That’s the cynical take on it, and I’m sure that’s a part of it, but from my point of view that’s just how you practice good medicine. You don’t just give someone medicine without checking to see whether it will do more harm than good.
Marc
This is still a controversial area, but the preponderance of evidence suggests that long-term oral contraceptive use increases the risk of cervical cancer in women infected with human papilloma virus (the infectious agent that causes cervical cancer). Cite.
A literature search turned up one recent paper that found that only a small minority of OB-GYNs would prescribe birth control pills without restriction unless the patient consented to Pap tests, but that many would do so on a short-term basis. This doesn’t seem all that unreasonable on both a health and legal liability basis, but there are those who think that the overall risk is small enough for mandatory Pap provisions to be dropped (and younger docs tend to hold this opinion more often).
I’ll concede to jsgoddess that my earlier statement should have been that it is better to risk unwanted pregnancy than to risk cervical cancer. There are decent barrier methods that greatly reduce the chance of pregnancy, but no good alternatives to a pelvic exam (involving Pap + HPV testing) for detecting cervical cancer or its precursors.
Cervical cancer is a devastating disease. And it’s readily preventable.
I’m not convinced at all that the risk factor of cervical cancer is commensurate with the invasiveness (and pain, in my case) of the test. Jackmannii’s cite seems to suggest that prolonged OCP use and persistent viral infections are equal factors. www.cancer.org tells me that the HPV mentioned frequently comes with external lesions or benign tumors. So wouldn’t most women with the predominant risk factor have rather obvious indicators other than the Pap test?
Were cervical cancer an epidemic, I would feel differently. But requiring Accutane patients, hormonally imbalanced thyroidectomy patients, or people with no family history of reproductive disorders to undergo the exam just because “well, it might help” seems silly, and expensive.
Re the OP: invasive tests would only be directly harmful to public health if large numbers of those with the disease were avoiding treatment, which given the cited low death rate seems unlikely. But as someone who waited until 21 for an exam, I can see how an overused and painful procedure can inure people against going to doctors in general.
HPV does not always present with extrenal symptoms. So, no you might not know; more importantly your doctor might be doing something to cause you to get a deadly cancer (without looking for it).
The cancer can be sucessfully treated with early detection, I can’t imagine a few minutes of discomfort once a year being worth my life.
I don’t much like be checked for Prostate Cancer, but I think it is worth being checked.
No, it concludes that long-term OCP use predisposes to increased cervical cancer risk in women who are infected with HPV.
Cervical cancer is a low-incidence disease precisely because of the Pap smear/test. It’s one of the most outstanding success stories in the history of preventative medicine.
Pooh-poohing the need for Pap/HPV testing is like arguing that we don’t need vaccinations because of low rates of the communicable diseases they protect us from.
http://www.dartmouth.edu/~vox/0304/0209/cancer.html The flip side, with folks preferring being overtested and overtreated…
In a word, no.
*HPV is a group of related viruses. 30 of these viruses are sexually transmitted. 10 of these viruses are linked to cervical cancer
*According to the CDC, 50% of men and women will aquire HPV at some point in their sexually active lives.
*By age 50, 80% of women will have aquired HPV.
*Many of the strains of virus have no signs or symptoms. Most infected people never notice any symptoms.
*Most women who develop invasive cervical cancer have not had regular cervical cancer screening.
Source: CDC HPV Page
Getting a pelvic exam is mentally and physically uncomfortable – even painful for some people. However, do you really want to die of an easily preventable cancer just because you couldn’t suck it up for 15 minutes a year? Really really?
I am a poster child for this statement, as discussed previously here. The strains of HPV that cause genital warts are not the same strains that cause cancer, so it’s quite possible to have cancer, feel fine, and have no symptoms at all.
A routine Pap smear may very well have saved my life; the cancer was just becoming invasive, and yet I’d never had a previous abnormal exam, though cervical cancer normally develops over years - or even decades. Long-term survival rate for cervical cancer, detected early: well over 95%. Survival rates for cervical cancer not detected while still localized: not nearly as good. Personally, I will go for followup testing as often as my doctor wants, and urge everyone else to do the same - Pap smears aren’t my idea of a good time, but they sure beat the alternative.