To not let dd have the HVP vaccination?

[DogGoneMad]

Dh and I really disagree on this.

If you look at the IARC.fr site I linked to before, there's the WHO doc about setting up screening programmes. I haven't read it recently but in it previously there was alternatives to cytology screening.
So it did suggest that one of the ways of getting some cervical cancer screening going in resource poor countries is by using the VIA method - visual inspection with acetic acid (aka vinegar).
It's not as good as cytology but its quicker to set up and better than nothing. It depends on the circumstances for that country at the time.

In both the US and Canada (where btw I found both screening and treatment approaches in my experience and opinion as a user rather than a medical professional vastly superior to my experiences in the UK), VIA was used as well as cytology screening. I presume because it allowed my doctor to have an immediate, if less definitive, view.

I could not agree more with that Leonie wrt pap smears in the US and UK -- the difference is like night and day.

Bm, I find it really hard to believe that you can say with confidence, 'this system works' from solely the info in that article. No refs, no data, no indication on the measure of efficacy except WHO said.

WHO also recommended that the HPV vaccine is should be given to an identified population. I have demonstrated HUGE amounts of data to support it is safe and effective, but that's not good enough for you??
How can you have such double standards when making decisions about what is safe and effective.

You have completely misread my post which was about ensuring access, not improving the process.
How far does a woman have to walk to be tested, does the community understand the value of testing? Can tests be acceded regularly etc

There are differences in healthcare between the UK and the US. There are also difference in how its funded. There are also big differences in the way "screening" works.
It's difficult to explain but a lot about reading the Pap tests is subjective and psychological. It's not a black/white answer, more shades of grey.
So if you're going to do a Pap test on someone every year then the way you read a sample is different. The threholds at which the screener has a cut off between negative and positive change: if you know someone will be back next year then you may be more likely to think "hmm well those cells look a bit funny/active but it'll be ok for a year". The US generally has a much lower threshold for investigation than over there too.
Hopefully from the other info I've posted you can see that screening is a balancing act: trying to make sure the only the women who need treatment get it. If you move your threshold lower you're less likely to miss an abnormality but you are more likely to over-treatment people. What is considered "over-treatment" differs as well. It can be argued that short-term low grade abnormalites seen in cytology are probably linked to the transient HPV infections.
However that's another discussion altogether - there is spectrum of how you could run a screening programme really between (and I'm stating the extremes here to illustrate that the schools of thought can be very different) (a) investigate every abnormal result in case the woman has got cancer and (b) leave her alone until it looks like she might have cancer.
Most people working in screening are somewhere in the middle, trying to achieve the best for the population at risk.

But why should a pap smear hurt and cause dread in the UK while it is nothing of the sort for most women in the US?

Have done the annoying thing of not reading the whole thread sorry so surely repeating someone sorry - bit worrying that a lot of posters seem to think the HPV vaccine is vaccinating against Cervical Cancer - it vaccinates against the HPV virus which causes genital herpes and can also cause changes which lead to cervical cancer.

It is possible to have the vaccine and still get cervical cancer - its just ruling out one strain - so while a great advnace it is not going to eradicate this disease.

OP you are nuts not to allow your DD to have this vaccination.

And just to be clear, HPV causes genital warts, general herpes is caused by a different virus and doesn't cause cervical cancer

Wheremysanity,
I misread you last line, sincere apologies. Totally inexcusable, though have clearly tiered myself out staying up late posting!!
In all honesty, I still think it's unfair to say that someone is nuts if they make the best decision they can when faced with all the evidence, as much as I personally believe vaccination is right.
Really though, even if you support the decision, please be sure you understand what it means. It gives NO protection against genital herpes

mathanxiety "But why should a pap smear hurt and cause dread in the UK while it is nothing of the sort for most women in the US?"

I am in the UK and have never missed having a smear done and I have never 'dreaded' it and it has never hurt. So I don't recognise your description of having a smear in the UK.

I think 'bad' or uncomfortable smears can probably happen in both the US and the UK. And the US system by nature includes extremes of great care and very very poor care. So I don't mean to over-generalise.

But the more preventive approach (more aggressive approach) often taken in North America suits my own (admittedly highly personal) care needs/desires. I also feel certain that the course of treatment and the type of care I received in North America would not have been available to me here, and I would be childless today, if not dead. (I also fully acknowledge that the US system is terribly unfair and I was incredibly fortunate in my circumstances, because it could have gone very differently as an uninsured woman or even one living near a different hospital!)

My DH's first wife died after a horrendous (non-cervical!) cancer misdiagnosis here in the UK, and I admit that this probably further colours my feelings about cancer screening approaches.

I've had experience now with care in Canada, the States, and the UK. Very different. But obviously a huge issue and a whole other thread (or host of threads!) Sorry for the digression...

I've seen threads here where women were taking friends along for support, and really dreading it. Personally I have never thought twice about getting one or felt I had been subjected to any sort of pain or even discomfort. I had to make sure it was pap smears people were talking about and not biopsies without anesthesia or root canals as it was news to me that a pap smear would hurt. But there was a lot of fear expressed, which I had never encountered before, and many horror stories. And a good deal of irrational fear of what might be found too, which to me is really crazy. If there's something to find, better to find it after all.

mathanxiety I guess it may be because women who don't find it a problem are far less likely to start a thread "I went for my smear today and it was fine".

The finding something depends what you're defining as the something, which what I was trying to explain. Peoples' definition of what is significant in terms of abnormality is actually quite different.

I never had a pap smear in the US done by a nurse -- was my OB/GYN each time.

ditto.

Difference in the healthcare system again. Practice nurses here do around 70-80% of the pap tests, and the majority are really good. They have come under a lot of pressure to have the appointment slots cut down, at a recent training session some were telling me they are only allowd 10 mins. They are not very happy and are fighting their corner.
In the UK, the gynaecologists do take Pap tests but it's under certain circumstances (clinically difficulty, other conditions, investigation). There simply are not enough gynaes for them to regular screening and to have enough to permit that would be very expensive.

Ok just to pose that idea you're proposing in a slighty different scenario:
I go to the dentist annually and loathe it (in fact I didn't go for 15 years). Should I go more frequently then? I still hate it if I go privately and have longer appointments.

Agreed it should not be a rushed appointment and there may be a minority people not ideally suited to the job, however I am not convinced that having gynaecologists doing them and annually is the answer.

I think any fear is more to do with the British psyche - and remember we're seeing a small proportion of people posting on here, rather than the majority who probably don't have a problem.

I never got more than 15 minutes total at any routine medical appt in the US. Into examining room, change into ever-so-fetching paper gown, perch on examining table, get vital signs and weight checked by nurse, wait and wait for OB/GYN to come in and check pregnancy (look over nurse's notes, measure, do doppler, ask routine questions about nausea or other concerns) or do pap smear, dress again, dump paper gown in bin, out -- was the way appointments went.

Ah, another factual story. Full of evidence and objective reporting.
A lot of claims made in that report with no evidence to back it up.
What sort of fb do you have anyway?????