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Should women get PAP Smears?
You may believe that Dr's make their medical decisions based on current medical literature and what is best for the patient. You are wrong. And you could be literally dead wrong. Few Drs have the inclination, economic incentive,or time to objectively read medical journals. Drs get most of their medical information from drug reps and drug company sponsored lectures. Medicine is a business and it is run as such. Medical decisions,as other business decisions are based on the company's bottom line.
Every company has "bread and butter" activities-routine sales that generate profit. In medicine "routine" tests and screenings generate huge profits for hospitals and Dr's offices. Drs order "routine" blood work and X-rays before they ever see a patient. The majority of the test are unnecessary and would not be ordered by a thinking physician. Any radiologist will tell you that most of the X-rays,CT scans,MRI's etc they read are boringly normal because Drs don't don't examine patients adequately enough to assess whether these test will have a high yield. Similarly,most "routine" blood work is useless except that it generates huge profits.
For gynecologists,a "bread and butter" procedure is the annual PAP smear. This is done by putting the woman in the most undignified of positions, inserting an instrument into her vagina and scraping cells from her cervix to be examined under the microscope by a pathologist. Since its introduction,the incidence of death from cervical cancer took a steady decline and then leveled off. During that time it has been found that the biggest risk factor for the development of cervical cancer is the presence of specific strains the HPV virus. We(those of us who read) have have known for several years that a simple blood test(which can be ordered by your family practitioner,PA,or nurse practitioner) for these viruses is a better predictor of who will get cervical cancer than the humiliating experience of a PAP smear. At one point this indignity was justified as it saved lives. That is no longer the case.
Most likely,if you're a woman who sees a gynecologist,you are still advised to get an annual PAP smear. Why? Not because that is what the current medical literature says should be done,but because that is a "bread and butter" procedure for gynecologists. Many women don't have a family doctor and only see a gynecologist. If that is your situation,request HPV testing rather than a PAP smear. If that test is positive,then you need to follow through with the PAP smear. If the Dr does not consent to HPV testing,find a Dr who does.
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