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How do different nations approach a girl's first gynecological exam

 
 
Eliz52
 
  2  
Reply Tue 24 May, 2011 12:16 am
Some of you may be interested to read the handout prepared for doctors by Assoc Prof Margaret Davy and Dr Shorne, "Cervical cancer screening" in "Australian Doctor" 27/7/2006....
"No country in the world has shown a reduction in the incidence of or the mortality from cervical cancer in women under 30, irrespective of cervical screening. Many countries do not perform cervical screening in women under 30"....
We have known for a long time though that screening women under 30 results in great worry and harm producing very high numbers of false positives that often lead to potentially harmful over-treatment.
Also, see the hypothetical question at the end of the article...women over 30 with a negative HPV test who are no longer sexually active or in a monogamous relationship will still be tested because screening is about populations, not individuals and doctors can't assume her risk profile won't change...
Of course, I believe women should be given honest and complete information and left to make their own healthcare decisions - it's not a doctor's place to "assume" anything about my life....that's paternalistic.

Also, it's 88% of cervical lesions that do not progress to cervical cancer - the lifetime risk of this cancer is 0.65% and fewer than that number are helped after you take out false negative cases and factor in the other things that are having an impact on the cancer - more hysterectomies, fewer women smoking, less STD, better hygiene, better condoms etc

Some of you might also care to listen to an interesting lecture given by Prof Michael Baum at UCL recently, "Breast cancer screening: the inconvenient truths"...at the Medphyzz site.
It is totally unacceptable that the medical profession have zero respect for informed consent in our cancer screening.
0 Replies
 
sonia111
 
  -4  
Reply Thu 28 Jun, 2012 03:38 am
@aidan,
It's not like that in all other countries, everywhere in europe you get pelvic exams when you want to and even they encourage you to do one every six months. It's only England that is backward, they don't exam woman ever! even during pregnancy!
Eliz52
 
  2  
Reply Mon 17 Sep, 2012 10:26 am
@sonia111,
You should do some reading, routine pelvic exams are of poor clinical value and expose you to risk. Dr Carolyn Westhoff partly blames this exam for America's high hysterectomy rates and the removal of healthy ovaries after false positive exams. There are many articles covering this topic.
Women should understand what they're agreeing to....it can lead to some ugly places.
Also, on the subject of pap testing the new Dutch program is very interesting. This is one country that has managed to keep their program directed on woman, and what's best for them. They will move from their 6-7 pap test program, 5 yearly from 30 to 60 to 5 hrHPV primary triage tests offered at ages 30,35,40,50 and 60 and only the roughly 5% who test HPV positive will be offered a 5 yearly pap test. The vast majority are HPV negative, not at risk and they will be offered the HPV program and there is also a self test HPV device, the Delphi Screener. Those HPV negative and confidently monogamous or no longer sexually active may choose to forget all further testing. This program will save scarce health resources, save more lives and spare huge numbers from a lifetime of unnecessary pap testing and the risk of over-treatment and excess biopsies.
Some countries may never offer women evidence based screening, excess generates huge profits...women will have to demand smarter testing. There was never a need to worry and harm so many women, now there is no excuse....
HPV Today, Edition 24, sets out the new Dutch program
The Delphi Bioscience site provides info on the self test HPV device.
So far from being backward, a country or doctor that does not promote unhelpful and harmful exams and excess is acting in your best interests...and internal exams during a normal pregnancy are unnecessary as well. Excess is not a good thing and just exposes you to risk....I consider it bad medicine.
Ceili
 
  2  
Reply Mon 17 Sep, 2012 10:18 pm
@Eliz52,
I think your single mindedness diatribe is dangerous. But continue to parrot your beliefs and have the preventable illnesses and deaths of the women you counsel on your shoulders. Hope it helps you sleep at night.
0 Replies
 
student1991a
 
  1  
Reply Mon 26 Nov, 2012 04:36 pm
@CalamityJane,
I am a 21 year old from the UK. I have never been sexually active and have never had a pelvic exam or had any other kind of intimate procedure performed on me by a doctor. Here girls are not expected or pressured into having such exams unnecessarily. I have three doctors in my immediate family - one of which is a gynaecologist and none of them see any reason for a perfectly healthy girl such as myself to have to undergo such a procedure unless there are related medical problems such as very painful periods and even then any abnormalities that may be causing such problems can usually be picked up on ultrasound scan - which in the UK (where healthcare is free) would normally be the first course of action after a consultation with a gynaecologist anyway. Personally, I would have found it traumatic if I had had to endure a pelvic exam as a young teenager (plus many of my friends feel the same way) - Sorry but this American way seems some what disturbing to us Brits!
Also here all girls are given vaccinations against cervical cancer anyway.
ossobuco
 
  1  
Reply Mon 26 Nov, 2012 05:19 pm
@student1991a,
And how do you think vaccines against cervical cancer were even thought of?

