Advice needed

[jasper100]

I am about five years post menopausal, 55 years old and childless. I have had regular smear checks, the last one five years ago. My doctor gave me Ovestin recently for urinary and dryness issues (many thanks to mumsnet menopause section for this information) and it's been brilliant. I've had to stop it for a couple of weeks because the smear test results wouldn't be precise if I've used this. So, I had my appointment the other day and it couldn't be done because it was so painful. They've called me back at the end of the month and they're going to try a smaller speculum. I'm dreading it as it hurt so much and I'm tempted to cancel it. Does anyone have any advice or should I just grit my teeth and get on with it?

I think you are being irresponsible to suggest women question screening because if it was a waste of time and money it would be stopped.

I also find it shocking that you worked in a clinical role- that could mean in a lab, it's meaningless unless you say what- and have this attitude to screening when you were working with women who had cancer. Did you ever tell them they'd be better off not having been screened?

Screening saves lives. maybe not many but that's not a reason to avoid it.

What are your reasons about of interest other than not enjoying it?
Why do you say 'put yourself through it'? I'd rather have smear than have my teeth descaled but I do that every 4 months!

I suggest as you do not medically qualified you do some research. I am NOT suggesting women are not screened but they base decisions on all available medical information. Indeed recent case law Lanarkshire Health Board v Montgomery states that patients should told all available information so they can make an informed decision.

By putting myself through I mean generally the risk of over diagnosis and over treatment are very real.

befair I totally agree.

But don't you accept that if screening showed up changes, you could then decide what to do next?

No one has to agree to treatment.

I've already said that I'm not interested in reading because I've heard it from you and other posters before.

I think it's a silly argument to say you want to avoid screening in case something is found and you are pushed into treatment unnecessarily. The point is you need screening and then you decide what to do next.

And you are being very evasive about your actual role yourself. If you are a dr, say so. If you do lab work, come clean. Stop trying to pull rank but not actually saying what your work was.

I do not do lab work. I clinically treat oncology patients. I am not outing myself for your benefit. You cannot say something is silly unless you have read the medical evidence and arguments. It's really rather appalling you read everything so you are update on HRT yet you refuse educate/up date re the associated side issue of screening.

I suspect you are a pharmacist in a hospital or do research into drugs and do trials. If you were a dr you'd just say so!

But anyway.... I think it's bad that you come here and try to suggest screening is a bad thing and won't say why. There is this clique on MN who try to convince women that screening is a bad thing. Screening saves lives. I want to hear your argument against it properly, other than just saying there is a risk of over -treatment or that you personally don't want to put yourself through screening. Maybe you have few if any risk factors, like women who have never had sex. I don't know and that's your business. But the point is no woman knows she has cervical changes until she has symptoms - usually bleeding- and by then it is sometimes too late.
There would certainly be surgery.

No one says screening(any screening) is perfect, that it spots everything or that false positives don't happen.

Given that we only had cervical cancer screening in the media headlines a couple of weeks ago with women encouraging other women to be screened, it's incredible you are suggesting otherwise.

If it's so simple and you feel so strongly, take it to the media. Put yourself forward as a case study of a woman who won't be screened. Or at least spell out the facts why here, rather than referring us to some single, obscure GP who happens to be on a working party - to achieve what, exactly?

And don't patronise me please by saying I should read up on cervical screening. You have no idea of my background, you assume too much. Just because I don't agree with you or haven't read the book you talk of, doesn't mean I've not had conversations with doctors (not GPs) about the merits of screening.
That's all I have to say. You carry on being an ostrich and let's hope for your sake you are never going to find out too late.

www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer#heading-Zero

Over 3K women a year are diagnosed with CC.
9 women a day. 800+ die each year.
Rates are rising all the time.

Without screening, how many of those 3K women would die?

Yes Stats say anything. A cancer charity with a vested interest! Cervical cancer has in actually fallen since the 60s not necessarily due screening but better nutrition etc. Read the medical references in Margaret's books instead of random Google searches. Only the other day some GPs were saying privately that Jo's Trust pushes screening to get funding. Margaret discusses the medical charities and their vested interests in relation to screening and the GP contract. Cervical cancer is rare 0.75%. Jady Goody had a cervical adenocarcinoma which are not picked by screening and she ignored symptoms and did not attend follow ups.

