethical and harmful programs. (I’d add unlawful)

      • Elizabeth, I am in awe of the amount of work you have put in over the years, and how much abuse you must have put up with in the early days, from people believing that this ridiculous test was the golden solution to women’s health. I’m also grateful to Sue for maintaining this website, which has been a source of comfort for all of us battling the system. But I also think that the logistical and cultural problems of bringing pap smears to the third world where cc is more prevalent has been a major factor in the pap reaching the end of the road. These women do not live in an over-medicalised society where the stirrups are promoted as a part of a woman’s health maintenance, so a less invasive solution such as a vaccine had to be found. We can be grateful to women everywhere for refusing to attend, and pushing for change. I would so much love to see this screening programme fall like a house of cards, and those who have pushed this testing, in the courts for human rights abuses.

    • The united states still has long ways to go. Woman hear are still pushed to have “well woman exams”. When woman submit to pelvic exams every year they have no idea they are given paps at the same time. Don’t get me started on american TV and movies. Drenched in healthy woman going to gyns joke’s about being up in stiurups ” because all woman have too” so why not make a joke about it. So much brain washing and all these reality TV shows with the healthy femail cast filmed going to gyns. I’m sick of it.

      • There’s an episode coming up in the new series of Orange is the New Black, called “The Rapiest Pap Smear”. I can’t find any synopsis but comparing it to a rape, and knowing that the programme and book it’s based on are very much focused on how the prison service cares (or doesn’t) for its female inmates, I’m hoping this will be the first time pap smear objection is raised on a popular television programme.

  15. “I would so much love to see this screening programme fall like a house of cards, and those who have pushed this testing, in the courts for human rights abuses”

    So would I…that would be a huge step forward in women’s healthcare and improve quality of life, this testing has a huge and negative impact on our lives.
    The African rates of cc have been used here to scare women into our program, the lies are shocking, “we don’t have these rates because we have a fabulous, amazing, stupendous cervical screening program, we’re all sooooo lucky”
    Of course, we all know that’s absolute rubbish.
    I know the Bill and Melinda Gates Foundation are vaccinating some African women (HPV) and some pap testing is being conducted here and there.
    CC IS a problem in Africa, but other things are still far more likely to take your life…violence, starvation, childbirth, diseases like AIDS, TB, malaria etc.

    The numbers taken from the World Health 2012 Global Burden of Disease chart: (WHO)

    AFRICA – Deaths in 2014
    620,000 HIV/AIDS
    289,000 Childbirth (or as a result of childbirth)
    320,000 Malaria
    203,000 Starvation
    124,000 TB
    50,000 Cervical cancer
    26,000 Syphillis
    4492 Ebola

    I don’t mean to be flippant about the higher rates of cc in Africa, but decent condoms handed out to the population, educating men and women on their proper use, and promoting contraception/safe sex makes more sense than pap testing and HPV vaccination. (condoms would also, reduce the risk of HPV and pregnancies)

    So even in Africa, does it make sense to channel lots of resources into pap testing, vaccines etc. when there are far greater risks? Although that’s what we do in the developed world, we spend a fortune on cervical screening and ignore or underfund FAR more likely risks to our health.
    Training women to be midwives and funding their services would also, save more lives.

    The hysteria about cc in the developed world has IMO, been manufactured by the program itself, by pressure/lobby/women’s groups (who haven’t a clue) and by those with a vested interest in screening and over-treatment. (and by the very large number of “survivors”)

    • I’ve been investigating the UK government’s new ”Be clear on cancer” campaign, as I saw one of the first adverts on TV last night. The campaign is sensibly, deliberately avoiding 2 things: cervical cancer is not part of the campaign, much to the disgust of Jo’s Cervical Cancer Trust, (who have made it part of their manifesto to get back into the campaign). The other is that screening is not featuring as any part of the campaign. The emphasis is on making clear what the symptoms are, and telling people to get their symptoms checked out if they have had them for more than 3 weeks. I agree with this policy, and hope it will see a shift in tackling the main cancers, rather than the pink ribbon ones.

      I also read an article, (can’t find the link now), about how to wind down screening programmes, and this said that instead of having the “all or nothing” 80% incentive target for doctors, this should be changed to a stepped system of bonuses, so the poor doctors don’t suddenly find themselves with a drop in income, and can settle for something a lot less than 80%. This change has happened in the UK recently, and we now have the stepped increment system. Another change is that the centralised management of the cervical screening programme has been wound up, and devolved to local authorities, who have been left to promote or not promote their services as they see fit.
      Yes, it is the start of the big people at the top, washing the blood off their hands.

