Smear tests to subordinate women

[sakura]

I have been looking at the recent threads about compulsory smear tests in Poland, and I have to say, it doesn'T surprise me that they're compulsory in some countries. THis is a natural, inevitable, progression from the actual purpose of screening.

[Oh, did you think smear tests were about saving women's lives?!?!]

wildkittydear made an excellent point (I hope she doesn't mind me quoting her}
"It is shocking that Poland is thinking of making very personal medical examinations for women compulsory. I personally am very offended by the way only breast and cervical cancer are championed as the only killers of women and I know that is an exaggeration!! but do you get my drift? Some illnesses get priority in the media and I am not convinced there is always a benign reason for this."

Yes, Womanhood is the "problem" to be cured. Women's organs that are seen as faulty-- because men don't have them. Not male = pathology.

The truth is that women's bodies are much, much healthier than men's because we have two Xs in our chromozomal make up and each X contains lots of life-preserving genes, whereas the Y is slightly pitiful by comparison.
This is why women live longer and why boys are more like to be born with chromozomal abnormalities or die when they get sick. Girls tend to recover.
The extra X gives women the biological upper hand.

Men don't really know how to look after their bodies either, in a general sense (healthy diet etc)

Considering this, it's really important to question why the medical fraternity is obsessed with getting women to their tests and not men. Men are more likely to contract all sorts of diseases and cancers, and much earlier in their life than women too.

But men are trusted to look after their own bodies and decide for themselves whether they want to be screened or not. There is no goverment promoted mass-screening programme of testicular cancer, for example. BEcause testicles belong to men, and are therefore regarded as "healthy until proven otherwize"Men are not frightened, coerced or cajolled into being screened because there is no obsession with controlling them.

THe history of medicine teaches us that women, and by default their sex specific organs, are regarded as defective and pathalogical. (when if any sex is defective, it is the male sex due to the Y, which renders them biologicaly more vulnerable to disease in a number of ways)

Greer has covered this in detail in The Whole Woman. She has examined the evidence which shows that cervical screening has done nothing to save women's lives.
Women are still dying from cervical cancer. Although the rate of cervical cancer has been dropping , that is not because of screening, but because because it was actually dropping naturally before mass screening was invented, and continues to drop at the same rate.

Often mistakes are made in the laboratories, and there have been cases of women who actually had healthy cervixes being treated for cancer, and women who had cancer were missed, and ended up dying.

As I said, the point is not to actually save women's lives, but to get women to comply, to STFU and to be penetrated by gynelogical instruments.I don'T get screened, because I've looked at the statistics and found that, despite screening, women are still dying of cervical cancer so the margin for human error in the tests is too great.

Which brings me to another important question. WTF are men doing in gynecology anyway? I mean, WhyTF are they even there? In the room? Sticking bits of metal into women? Researching vaginas, when it's not their place to do so? THe funding should go to female scientists and doctors [but that's for another thread]

I haven't had a smear test for over ten years. WHen I had my first at 18 the results came back telling me I needed to go for a re-test for possible cancerous cells. I went back, had another check, the second time it came back clear (after me scaring myself to death). After doing research I learned that if you have had sperm or even your period (if you'd just finished it) can interfere with the findings, making it look as though there may be cancerous cells when there aren't.

WHat a joke. And the joke's on women. And I haven't been back since.

THe Y chromozome, by comparison, is much weaker and contains far less life-preserving DNA

I'm still laughing at being called an eugenicist.

You're talking to a woman who refused all scans in her pregnancies because I find the concept of "checking for "abnormalities" abhorrent"

That is eugenics

YOu're talking to a woman who has bi-racial children

You're talking to a woman who has a boy and a girl

Eugenics? For commenting on the fact that an X chromozome is stronger than a Y?

This is why anti-feminist arguments have to resort to the misuse of language to create a counterpoint.

Eugenics does not equal stating evidence about DNA

Eugenics equals justifying eliminating people/foetuses for disabilities/supposed unfitness, eugenics equals sterilizing healthy people (like the trans activists are doing) or altering DNA/cloning.

instead of participating in a witch-hunt against someone who dares to contradict the wisdom of the demi-Gods i.e doctors

This is my first problem, it has never occurred to me that a doctor is a 'demi-god'-they are just a person who has studied the human body and made it a career-they simply have more knowledge than me.My doctor always treats me as an equal and explains everything. He isn't always right. My doctor before was a woman-I'm not in the least fussed about the sex of the doctor. I think that any doctor who thought of themselves as a demi god would be weeded out at university stage.