Detailed information on screening here margaretmccartney.com/2012/04/10/womens-hour-cervical-screening/ It is NOT about being against screening it's about balanced information and informed consent.

So the stats on Cancer Research are 'random google stats ' are they?
Please clarify is that's what you are saying.

You have made the point about Jade Goody. You have made the point again about one type of cancer not being picked up. So?

What about the 3000 women who have a cancer diagnosis each year? I notice you aren't commenting on that. How convenient to ignore! If they had not been screened what would their outcome be?

You are clearly ignoring these questions.

I have had conversations with my own consultant about the value of screening I respect him and his opinion. I opted out of the NHS screening because at my age they only do it 5-yearly. I have known women (friends and friends of friends) who, if they had waited 5 years between screening, could be dead now. I have smears every 2 years.

I am sure some of what she says is valid but having looked at her website, she is a bit of a maverick in some ways. But I think you are taking ONE thing she writes about and make it Your Thing because you don't want screening.

I hope you are confident that your risk is zero.

You have made these points on other forums, mainly along the lines of practices being under pressure financially to get their quota of women screened.

I haven't seen any good arguments from you about why screening per se is a bad thing. I'd respect your views more if you were able to state those, rather than refer to a GP who has her own opinions (and which many far better qualified drs would disagree with.)

And finally- because we are going to have to agree to disagree here- 0.75% risk is almost 1:100. That is not the tiny risk you seem to think. It's one women in 100.

Polly it's clinically unqualified people on the internet that worry me immensely. I have not said I am against screening but that women need to make an informed choice. I pointed you in the direction of relevant medical references you rely on random facts you Google.Dr Google at its best. It is incredibly dangerous to push your views on women. Women need all the facts. We are going back to the dark ages if woman are denied the right to all the facts to make an informed choice. It is shockingly bad your blinkered view points when you are supposedly pro choice re HRT. A GP who is a RCGP Council Member is NOT a maverick nor are GPs who are part of the overdiagnosis working group at RCGP. Just because you do not agree with someone does not make them a maverick. Screening is highly complex with lots of vested interests and woman need balanced information. 0.75% is very low risk to me and I am not prepared to over diagnosed and run the risk of false positives etc.

Why don't you take it elsewhere ladies, this thread has turned into a slanging match and doesn't encourage anyone to go onto MUmsnet. Please, out of respect stop this.

I think you are overreacting a tad Disco.
Debate is always good.
However, befair did come along and start querying screening per se, rather than start another thread on AIBU! I don't see what she is adding to the OP's question.

I am saying women need to look at the whole picture to make an informed choice, especially they are struggling for whatever reason (medical or otherwise) with being screened. This not against screening it is about having all the relevant information to make an informed choice.

I disagree, I don't think that every woman need to know everything and to search everything. It's crucial to trust her docs, her gyns who follow the main medical guidelines. Knowledge is power of course and I think that we need to trust and to cooperate. We cannot know everything and it's very distressing to search everything! And we cannot also understand everything!

Disagree new case law that turns consent on its head. It basically says need to know all information. It's Montgomery versus Lanarkshire Health Board. If a patient found out additionally information later on that would change their decision they could sue the doctor/HCP and win.

I think that it depends on special circumstances and more complicated health problems, it's not the mainstream. If a patient thinks that he knows better then he takes the responsibility for his decisions. The medical staff has to follow the basic medical guidelines. And of course the patient can decide against.

It is for the main stream. There was a lot about in the medical press at the time. It really does legally turn consent on its heads. It is no longer a case of the doctor knows best.

I think that you don't understand my point of view. If a patient disagree with the medical diagnosis and treatment has to take the responsibility for that. And the doc has also the responsibility to inform and to make the proper diagnosis. The patient can deny the diagnosis and the treatment as well with his written consent.

Yes very true. Although you are missing the point of the Lanarkshire Health Board case doctors/HCPs now have to make patients aware of all material facts. It turns Bolam and the old doctors knows best (for want of a better phrase) on its head.

I'm a doc befair, and not in UK.

This is a UK judgement and extremely relevant to consent in the UK. Numberous emails briefing us re consent. Bolam is dead in the water.

Just an update, had my smear with a smaller speculum and it was fine! My doc is referring me to a meno clinic so I can get back onto Ovestin which makes everything more comfortable. Thanks Pollyperky for your advice.