  16. Uncovering more truths about all this HPV and cancer business.

    I just came across this tidbit. The AAV2 virus. This virus does not cause disease but women who have it are NOT likely to get cervical cancer from an HPV infection. It has antitumor activity.

    So quite bogus to push pap tests and HPV tests to scare women.

    • Now they’ll probably try to put this virus in some kind of injection that’ll do other shit. Cynical of me, I know.

  17. Hi everyone, I’ve been pretty busy lately but I still think of you all.
    I just got a note from my daughter’s school about vaccinations. They want to do HPV, varicella and diptheria,tetanus and pertussis vaccinations. I am refusing the HPV vaccine on the grounds that it says by consenting to the HPV vaccine you are also consenting to your daughter’s details being collected by the National HPV Vaccination Program Register and linkage to the National and Cervical State Cervical Screening Program Register. And then of course they have the blurb about how 2 yearly pap smears are still important, even after getting the vaccine. So angry that they think they can give my daughter’s medical details to whomever.


    We all know what happens in Australia, informed consent in WOMEN’S cancer screening is an academic concept largely ignored in medical practice, in some cases there is no consent at all.
    We have the AMA continuing to “link” pap testing and the Pill, one spokesman even seemed to be endorsing medical coercion. We have doctors who see the consult for the Pill as an opportunity to engage in excess and to pressure/force/mislead women into cancer screening.
    Talk of taking the Pill off script has the AMA screaming, “NO!”
    The pathetic attempts to justify keeping the Pill on script are so transparently about maintaining market share and protecting profits from over-screening, excess biopsies and over-treatment.
    The AMA still protects our cervical and breast screening programs, not women.
    A doctor objecting to the Pill coming off script said he saw the consult as an opportunity to do STI testing, talk about the importance of breast self exams, do a pap test and blood pressure test.
    Yet this same doctor I’ll bet would not vote for condoms to go on script so men might be forced into the consult room for STI testing (they get STIs too) or a testicular exam. (not recommended, but neither is breast self-exams, it doesn’t seem to matter when it comes to the female body)
    It’s clear that many/most of our doctors “assume” consent for pap testing, they view it as mandatory, something we must or should do…that’s not ethical cancer screening.

    • Yeah, the very same AMA is actively pushing the eHealth upon us. They are dreaming of compulsory usage of eHealth to be forced through. Even though that there are many doctors who say that compulsory (or opt-ot) eHealth will damage the patient-doctor relationship, destroy the remnants of trust and make people avoid seeking health care due to privacy and information security concerns.

      I guess as much as practicing doctors can be bent, the health bureaucrats are even worse!

      • I don’t get it. How does eHealth work into anything? Is it just having a record to harass people with? Not for nothing, but falsifying records isn’t really a new thing & neither is identity theft.

      • My experience of eHealth is not good. I dropped out of the pap testing stream years ago when i told them to discontinue the letters. However i did not know that they could keep all my information and contact my new family doctor when I signed up with one. My refusal to get paps and other cancer screenings and meet other bonus rewarding goals such as vaccinations destroyed the relationship i had with the family doctor. In fact i think he was actually stalking me. Whatever he recorded in my medical records is there forever and i have no access to read it or correct it.

      • The aim of eHealth is not to improve the patients’ involvement in their own health care, nor to help those doctors who are really acting in the interests of their patients.

        eHealth system is instituted to assists the governments in keeping the public under medical surveliance, and in finding new ways of making the health care cheaper (note: “cheaper” doesn’t mean more affordable) while scoring maximum political brownie points.

        Only a medical bureocrat who has never saved anyone’s life or made a good difference in anyone’s health could propose and insist that violating people’s privacy and undermining their security by storing personal information in a spread-out system like eHealth is a “big improvement” in national health care.

      • Alice, the system in the UK was to make patients medical records electronically available to those across the medical profession who needed to access them, a good idea, but then it became clear that private non-medical people such as insurance and drug companies would be able to access them. The onus was on the patient to opt out, and, unexpectedly, huge numbers of patients started opting out. It was then realised that opting out of also took patients out of cancer screening, so many in fact that the NHS started disregarding patients wishes and put them back into again so they could be sent their recalls. It has been total chaos in the UK, no-one knows what it means to opt-in or opt-out anymore.

      • @ adawells
        Precisely! Here in Australia we also were initially promised that eHealth will be exclusively for the patients’ good and in total patient’s control. It was rolled out as voluntary opt-in.

