@Clymene
What are the risks of cervical screening *@RedToothBrush* ?
Many women have unnecessary treatment which in some cases affect their ability to have children. Unfortunately the problem is that doctors cannot tell the difference between false positives and positives. Some women may never know their treatment was unnecessary either because of how this works - instead they believe 'their life was saved'.
This is uncommon but it is a risk. This is a studied risk.
As is the risk of women feeling traumatised by having a smear - sometimes because of a medical reason or something in their past or because of a practitioner having poor skills. This is not a properly studied risk.
We have a culture of put up and shut up which minimises both of these which very much affects women much more than men.
We have far too many women who normalise poor experiences and say we should accept this 'because it saves lives' when actually we should be pushing much harder for more modern and less invasive techniques as an alternative to smears and better reliability in testing. We should be studying how many women find the experience of a smear traumatic.
Instead we have the narrative of 'embarrassment' which I do think shames and blackmails women (who may have been sexually abused or assaulted) rather than sympathising and helping them. Far too much promotion to women who don't have smears does not stress and provide adequate support for women in this situation. Instead it has the effect of alienating some and that affects their wider trust of health care because there is a total lack of empathy.
We should not be telling women who have had poor experiences to take or request a sedative before having a smear - which is a suggest I see far too often on these threads.
There is also no discussion about how women are allowed not to join in screening. Its just not in the language of society and thats also wrong. Informed consent must include the right to opt out - instead stressing the informed part as being important (hence why I am careful to say if women opt out it should be because they have accurate information and appropriate support as part of this process. The OP here is leaning one way on the basis of something of a fallacy so should seriously consider that before making up mind).
Its near impossible to opt out completely from screening which I also find poor, particularly because of the way that this involves money - GPs get paid if they reach their % target of woman who have one so they have something of a conflict of interest going on here which isn't necessarily in the woman's interest. (Areas of deprivation have lower take up, this affects other healthcare provision because GPs dont get paid for achieving target. It also means these women get more coercion applied to try and meet targets rather than investment given to areas with lower take up to tackle underlying social issues - perhaps like a higher rate of sexual abuse / assault - particularly since these communities are more likely to be at higher risk to begin with). There are well respected and educated GPs who find this highly problematic and stress how this can affect GP/patient relationships elsewhere - leading to women feeling like they want to avoid the GP for other reasons because of how they will be harrassed for an overdue smear. This may lead them to delay seeking health advice when they need it, and increase indirect health risks from screening (eg a woman avoids the doctor cos she gets hassled for her smear but has undiagnosed heart problems or diabetes as a result - thus indirectly affecting her health). Again this isnt well acknowledged never mind studied (we have heard a lot about indirect consequences on health in other areas from the covid crisis so I would hope there was greater awareness of indirect public health issues going forward).
Women who have symptoms should also have a smear. Unfortunately the screening programme is also hiding a problem - women under the age of the programme have found it hard to get one when they actually need one - some GPs fob them off rather than recognising they have symptoms because of their age. Or women with symptoms under age of the programme are less likely to seek advice because they mistakenly believe that it cannot be cervical cancer because they are 'too young'.
As it stands the advice is that women who are eligible should get a smear. We should stick by that. We should also have greater awareness and understanding of why women don't have them, rather than pressuring them to have them because of indirect effects on health in other areas. We should be doing more research to improve techiques and get rid of smears completely in favour of less invasive testing. We should stress the need for women to actively seek testing if they have symptoms regardless of their age. And funding of GPs around screening should be completely overhauled.
So yes, I do think their are inherit risks on an individual level, on a community level and on an institutional level associated with screening (of all types not just smears) which need better awareness, acknowledgement and addressing - and aren't necessarily purely about what is being screened for in the first place.