As regard to OP if you read it, not knowing anything at all about separatist feminists , the only conclusion that you can come to is that it is someone who has had deep trauma and needs counselling. It is only after reading up about it that I can see that isn't the case.

instead of parcticipating in a witch-hunt against someone who dares to condtradict the wisdom of the demi-gods.........]

well-i question the wisdom of the demi-gods Sakura but in a diffrent way.
as i said-i can see what youre saying and i do partly agree-however my agreement would be in more along the lines of phyciatry!
regarding eugenics-yep-i agree.
i dunno Sakura-if we re on about the partriarchy-it dont make sense from what youre saying and from what is happening in other parts of the world-
eg india[i think far more women arent tested and die from cancer]
can you see what im saying?

If you want to contradict the wisdom of the doctor do it face to face in the surgery-it is a two way thing-there is no need to just be a passive subject.

im not sure who you are talking to exoticfruits?
but my thoughts on what youve just said is-
if we re talking about a partriarchic angle[which i am]
its not much use having a conversasion in the surgery as the doctor probably wont understand what im on about as the partriarchy has given him the upper hand in the first place.

Talking to OP sparky-that doctors are not demi gods-probably 50% are women anyway (they are in my surgery). Mine certainly listens (the reason he runs late with appointments) and he is a man. Change doctors if you don't like yours.

oh right
im not spacificlly talking about my doctor or any spaccific doctor really
im looking further than this.

Here's some facts for all you naysayers.

Cervical cancer is as common as mouth cancer.
Why aren't men and women both regularly screened for mouth cancer, hmmm?

Answer that question and get back to me.

And that's before we get onto all the over-diagnoses of cervical cancer ( in other words, women believing they have cancer when they haven't)

"In the NHS cervical screening programme around 1000 women need to be screened for 35 years to prevent one death"

Mass cervical screening is utterly, utterly unecessary.

It makes as much sense as mass screening healthy people for mouth cancer.

A close friend of mine had mouth cancer at the age of 17, had to go through chemo, the lot. IN Wales, bowel cancer rates are the highest in Europe, and research suggests it could be connected to lack of vitamin D due to the weather.

THe point is, femaleness doesn't kill you. Breast and cervical cancer are zoomed in on by the government. For. No. Logical. Reason. At. All

Informed consent is missing from Pap smears and cervical cancer screening

"The facts are that cervical cancer is a rare disease in the US, a point which is never made. The American Cancer Society (ACS) predicts that there will be just over 11,000 cases in 2009. There will be nearly as many cases of testicular cancer, 8,400. In comparison both breast and prostate cancer are just under 200,000. Most women have been led to believe that cervical cancer is rampant and they need yearly screening to prevent it. Testicular cancer however, is rarely mentioned. Most physicians don?t even bother to recommend that young men self-examine."

Sakura -

I think healthy men and women are regularly screened for signs of mouth cancer, it is one of the things dentists look for, they just don't tell you they are doing it. Same as when you go for an eye-test - you are mainly interested in your eyeglasses prescription, but the optometrist will be checking for all kinds of other things.

The article you link to is interesting - I guess one point is that what is driving pap smears in the US is the healthcare system where women routinely see gynecologists and their is an incentive for them to do more testing, so many go every year even though they have no abnormal results. Whereas in the UK where most women never see a gynae but are treated by GPs the frequency is determined by the NHS and government (I guess by NICE)...I think it is 3 - 5 years?

As with any screening program their are pros and cons and ways to improve. I am just not convinced that the current screening regime is driven by some perverted desire to 'stick bits of metal into women' or to subjugate them.

I guess if it were made clearer that the benefits of screening are limited for women at low risk - no previous abnormalities + not having sex, or with one faithful partner it would save a lot of women the hassle of going for a smear. But it would also mean that many women who are at risk wouldn't go for testing because it wouldn't be universal and routine. So you have to weigh up the costs and benefits either way.

Sakura, what you're saying about cervical and breast screening is just not true.