        However, the uptake was very low: only 5% of population trusted the government system to collect and keep their most private and sensitive information. There were weaknesses and security holes in eHealth, and many people already knew that Australian Medicare (another government-run health-related system that initially was meant to manage tax-funded subsidies) became a means of government surveillance over Australian people (it reports of people’s movements to other government departments and discloses personal data to research companies) and has hundreds of privacy breaches every year. The Medicare system is run by the same department that is now responsible for maintaining and imposing on people the eHealth and another eGovernment initiative that forces the people to submit and keep all their personal affair data online (tax, children benefits, vaccination, disability, vaccination, passports, etc.) — all this information is out there for hackers to hack and commit identity thefts.

        The low uptake of Australian eHealth was people’s reply: they had enough of privacy invasion, surveillance and risking to become a victim of identity theft!

        So, how did the Australian government react? Did they listen? Huh!
        They made it impossible for individuals to use tax-calculating software without registering an online account with eGovernment. There are also rumours that soon people won’t be allowed to mail paper tax forms — everyone will be forced to go online. The government also proposed eHealth to be made opt-out, with diminished patient’s control of what goes and stays on record. AMA supported the idea and proclaimed that if patients have any control over their medical records, the records become useless to the medical system, despite many doctors saying that doctor-patient trust is more important than a record. Many Australians are suspecting that eventually the opt-out ability in eHealth will be removed, and everyone will have an online health file, whether they want it or not.

        Many people are going back to using paper and other old-fashioned means because they feel it is more secure. And they very suspicious of every new eSolution that is rolled out and touted as something wonderful, because even small medical centres are mowing towards heavy usage of integrated IT systems where “everything is in the cloud”, and the patients’ records are linked to recall and reminder functions. But they forget (or have no idea) that the software solutions they are purchasing and using may be of low quality, made and maintained overseas in third world countries, and “the cloud” means that the patients’ information is kept who-knows-where.

        It is very ironic. The doctors often tell us that patients shouldn’t make medical decisions and interfere with their health care because they don’t have adequate training. Doctors spent years in a medical a school, and therefore doctors know better. But when it comes to data safety, hackers, information leaks, security holes and clear understanding where exactly the data is kept and how it is safeguarded, how much an average doctor knows about all that? Do they have adequate training in this area? No! Which means they shouldn’t be using these systems and endangering their patients just because that is convenient or fashionable.

    • I don’t take the pill but if I went to my doc for a repeat prescription I’d expect that and no more. If I. Wanted to discuss my sexual health or my breast health I’d bring it up myself!!

  19. Creepy. There is a very possessive manner with medical personnel, I’ve noticed. At least that seems to be the case in the Anglosphere/America-esque countries. Plenty of other ones seem to leave people alone more. That, and they don’t seem to be so inclined toward iatrogenic attack across the board.

  20. Important Australian study that shows informed women are less likely to have breast screening. (it comes as no surprise to me)
    It also, says to me the program will fight this move to give women risk information, they’re chasing a target and don’t want women going off and making informed decisions not to screen….they’re counting breasts and have no interest in anything that might put women off screening.

    • Even the fluffy pink pamphlet is not as stupid as the one they put out in Canada. I might add that finding a lump in the armpit is not serious. Usually it is a swollen gland and goes away. I see women runnig off the doctor because thye have a swollen gland.

      What neither pamphlet states is that women can die from cancer treatments themselves because they weaken the immune system. I have seen this many times. Also a person might have a small less serious type of cancer tumour the first time but the depressing effects of the treatment on the immune system causes a more serious type of cancer to grow in the next few years. The statistics will show that successful cancer treatments are deaths that are prevented for 5 years only even if the quality of life is pathetic.

      • I heard of that too: the “successful” cancer treatment stats include every patient who was alive for 5 years after the diagnosis. They can die next day after 5 years – still counted as successful survivor. They can live for 5 years in dreadful pain and misery – still reported as success of the modern medicine.

  21. Pardon for the rant, but I simply have to went it out in the company of educated people, because I feel like I work amongst a group of suicedees.

    Yeasterday I ended up doing some work in an office with all female staff. They were talking about everything, and someone said that someone’s 97yo relative has just been operated for some tumour. Then the talk went about people dying of all sorts of cancers, and then one lady said that cancer is everywhere and it scares her that her 20yo daughter is so slack about her own health. She is already 20 and only had a Pap smear once(!) She is walking towards a certain death of cervical cancer if she wouldn’t look after herself and won’t do Paps more often.

    I couldn’t bear that medieval noncence any longer and told the worried woman to stop panicking. If her daughter was living in Finland or Netherlands, she wouldn’t have had any Paps for at least another 10 years, and yet would have had a much smaller chance of ever developing cervical cancer, though even in Australia her chances tiny.

    Then another lady spoke up, saing she disagrees because her daughter was saved from cancer at the age of 21 by a Pap smear. She had multiple treatments during a few years, and now at the age of 30 has troubles getting pregnant, but at least she is alive!