0 Replies
 
djjd62
 
  1  
Reply Mon 26 Nov, 2012 05:39 pm
How do different nations approach a girl's first gynecological exam

i'm guessing they approach from the ankles and work their way up
0 Replies
 
chai2
 
  2  
Reply Mon 26 Nov, 2012 06:14 pm
@student1991a,
student1991a wrote:

Personally, I would have found it traumatic if I had had to endure a pelvic exam as a young teenager (plus many of my friends feel the same way) - Sorry but this American way seems some what disturbing to us Brits!



I find this really odd, considering Americans are often, and by that I mean almost always, portrayed as backwards, prudish, and overall repressed about anything relating to sexual matters, sexual health as compared to the infinitely more progressive and sophisticated Europeans.

"Endure" a pelvic exam? What's to endure? It's essentially no different than a physician/nurse practitioner/nurse looking inside a persons mouth, probing around the insides of the cheeks, around the teeth, tongue, tonsils etc. and scraping off some cells for examination.

Why is it different because it's a part of my body that just happens to be between my legs rather than the middle of my face?

A pap no different and no more uncomfortable than having someone look up your nostril. My doctors have looked up my nostrils during every routine exam, why not my vagina?
ossobuco
 
  1  
Reply Mon 26 Nov, 2012 06:28 pm
@chai2,
When I was a lab tech trainee, the last thing I wanted to do was dig in people's nostrils, which I then did. My problem was not the repulsion, I already caught the early morning **** cups, and yes I washed my hands though I never touched any of it, but from fear of hurting someone. Those might have been different lab watches.

I presume there are better methods now.
0 Replies
 
ossobuco
 
  1  
Reply Mon 26 Nov, 2012 06:33 pm
@chai2,
From the earlier part of the thread there is a fair amount of people against pelvic exams, exams from which has gathered statistics have helped.

That is not my view.
0 Replies
 
Ceili
 
  2  
Reply Mon 26 Nov, 2012 08:06 pm
@student1991a,
If pelvic exams were forced, this would be another discussion. They aren't.
While were on the topic, what the hell do Gynaecologists do in the UK. They don't deliver babies, they leave that up to midwives? What pray tell is their purpose?
ossobuco
 
  1  
Reply Mon 26 Nov, 2012 09:30 pm
@Ceili,
Hi, Ceili.

I'm interested in all this but it's late here now.

ossobuco
 
  1  
Reply Mon 26 Nov, 2012 09:49 pm
@ossobuco,
I should explain. I get earlier than naturally would becuase of Furface.
0 Replies
 
suzannewman
 
  1  
Reply Mon 24 Dec, 2012 12:03 pm
@CalamityJane,
I am amazed at what I'm reading here below! I'm presuming that most of these are written by men? I was one of the women that was molested by Dr. Social Path, Peter Plum! Sociopathic behavior is very interesting! The men are usually extremely charming, come across as kind and loving and caring then, as most predators attack their prey, they have gained their trust. When you are a woman you believe that Dr. especially one who is taken time to come across as an angel!

What this man did to me was on believable and sick and the chiropractor they touch your body, they palpitate your spine. In many cases with the dozens of women that he has ruined their lives, you do not expect this from someone who so sickly manipulate you into trusting him. How dare all of you make the woman at fault once again how common! To all of you shame shame on you!

There are so many women coming forth that it is sickening and the Lawrenceville police have a strong case against this bastard. Shame again on you again, how would you feel that that was your daughter you ignorant ignorant people!

I will be going to court and I have proof without a doubt! He will lose his chiropractic license as he should and God help the women's lives he's destroyed. Mine, being one of them!
0 Replies
 
ehBeth
 
  1  
Reply Mon 7 Jan, 2013 05:28 pm
@Eliz52,
Canada has now gone very much the way of the Dutch program re pap testing.

http://www.cbc.ca/news/health/story/2013/01/07/cervical-cancer-pap-hpv-test.html

Quote:
Stop Pap tests in women under 25, Canadian panel advises


Quote:
Compared with the task force's previous guidelines for doctors and policymakers from 1999, the major change is increasing the starting age for screening from 18 to 25, with an emphasis on women 30 to 69.

The new recommendations include:

No routine screening for women under age 25, including sexually active women.

A strong recommendation for screening women aged 30 to 69 every three years.

Ending screening for women aged 70 and over who've had three successive negative Pap test results.



Quote:
Cancer Care Ontario recommended that starting this year, HPV tests should be done first, followed by Pap testing only if the viral test is positive, Dollin said.
0 Replies
 
 

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