Screening programmes have been instituted for these diseases because screening produces a net benefit, ie it saves more lives and reduces harm more than it costs lives and increases harm. This tradeoff exists for every single health intervention, because every action or lack of action has a cost for a population as a whole in terms of morbidity or mortality.

Screening programmes have not been instituted for other diseases because screening would not produce a net benefit. For mouth cancer, this is because there isn't an available screening test to spot pre-oral cancer, and the money is better spent on prevention, encouraging people to cut down on their smoking and drinking.

There is a completely legitimate argument about what additional stuff the NHS could do to prevent CC rates, eg by promoting condom use. But frankly the reason the NHS does not do more on this stuff is the same reason it doesn't do that much on obesity or other diseases with large public health / behavioural components - any social marketing efforts are pissing in the wind compared to the enormous social and commercial pressures that shape how people behave. Could government legislate? Probably, if they were sufficiently imaginative and bold. But the fact that they aren't is only partly down to misogyny; they are venal and useless across an entire range of health issues, it's not specific to women's health. Otherwise, we'd have had a ban on soft drinks & fast food outlets near schools, would have greater restrictions on tobacco use, would have decriminalised drugs, etc etc.

Honestly, this entire argument strikes me as no-win. If the NHS did not institute these programmes, it would be easy to attack it as treating breast / cervical cancer as women's diseases which weren't worthy of the effort. As your very own quote from the ACS says, male-only cancers are broadly ignored, to the detriment of men's health. If the resources were switched from screening programmes for breast and cervical cancer to testicular cancer, how would that be better for women?

I am regularly screened for mouth cancer by my dentist-it is one of the things that he does.
I find it weird that people wouldn't take any screening on offer.

Exotic - Its not necessarily weird to not take up screening (or to not offer it)

You only need for a test to have a small chance of false positives for there to be a much higher probability of a false positive than of finding something wrong.

Someone who knows Bayesian stats better than me can explain it better... but gist is that the rarer the disease is the higher the chance of having a false positive result. So sometimes people may decide quite rationally that it is not worth being screened - they would rather live with the small risk of having the disease than expose themselves to the much larger risk of undergoing unnecessary treatment.

This is the point about informed consent. I remember reading somewhere about an experiment where they ask Doctors to solve some basic probability problems using Bayesian probability and a huge proportion got it wrong -- it points to the cock-up rather than conspiracy theory about why Doctors are so bad at explaining this stuff to patients (male and female) ...

HPV is the root of cervical cancer, which is contracted through intercourse (a STD, basically)

[[http://healthmad.com/conditions-and-diseases/condoms-prevent-cervical-cancer/ World health experts have revealed that at least once in their lives, half of adult women who were sexually active were infected with HPV (Human papilloma virus). Although sometimes the infection is not harmful, but exposure can trigger abnormal cell changes in the cervix that can later develop into cancer.

But now women no longer need to worry, the results of research published by the New England Journal of Medicine says that condoms are proven to be very effective to reduce the risk of cervical cancer and also prevent transmission of HPV.]]

AND

Hormone in semen triggers cervical cancer [[http://www.medindia.net/news/view_news_main.asp?x=13874
A team from the Medical Research Council suggests that cancers like cervical cancers or womb cancers may be triggered by the presence of a hormone in semen. The researchers said that high levels of prostaglandin spurred the development of tumors. ]]

AND

Semen fuels cervical cancer

no, it's not weird for a healthy person to get tested for one type of cancer as opposed to another type of cancer when he/she has exactly the same risk of either

Remember, the risk of cervical cancer and mouth cancer is the same. So if you're a woman who insists on condoms then your risk of cervical cancer is reduced even further.

It's utter madness to test healthy bodies for no reason at all.

I hope nobody is overlooking the fact that there is money in this. Gynecology has always been a hugely profitable industry.

I'm all for testing healthy bodies-they may not be healthy- and I would far rather find out early enough to do something about it. By the time you think there may be a problem it may be too late.
No one is forcing you-everyone is able to make their own choice-mine is health checks. I think my cholesterol level is low-this doesn'tmean I would turn down a test if offered- I might be wrong. I'm not going to say to my dentist 'don't do a mouth cancer check'.

sakura, you did not respond to the substance of what I said.