    And then another woman spoke in support of this Australian female genitals mutilation cervical screening program saying that her daughter’s friend had “cancer” when she was 23 and if it wasn’t for Pap she would sure be dead now.

    It no longer mattered what I tried to say about the facts, the research, the unnecessary harm… The herd was sure that Paps saved nearly each woman from a certain cancer death at their early 20s and onwards, and those who doubt the doctor’s recommendations and the life-saving program need to be forced to “take care of themselves”.

    It is such a terrible feeling to see people just handing their bodies over to the system and being so sure that whatever it does, it is always for their own good. I just feel sorry for their daughters who had to go through agonising “treatments” for absolutely no valid reason.

    • Heather you are spot on, and I think it is one of the main reasons why the many women who don’t roll up for screening keep their heads down, and don’t raise the subject.
      Don’t despair, as you may have sown a seed of doubt amongst those who work in this office. The more these people feel they haven’t got everyoine in agreeement the less likely they will be to raise the subject in future. The first time these things are mentioned you will get outright disbelief and resistance to the idea, but sooner or later they will come across someone else, who doesn’t believe in the screening mantra, and once they spot a few others in the herd, a tipping point will be reached and they will start to doubt the whole system. It is happening already. Every time there was a news item that women are not going to their screening tests, there would be posts condemning them – now we are seeing a lot of posters fighting back, and it has forced many of these pro-screening people onto the defensive. They are beginning to realise that they will come in for criticism if they say these things, and are not coming out in so much support anymore. A lot of these programmes need a minimum of 70% attendance to make them viable, and in the UK attendance rate for paps is 78% for attending once in 5.5 years, when the recommendation is 3.5 years for those under 50. Attendance at 3.5 years is only about 73% in the UK. It only requires a drop of 8% to make these programmes unviable, and it is steadily going our way. I have read in a NHS document that attendance at paps is expected to slump this year quite drastically due to the first cohort of vaccinated girls entering our screening programme here in the UK. It is music to my ears to hear many of them, like the daughter of your work colleague, saying that they’ve been sold the vaccination on the basis they won’t get cervical cancer, and they feel they’ve had enough not to have to do the paps as well. The young women of today are more sassy than we were and they have the internet, which we didn’t. We don’t need to get 70% of women to see the light, if just 8% more make a stand against this form of FGM, the rest of the herd will follow.

      • You are so right! That’s exactly what the daughter of the colleague was telling her mother: she was rounded up for HPV/Cervical cancer jabs at school years ago with the promises to save her from something like 90% of genital cancers. So now she no longer wants to be the government’s guinea pig and thinks that she has that cancer “covered”. She says there are other things in life to worry about.

        She sounds like an bright girl to me. Especially nice to hear this given that she is now studying to be a nurse.

        And you are absolutely right that we don’t need to convince all the “papping” herd to analyse the true facts. (A person can be tricked to believe the government’s BS, to believe that this sanctioned FGM will save them from a “rampant” cancer, but it is impossible to make the person TO THINK, unless they want to.) Just another 8% (around 13% in Australia) of women, and the government will have to work hard to justify this waste of money. I sincerely hope that one day the health austhoritues will also have answer for all the harm they have done over all these years, after if became known that pap screening does more harm than good.

    • What’s so damn good about not dying if you’re not going to be living your own life?

      Also, I’d definitely think they’d have an issue if the HUSBAND told them to do this. I’d be more than willing to bet if their FATHER made a demand, they’d disregard it.

  22. Good news from Alexandra Barratt in Sydney regarding overdiagnosis in breast screening:
    Overdiagnosis in mammography screening: a 45 year journey from shadowy idea to acknowledged reality

    It recommends:
    “Quality information for patients.
    Many women continue to be “prescribed” or encouraged to undergo screening rather than being supported to make an informed choice. Women should be given information that has been carefully developed and tested, because information is an intervention that may have both positive and detrimental effects.

    Screening targets for screening services should be questioned, and consideration should be given to ensuring the provision of balanced information—for example, using the “consider an offer” approach outlined by Entwistle and colleagues in 2008. Practitioners should not be incentivised to achieve participation, nor should high participation in screening be regarded as a marker of health service quality.

    Think twice before extending screening programmes.
    Extending screening to women in their 70s has been shown to significantly increase the incidence of early stage breast cancer, and this could have detrimental effects for older women. The risk of overdiagnosis and overtreatment of breast cancer is influenced by competing mortality risks, which increase with age”.

    Good to see this article from the BMJ published just days ago, but is shocking it has taken 45 years. Weren’t Baum et al saying this decades ago?


