Major changes to women's health screenings

by - Tuesday, November 24, 2009

Warning: Today's post departs from my normal frivolous ramblings to tackle an issue that's been a hot topic this past week.

Why all the changes in protocol for women's health screenings?

First we had the news last week (and people are still trying to make sense of it) that the age women should start getting mammograms was pushed back from 40 to 50 and that screenings should only be done every other year, not annually. The findings from the big study by the U.S. Preventative Services Task Force also threw out the idea that breast self exams were beneficial.

Then news broke that there were big changes in the recommendations for Pap smears. The American College of Obstetricians and Gynecologists said that women shouldn't get their first Pap smear until they are at least 21 and then didn't need to have one every year. Women younger than 30 could have them every two years and women older than 30 should get them every three.

Previously it was recommended that women get their first Pap when they become sexually active, but not later than 21 and then every year after to detect changes in cervical cells.

For both breast cancer and cervical cancer treatment and survival, early detection is key. So it blows my mind that all of a sudden we're seeing these changes in recommendations. It was drummed into my head growing up and in the many health classes I've taken in high school and college that my health is my responsibility and one way to take control of that is through preventative screenings.

As a very health conscious person, this new changes really upset me and I'm still not sold on the reasons they give. Decreasing the number of mammograms is supposed to decrease the number of false positives, but what about each true positive that they detect early and someone's life is saved because of it. It's true there is a concern about exposing women to extra radiation, but it seems to me that the overall benefit outweighs that risk. Early detection could be saving someone's life.

Same thing goes with the changes in the Pap guidelines. Cervical cancer can be really hard to detect without a Pap smear. Symptoms are things like spotting, painful sex or a change in your period. Those symptoms also be caused by about 500 other less scary things. That's why cervical cancer is usually detected so late in most cases. The Pap is supposed to help prevent that, so again, I don't get this change in guidelines.

The ACOG says that annual Pap smears lead to over treatment in younger women. Apparently because cervical cancer is such a slow developing cancer, they believe changing the screening window will not result in additional cases of cervical cancer. I'm skeptical at best.

And I tend to agree with a lot of this woman's argument in a column in the St. Louis Post-Dispatch. Cutting costs should not come at the detriment of women's (or anyone's) health. I'd rather deal with the stress and anxiety of having a false positive, than deal with having to go through extensive cancer treatments because I waited longer to have a preventative screening.

I'd love to hear what you all think about the new recommendations. And I promise I'll be back to my normal ramblings tomorrow.

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  1. I agree with you. Cutting costs should not be at the risk of death. As much as I'm all for universal health care, I worry that government studies like these will affect how well the care serves the populace.

  2. Since women pay for their own health care, how is changing the guidelines cutting cost? Unless they are using the "public ('s money) option? Ultimately, the individual should establish their own opinion and follow their own program. Let other folks argue about what is right and wrong.

  3. I find all of this to be totally rediculous!! Not everyone falls in the "norm" even though their recommendations don't even go along with "norms". Try giving that line of shit to my cousin who was diagnosed at 21 with cancer. Early detection has allowed her to battle these last 5 years.
    Not to mention my other cousin who had HPV detected at the age of 18. She treated it and is fine, but left untreated, she may have ended up infertile.
    NUTS I tell ya!!

  4. My doctor told me I only have to get a PAP every two years. But I get one every year anyways. I think the new recommendations are a little ridiculous too!

  5. I am right there with you Jess. How frustrating is this! :)

  6. I *hate* how we don't do preventative health care in this country. Let's wait until everyone has dug themselves too deep a hole to treat them for diabetes, hypertension, COPD, etc. Let's not help them stop smoking or lose weight. Or don't let people get screenings that will catch diseases early in the game when the chance of a cure is greater and the cost of treatment is less. But noooooo let's just wait until it's all out of control.

    End rant.

  7. agreed. i'd rather pay for my yearly visit than be treated to a "surprise" a couple years later. i'd also rather deal with a false positive than a real positive... frustrating.

  8. I agree. Frusturating stuff. And you can bet I've made a note to bring up any questions I have when I see my doctor in March.

  9. Jess,
    1. There can be no possible rationale for telling people to NOT check themselves for breast cancer. Even if it only provides a 3% chance of detection (pulled that number out of the air) it's free and it can help.
    2. I agree that this is most likely bullshit, and all the women I know who are breast cancer survivors are furious. But here's one perspective that made me think - if every person who was of age got ALL of the screenings out there, some say it could cost so much to make the procedures prohibitive for EVERYONE. It's similar to predictions people make about the Health Care bill (which I think is 100% essential to our economic and moral well being) - they say that if everyone has access to care, they will get as many treatments and screenings as they can, because why not? The increase in unneccesary screenings could balloon out to a size that no one could predict, while at the same time not necessarily creating a more healthy population. Just some bullshit for thought.... I don't know the real answer.

  10. My wifes mom died of cervical cancer at 53 and now she is considered high risk.

    If we follow the governments recommendations, she may well die if it is caught too late.

    Too bad, politicians in Washington have to get in the way of womens health.