I will try to be as clear as possible. We would be being really stupid - spectacularly dumb - if we chose which diseases to screen for simply on the basis of how prevalent they are. We need to take into account several factors:
1 Can we spot it early? Is there a fairly reliable test?
2 Can we do anything about it if we do spot it? Do the interventions available do more good than harm, on balance?
3 Is it worth the effort, compared with the other things we can do to cut the harm caused by this disease?
4 Is the harm caused significant enough to justify the screening programme, compared to spending the money on other diseases?

You are overly focused on point 4. The other three are just as important. I explained that for mouth cancer, there is more value in other interventions, especially cutting smoking and drinking rates.

And your theory about money makes no sense in the context of the UK. Gynaecologists do not do screening in their private work, so the profit motive simply does not exist in the way you assert. The national screening programme is carried out by GP practice nurses, mainly. They are not profit-driven. While practices get some income from screening, I doubt that many of them could demonstrate to the satisfaction of their accountant that it makes them a profit to do this work. Practice finances are too murky for that.

It is utter madness to describe the screening programme as "testing healthy bodies for no reason at all". It is testing people who run a small but real risk of being about to develop something that could kill them for the purposes of preventing them dying.

Sakura, on another note, I'm not sure why you were posting all that stuff about CC being effectively an STD. On the off-chance that it was aimed at me, I know about it. It's why I said what I said about a legitimate debate about whether the NHS can do more on prevention.

himilaya

Someone who knows Bayesian stats better than me can explain it better... but gist is that the rarer the disease is the higher the chance of having a false positive result. So sometimes people may decide quite rationally that it is not worth being screened - they would rather live with the small risk of having the disease than expose themselves to the much larger risk of undergoing unnecessary treatment.

to make an informed choice, you need to know
A. the chance of a false positive (the chance you will be told you need follow-up even though you are healthy),
B. the chance of a true positive (the chance you will be told you need follow-up when you do have CC or precursors to it), and
C. the chance you have CC/precursors.

if C is 0 (you are a nun, a lesbian who has never slept with men, a virgin) then you don't need to be screened. if B is fairly high (close to 1) then the test is sensitive and you can be confident that if you need treatment, the screening will pick it up. If A is fairly small (close to 0) then the test is specific and you can be confident that you won't get sent for treatment you don't need. but as A rises, and particularly if A is bigger than CxB, then you would worry that more people get sent for necessary than unnecessary treatment. with a quick google I haven't been able to find these figures for CC in the UK but for a screening test to be adopted, these figures will have been worked over closely, and they are reviewed periodically to make sure it is worth continuing with. the NHS does not like to spend money unnecessarily (especially on women - just look at the state of maternity services).

sakura

the fact that an X chromozome is stronger than a Y

this keeps being repeated, but where does this "fact" come from? is it a deduction from the longevity of women vs men or from somewhere else? the evolution of the Y chromosome interests me, but I wouldn't say one is stronger than the other. I would be interested to read the basis of your "fact".

with apologies for the triple post, as the HPV vaccination programme becomes established, I fully expect that cervical screening will not be routinely available for women in age ranges where most are vaccinated, because the chance of disease should fall in this cohort, and screening will be uneconomical/the false positive rate will be unacceptably high compared to the detection rate. eventually the screening programme will be abolished because there will be no point maintaining the labs/expertise etc for an ever decreasing number of tests. will women in the unvaccinated cohorts then protest that they want to be screened? I think it will become a feminist issue again, from a different perspective.

This development is certainly quite odd, as the Polish health minister is trying to pass a bill that if a woman refuses the screening, she will not be allowed to work. Nothing to do with saving lives or saving state medical bills as such: www.womensviewsonnews.org/2011/05/protest-against-compulsory-medical-exams-of-polish-women-workers/

Some Polish doctors have protested against this too.
Ethically, there is no medical reason to enforce screening on any person unless the disease is contagious and fatal if untreated - we are talking about conditions like smallpox and Lassa fever here, certainly not cervical and breast cancer.

While breast cancer is fairly high up the list, cervical cancer is not as high up as lung and colorectal cancer, whose complications are equally deadly - a chest xray as a screening test is certainly not as uncomfortable to a woman - but I don't see this being offered. Professionally, I would say this is an odd and worrying development in the political landscape of a country.