    We know colposcopy, biopsies and treatments cause a lot of anxiety, here’s something from the NCI website, yet here in Australia we maximize the risk of these things occurring to women with early screening and serious over-screening. It means about 77% of screened women will face a colposcopy and usually at least a biopsy, that a lot of anxiety, most of it could be easily avoided, if they cared about women. As it stands it’s a great source of income for doctors, specialists, pathologists etc. 77% of screened women would amount to HUGE profits.

      Yes the studies showed that only playing music seemed to reduce the stress and “perceived pain” (as if the pain was not real or exaggerated). Information leaflets did not help except to scare them to come back for more treatments.

      The information given to women about colposcopies is that “a special microscope will be used to look at your cervix. It does not touch the body”. No mention of someone looking at your genitals on a huge video screen, no mention of speculum use, no mention of painful biopsies (at least four recommended).

  24. This should also be added here….in stunning, undeniable simplicity….the one thing we should always have but rarely get

    informed consent in·formed consent (ĭn-fôrmd’)
    Consent by a patient to a surgical or medical procedure or participation in a clinical study after achieving an understanding of the relevant medical facts and the risks involved.
    …..nuff said 🙂

    • No, it’s consent- period. They can always say “Well, you just don’t know enough” or “There isn’t time to explain” or “You’re not in your right mind if you’re arguing with us” if it’s a question of being informed or not. They pull this with men & women, sometimes not even with the strange stuff.

      Speaking of which: With children, because they’re not seen to be capable of consenting validly to something, their refusal is also seen as nonsense. I figure people in the medical profession are VERY quick to size things up in that proportion- that they’re “like children & don’t know anything.” The situation with kids is fucked-up plenty of times & I don’t know what to say about it- parents sometimes pull bad shit as parents & sometimes they BLOCK bad shit as parents. The medical personnel taking that same mentality with adults is an issue if they are grading that discretion of the adults.

  25. If you have access to the BMJ:
    “Overdiagnosis in mammography screening: a 45 year journey from shadowy idea to acknowledged reality” by Alexandra Barrett, Australian Professor of Public Health.
    “Alexandra Barratt summarises and debates overdiagnosis in breast cancer screening and discusses how myriad uncertainties might be resolved so we can move forward”

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

    Interesting study on cervical screening, over-treatment and young women.
    I’d also, say we’ve been trained to greatly fear this rare cancer and many women mistake over-treatment for actual treatment or lives saved.
    It says to me the ability to make informed decisions about cancer screening relies on the provision of real and balanced information and screening presented as a choice. (respect for informed consent)

  27. Interesting that they put this down to “the cancer effect” and “high negative emotions” surrounding cancer. What about bullying tactics pursued by target driven doctors, alarmist reporting in the media and the usual emotional blackmailing by medical personnel that accompanies this screening? As always, it is always the patient who is at fault, and never the medical business itself which is doing much to drive the scaremongering machine.
    It would be wonderful if someone could record some of the things doctors say to us to bully us into this testing and put it on YouTube. I’d just love to find out if anyone has put such a thing on the web.

  28. The new cervical screening leaflet for the Netherlands

    Choice is clearly mentioned, privacy of information covered, how they got the womans name and address clearly stated, what the information is used for, low prevalence of the disease stated, and finally, how and who to respond and/or complain about the programme if the woman wants to. Much of this information kept from British women.

  29. I smell vested interests in this study, desperate to keep HPV AND pap testing in place in the States, of course, we know that this combination produces the MOST over-investigation for no additional benefit to women.

    Interesting the Dutch did not arrive at this conclusion, they’ll be using stand alone HPV primary testing. (pap testing will be confined to about 5% of women – those HPV+ and aged 30 to 60)

    “Cervical cancer was the leading cancer killer of women in the United States before the introduction of the Pap test. Our latest Quest Diagnostics Health Trends study involving one of the largest populations of co-tested women shows that the Pap test should continue to play a front-line role in the battle against cervical cancer,” said Douglas S. Rabin, M.D., medical director, women’s health, Quest Diagnostics.”

    Absolute rubbish….interesting, you find a study that makes no sense and then you see a statement like that…and the “study” suddenly makes sense. Consider the vast sums lost to vested interests if HPV primary testing is introduced and used the right way….HUGE sums down the drain. IMO, this is about protecting the business model, nothing to do with women’s healthcare.
    Actually: basic research is all that’s required to find…
    LUNG cancer is the No. 1 “cancer” killer of men AND women.
    Heart disease/attacks is the No. 1 killer of men and women.

