Nov. 21st, 2009

joreth: (Super Tech)
So you've probably all already heard, but for those who haven't, there have been big news in women's healthcare this week.

Both the Pap Smear guidelines and mammogram guidelines have been adjusted. In both cases, they are now recommending that we don't get screened as often as we used to.

http://health.usnews.com/articles/health/healthday/2009/11/20/new-pap-test-guidelines-start-later-have-fewer.html

For the pap smear, they are now recommending that you don't need to start getting one until 21, and to get them every other year, not annually. The reasoning is that research suggests that younger women, even if they do get HPV, are pretty able to take care of it themselves. Even if it starts to progress to cervical dysplasia, younger women, apparently, are able to treat themselves without the need for biopsies or surgical procedures. And, women who have had surgical procedures for dysplasia have a higher incidence of premature births later on.

But, doctors and research scientists are very careful to point out that this is not a MANDATORY screening schedule. They recommend discussing with your individual doctor your individual health needs and adjusting your screening schedule accordingly. They also stress that a reduction in pap smears does not mean we should reduce how often we get tested for STDs. I, for instance, as a sexually active adult with multiple partners, who in turn have multiple partners, will continue to get screened annually and/or 3 months after the introduction of any new partners.

http://skepchick.org/blog/2009/11/no-ladies-the-new-breast-cancer-guidelines-arent-patronizing/

Now the mammogram guidelines say that we don't have to get screened until age 50 (it was previously age 40) and we can get it done every 3 years. That's a scary thought, that someone who had cancer at age 40 will now not be getting screened for it. But, once again, the experts have very clearly stated that each individual woman should discuss her own needs with her doctor and plan an INDIVIDUAL screening schedule based on risk factors. Plus, if you're doing a self breast exam, like we're all still supposed to be doing, if you find anything unusual, a doctor won't refuse to screen you just because you're under 50.

I have to admit that my knee-jerk reaction to hearing this news was negative, to put it mildly. I have had it drilled into me from before puberty that I have to be rigorous in my health standards, I have to get tested often, and I have to knock a few medical heads to get it done because the bureaucratic machine doesn't care about us and will try to whisk us through as quickly as possible, even at the expense of adequate medical care.

I'm still not sure how I feel about this. My emotions continue to rage at the idea that doctors are telling me not to worry my pretty little head about something I don't understand. But I really don't think that's what they're doing. Between social awareness of women's health issues, and the recommendation that each woman develop a personalized screening schedule based on her risk factors, I think they are legitimately trying to calm down hysteria and panic.

People are getting all up in arms over the phrase "causes anxiety" as if that was the only reason to stop screening regularly. I know that I was certainly pissed when I had doctors tell me that I didn't need to get screened for HPV or herpes because I probably already had it, so why worry about it until it actually does something? Let ME decide what I'll worry about or not and just give me my damn test, thank you very much. Even receiving a positive result is less worrisome than an unknown!

But it's not just anxiety. It's unnecessary medical procedures that go along with false positives and positives for things that the body will deal with on its own that are the problem here. Not only is it more expensive for no real gain, but it's also invasive and sometimes harmful for the body.

But we need to strike a balance between avoiding unnecessary medical procedures and catching stuff while the survival rate is still high. And as long as the guidelines continue to say, EXPLICITLY, that it does not PROHIBIT more frequent screenings, and that individual risk levels should be considered when developing a screening schedule, I can see the value of avoiding cutting into my body when my body might take care of it on its own.

Bottom line here is that I have mixed feelings about it. I'll probably write more as it plays out in real life and we see how it actually affects women's health.



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