Pap smears, or smear tests as they’re sometimes known, are hailed as a great preventative tool, in helping women identify the presence of HPV and any subsequent cell changes that could lead to cervical cancer. It’s a relatively painless and quick process which could save your life – or so we’re told. The other side of the debate is often not addressed or considered by mainstream medicine, so I want to highlight some of these here.
Some of these screening tests, which are designed to get healthy people requiring medical treatment, are not always needed. Let’s take cholesterol checks for example. A very common test that will be offered as you get older but Doctors fail to identify a difference between good and bad cholesterol, instead looking at the overall number. This is dangerous. High cholesterol, which is mostly good cholesterol, is not cause for concern – we need cholesterol for our cell membranes and actually need more of this as we get older. These people are often put on medication, commonly statins, to reduce cholesterol. However, low cholesterol levels in older people means their uptake of Vitamin D is limited. We need Vitamin D to keep us healthy and support our immune system; such as prevent cold/flu and reduce our risk of osteoarthritis. Are we tackling a harmless test reading and causing a real problem in the body? Could we be doing the same with the smear tests?
Just for clarity, screening tests are for people with no symptoms. If you have concerning symptoms, such as bleeding between periods, changes in bowel movements, etc then testing for this is different – this would be a diagnostic test and has the potential to identify something that’s a true concern. You know your body and it’s important to always listen to the signs it gives us.
Cancer of the cervix is a fairly rare form of cancer in Britain, accounting for less than half a per cent of cancer deaths and around four per cent of cancer cases in women. Cervical screening does prevent deaths from cervical cancer – but to get that reduction, you have to follow up and/or treat all the women who have cell changes on their screening test. However, most cervical-cell changes found at screening will not lead to cervical cancer. The problem is we can’t predict which will, so all need further monitoring or treatment. A study from Bristol in 2003 found that 1,000 women have to be screened for 35 years to prevent one death from cervical cancer; and to prevent that death, 80 women have to have further investigation, with 50 women having treatment to their cervices. Four out of five women found at screening to have “high-grade” changes in their cervix did not go on to develop invasive cancer.
That potential for good has to be weighed against the risks of treatment. It’s known that having a cervical biopsy – which is done to get more information about the degree of abnormality – raises the risk of pre-term birth in later pregnancies. And the worry and anxiety that the results cause shouldn’t be underestimated. It’s apparent from research studies that when people get balanced information about screening tests, fewer people want them – but this is the crux of the issue. There is a lack of informed consent in our medical system, which means we are unable to make the right decision for us.
We each have to do what is right for us. If you are at an increased risk of cervical cancer then you may decide the benefits outweigh the risks. Increased risk factors include smoking, starting sexual activity early and having a high amount of sexual partners. We must also consider how healthy our diet is, if we have other diseases that our immune system is suppressed with, our lifestyle, hygiene, etc. Do your own research before making any medical decisions however harmless they may seem on the surface.