    Cervical cancer is not even the No. 1 cancer confined to women, that would be breast cancer, cc is way down the list, and it was always way down the list. We’ve been told for years that this cancer was a huge issue before pap testing, not true, it was always rare and in natural decline before pap testing even began, interesting how they start to believe their own propaganda. When your statements and “evidence” is never challenged, you can confidently quote misinformation.

    “Nearly 787,000 people in the U.S. died from heart disease, stroke and other
    cardiovascular diseases in 2011. That’s about one of every three deaths in
    • About 2,150 Americans die each day from these diseases, one every 40
    • Cardiovascular diseases claim more lives than all forms of cancer combined.
    • About 85.6 million Americans are living with some form of cardiovascular disease
    or the after-effects of stroke. ”
    (Statistics provided by the American Heart Association)

    Makes you wonder why they obsess about cervical cancer, while heart disease continues to kill huge numbers of women.
    Whenever they exaggerate the risk of cc or the benefit of pap testing, I know it’s about them, justifying excess to protect the billions made from over-screening/inappropriate screening and over-treatment.

    • Really? Isn’t it quite accepted that 100% of cervical cancers are HPV positive. I just had to google HPV negative cervical cancer. I even found several citations.

      I thought the Dutch used a self HPV test? Is that choice still offered to them or is their HPV test only done in a speculum exam?

  30. Checked them out on Wikipedia and this is what came up:
    “Quest Diagnostics set a record in April 2009 when it paid $302 million to the government to settle a Medicare fraud case alleging the company sold faulty medical testing kits. It was the largest qui tam (whistleblower) settlement paid by a medical lab for manufacturing and distributing a faulty product.[4] In May 2011, Quest paid $241 million to the state of California to settle a False Claims Act case that alleged the company had overcharged Medi-Cal, the state’s medical aid program for low-income individuals, and provided illegal kickbacks as incentives for healthcare providers to use Quest labs.”


    Condoms may be a good idea if you suffer from endometriosis.
    The good old condom is a great contraceptive, (used correctly) protects from STIs (one study showed the risk of HPV was reduced by 70% when condoms were used every time) and now, this study.
    PLUS another great benefit – avoiding pap test crazy doctors.
    If that’s not a great sales promotion, don’t know what is….
    I wonder if the condom is often labeled “unreliable” by the medical profession to keep women under medical control, let’s face it, the Pill consult has been used to avoid consent and informed consent in cancer screening and to tack on all sorts of invasive excess. A method that cuts out doctors is not in THEIR interests.

    I saw a study quite a few years ago that showed “unscreened” women were more likely to rely on condoms, not the Pill or any other method that required medical involvement.
    I wasn’t the slightest bit surprised to read that…I’ve never asked a doctor for the Pill, thus avoiding most pap test pressure. There is a good reason why the Pill was linked to the pap test, to FORCE women into screening…so screening with NO consent.


    Honestly, how many studies are funded about cervical screening?
    It’s an absolute waste of money, the cancer is rare! AND as usual, they can’t take NO for an answer.
    This study: how often do “late” or unscreened women visit their GP over a 12 month period? Is there an opportunity to increase screening coverage? How about offering HPV self testing to “late” or unscreened women during these consults?
    Once again they think nothing of sticking their nose into our precious consult time: perhaps, we might want to talk about the reason for our visit. Chances are whatever it is, it’s FAR more likely to be an issue than cervical cancer. Also, pressure in the consult room can put women off seeing their doctor for REAL health issues, not good for our health.
    These people refuse to take NO for an reason. Constantly plotting, how do we get to these women? The attitude clearly is: all women must or should screen, how do we capture them?

    Time these people had a look at heart disease, a REAL health issue, instead of obsessing about a rare cancer and screening some of us don’t NOT, NO means NO, end of story

    • Got to build their empires up and keep themselves in a job haven’t they? What I find highly amusing about this, is that they keep reeling out the old story that women find it so, so difficult to make a smear test appointment, and that they are too, too busy, and simply can’t get time off work, and here we are reading in this report that at least half the women visit their doctor at least once a year. The penny just doens’t seem to drop that these women are turning down the offer of a smear test. They ARE saying NO!
      East London has a huge migrant population, and they make a big deal out of the pelvic exam being too embarrassing for them out of cultural reasons. Never mind about other women in the UK who also find this test totally unacceptable, we are expected to put up with it. I am concerned they are thinking of keeping HPV self test kits on limited supply for Asian communities, only. I remember reading once, that HPV testing is more expensive than the pap, and will not replace the pap in countries which have a cheap, widespread pap scheme running. As you say, Elizabeth, it is all down to economics and keeping one’s job. Women just have to suffer.

