A recent communique on cervical cancer screening in America says that a possible 22,000,000 women have undergone an unnecessary â€˜Pap testâ€™. They didnâ€™t need it because they have previously had a hysterectomy. The disturbing data is from the Centers for Disease Control and Prevention, or CDC. The data needs to be looked at with caution because it Â may be biased. It is word of mouth from the women themselves rather than official medical records.
National medical guidelines around cervical cancer screening have been in place for a decade and make it clear that for some women, the screening is unnecessary. The screening waters have been muddied of late by the public awareness campaign run to explain the HPV, or human papilloma virus, vaccine.
The CDC estimates are derived from data collated between 2000 and â€˜10 by the Behavioral Risk Factor Surveillance System. This analysed reports on cancer screening with the Papanicolaou (Pap) test. Published outcomes said that while post hysterectomy screening had declined from 73% to 59%, there were still over a half of this section of women who were undergoing unnecessary â€˜Pap testsâ€™. Simply because they no longer had a cervix to test, given that nearly 95% of hysterectomies involved removal of that area. The health related media naturally deplore the enormous waste of money and time in doing this screening.
While the CDC says that benefits from screeningÂ “might be outweighed by the net harm.”Â The major downside of the testing is that false-positive results were meaning pointless anxiety and even invasive operations. False positives and the consequences are of far more concern than the regrettable waste of resources.
Experts from outside the CDC question the data, because of the self-reporting issues. They know that there is much confusion among women about the true nature of a Pap test. Too many think they have had one, even if they have only been examined between the legs, with or without a speculum. They feel that the survey is more a test of female perception of a Pap test post guideline changes.
Another big question mark over the survey is the unreliable nature of human recall. Most women can say whether they have â€˜never hadâ€™ or â€˜ever hadâ€™ a Pap test. But everyone will struggle to say if and when in the last 12 years they had one. There is surely enormous bias in these numbers.
Unnecessary testing that flies in the face of medical consensus guidelines is not restricted to women who have had hysterectomies either. Last year, the 3 most important medical bodies involved in this issue;Â theÂ American Cancer Society, theÂ American College of Obstetricians and Gynecologists, and theÂ US Preventive Services Task Force, gave out new guidelines, that were of one mind. Pap testing for cervical cancer must start at 21, and not before and should take place tri-annually. The CDC survey also had reports of annual testing which is again unnecessary. Clearly the new guidelines are taking some considerable time to permeate through to doctor and patient consultations.