      • As I have said time and time again, IF a woman wants a smear test, she will make time for one. The people that trot out all the usual excuses about why women “fail” to have a test don’t seem to understand that if a woman wants to do something she will. Women find time for everything else in their lives. They multitask for goodness sake! I manage a full time job, children, parents, nail appointments, shopping, housework, walking the dog etc etc. My friends and colleagues have similar lives. I’m sure I could squeeze in a smear test if I wanted one. As Ada has pointed out, the women in the report managed to find time to see a GP!

        Doctor, which part of NO I don’t want to talk about my cervix in this consult is so difficult to understand?

      • The thing is that the immigrants tend to stand their ground & not “make their case.” They don’t ask someone, they TELL them. I think (and pardon the phrasing, since it’s not strictly limited in this way) that white people tend to think it’s being “nasty” to outright make a statement, instead of to ask a question.

        Bet they wouldn’t do that if someone was to try stealing their wallet or their phone, though. Isn’t that odd? Compared to someone making their own decisions about what goes where anatomically, some women seem to have more of an issue with someone looking in their purse for gum or answering her phone to tell someone she’s in the bathroom (which is kind of mindless, but it happens). I imagine that’s not everyone, but it’s a resolute & definite response that is non-affirmative.

        I get that there’s different stuff going on & there’s different things at work- namely that it doesn’t seem to be realized that an action has to be engaged in order to occur, so this isn’t something that just “appears” because she’s a woman. That & simple coercion or tricking people into thinking that they’re going to die without screeening measures to “scare cancer off” (never said by the people this is directed at, but it seems to be mentally equated with eating Vitamin C to not get scurvy).

  33. It looks like the Australian government is proceeding with its plan to force everyone to have an electronic health record. At the moment, only the people who signed up for this privacy-invading system have the eHeath record. However, the Australian public turned out to be smarter than the government expected, and less than 10% signed up. So the government is going to create the record for everyone, promising that those who are not willing will be able to opt out. However, it is still unclear how simple the opt out process will be, and whether opting out will truly delete the patient’s data.

    Once the Australian government forced everyone to have the myHealth Record (that’s how they propose to call the PCEHR), it will most likely to use the system for surveillance of women, for sending screening recalls and reminders, and for hounding down those who refuse pap smears, mammograms and other harmful procedures.

    The opt-out will probably be available on the initial stages, to calm the public outrage, and removed later. So it may be wise to take the opportunity to opt out as soon as possible.

    • Thanks for that Alice, I’ll be opting out, but it irks me that we have to opt out of things we didn’t join in the first place. If a call and recall system is introduced for cervical screening, (or breast screening) I’ll be opting out of that too.
      I couldn’t agree more with your comments, women find the time for things that are important, we multi-task. I think they play down the embarrassment factor because they’ve been telling us for years to get over it, we HAVE to get used to it….ummm, no, we don’t actually. One of the principles for an ethical screening program, the test must be acceptable to the target population. You can see before the strong arm tactics, few women bothered with them, they had to break the law and behave appallingly to force women into the program.

      They always trot out the old, “women don’t make time for themselves”, I find it laughable that having a pap test is about making time for ourselves. Here it’s 2 yearly for most of your life, for most women it’s an unpleasant experience, for others it’s an ordeal, and MOST of it is completely unnecessary.
      It never ceases to amaze me the money they have to spend on cervical screening, vast sums. Brain cancer receives much less funding, we don’t hear a lot about it.
      It’s vested interests, the programs, and all of the “survivors” keeping these programs in place, and well funded to the detriment of far more serious risks.
      Mental illness and suicide has always been under-funded, woeful, if we were losing as many women from cc, they’d be funneling even more into these programs and awareness campaigns. it doesn’t seem to matter that more people of dying as a result of mental illness, heart disease etc.

      This is not about healthcare or we’d be casting an eye over all risks, where should we spend our scarce health resources? But NO, it’s vested interests protecting their turf, that’s one of the reasons why these programs have become untouchable, are so sensitive, “don’t get too close, how dare you, we’re busy saving lives!”.

      We’ll do HPV primary testing on women aged 25 and older, even though basic research tells us this is a BAD idea, we should not test before age 30. How can so many seemingly intelligent people ignore the evidence?
      It says to me the only way change can get through is keeping vested interests on side, happy, toss them some young women to test and over-treat. (40% will be HPV+)
      The program/government/medical profession can’t be honest at this point, they have too much to hide – they’ve misled women from the start, (even blatant lies) and harmed huge numbers.

    Exactly, and note Breast Screen here are still running prime time ads using celebrities to sell breast screening. Yes, celebrities, at this late stage with all we know about over-diagnosis and when it seems clear the risks of screening exceed any benefit.
    They clearly see themselves above the law and decent ethical standards (and have no moral qualms either) I hope they get a brutal reminder at some point that they have/had no right to risk our health and lives to protect their jobs and precious program and to focus on a govt-set screening target.

  35. Ada,
    There are quite a few people on that site that like to stick in the boots, they tend to talk down to you, “I’m the expert/doctor….” etc.
    I responded to Dave on that thread, but his opening line contains a put-down.
    The site seems to attract a lot of experts with a fixed position on screening and other topics; nothing will change their minds. (some are protecting their own interests)
    I’ve been amazed at the number of experts who instantly dismiss the new Dutch program or the Delphi Screener. How can you instantly dismiss something that will start next January?
    It’s not theory, it’s actually happening. They can’t argue the Dutch have lots more cc…so it comes back to put-downs to hopefully, silence dissenters.

  36. I tend to post once or twice on that site and leave it at that…some of the “experts” enjoy bullying posters with their “superior” knowledge. No point going down that path…IMO, they’re either ignorant or protecting self interest.


    They never give up, the same groups, the same people, desperately trying to save the cash cow. No doubt this will be on the News tonight, Breast Screen always make a fuss about anything remotely positive about screening, but have nothing or little to say about the ever increasing mountain of damning evidence – over-diagnosis, risks exceed any benefit etc.
    I won’t be taking their advice…no screening for me, informed decision.

  38. All on the news this morning
    It goes on and on, anything to “increase uptake” – no-one should be attempting to increase uptake in any medical procedure – not without “informed consent” of errors, risks, complications and everything else that goes with it. Just provide all the honest information and leave us to decide for ourselves. Not one mention this morning on TV/Radio about risks and limitations, unbelievable!

    • This: “breast screening with mammography saves lives” on its own simply isn’t enough for more and more women. Yes, screening inevitably saves lives, but patients need to see that weighed against their risk of over-treatment and their risk if they don’t screen at all. I feel like the pro-screening argument gets an absolute statement: it saves lives. Whereas the pro-choice argument gets something more wishy-washey: “some over-treatment”. In my opinion, a lot of people read “some over-treatment” and imagine a minority of cases. So, 90% genuinely helped, 10% over-treated. I can’t comment for breast screening, but we know it’s more like 20% helped, 80% over-treated when it comes to cervical screening. I think people dismiss the over-treatment line because they don’t know the scale of it.

      • And as long as the pro-choice line remains wishy-washey, people will continue to think that screening is still a no-brainer to decide to take part in. As long as they believe it helps significantly more than it harms.

      • Well, someone here spotted a report which showed the cervical treatment rate was around 80,000 or so. So, if we accept the dubious claim of the screening Nazi’s that 5,000 lives are ‘saved’ by the crank ‘n scrape test, then the overtreatment rate is more like 93%.
        But hey, because it’s an internal organ and we can’t actually see the damage that’s done, that’s ok!
        The pro-screeners are incredibly narrow minded – they’re obsessed with ‘saving lives’ through their pet project and don’t see – or don’t want to see – the big picture. They don’t care about the vast numbers of healthy patients harmed along the way (victory at all costs!), and the fact that screening gobbles up huge resources which could be better spent elsewhere (and indeed, save more lives) seems too difficult for their tiny minds to process. It’s almost like they’ve become a part of a cult, religiously following the instructions of their leaders.
        They don’t call it ‘The church of modern medicine’ for nothing.

    • That Pauline Daniels is a menace to womankind. She’s just typical of the types the screeners love: banging on the doctors door demanding screening invitations, and then running around afterwards telling everyone she has been saved, and then ordering everyone to do the same as her. Like Jade Goody she’s a very good reason NOT to go for screening.

  39. Sorry, clarifying yet again! 😀 We know the pro-choice line isn’t wishy-washey, but that’s how it gets presented in the media unless it’s a rare exception like Dr McCartney speaking up.

  40. 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.

    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.

  42. 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!


    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.

  44. 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.


    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:
    “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…

    • “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.

    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.

  47. “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)

    • 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.

    • 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.
        “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.


    “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.

  49. Also further news from the UK. I saw this advert for a new screening service being pushed.

    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, 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…


    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!


    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)

  52. 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??


        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:

        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 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.

  53. 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.

  54. “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”

    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.

  55. 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…

  56. 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.

  57. 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…

  58. 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…

    • 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. 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.

  59. 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)

      • 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…

  60. 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..

  61. 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!

  62. 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!

  63. 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!!

  64. 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

  65. 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

  66. 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.


    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.

      • 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.

  68. 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.


    • 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.

    • This is very importwnt news. Here is the company’s website. 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.

  69. 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…….

    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.

  70. 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 .

  71. 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”

    • 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.

    “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…

  73. 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,
    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

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