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	<title>Comments on: The Pap Smear &#8211; Not Too Many &#8211; Too Few</title>
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	<link>http://www.meyersmedmal.com/blog/2009/11/the-pap-smear-not-too-many-too-few/</link>
	<description>Medical Malpractice Law From The Lawyer&#039;s Perspective</description>
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		<title>By: Jerry Meyers</title>
		<link>http://www.meyersmedmal.com/blog/2009/11/the-pap-smear-not-too-many-too-few/#comment-71</link>
		<dc:creator>Jerry Meyers</dc:creator>
		<pubDate>Mon, 03 Jan 2011 20:14:03 +0000</pubDate>
		<guid isPermaLink="false">http://www.malpracticelawfirm.net/?p=207#comment-71</guid>
		<description>Your Dr. did not act in accordance with  recommended practice unless you are also HPV positive.   Your experience  does not justify the conclusion  you reached.  It is true that mild dysplasia does most often clear on its own. That&#039;s why colposcopy is not recommended for that finding.</description>
		<content:encoded><![CDATA[<p>Your Dr. did not act in accordance with  recommended practice unless you are also HPV positive.   Your experience  does not justify the conclusion  you reached.  It is true that mild dysplasia does most often clear on its own. That&#8217;s why colposcopy is not recommended for that finding.</p>
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		<title>By: Jerry Meyers</title>
		<link>http://www.meyersmedmal.com/blog/2009/11/the-pap-smear-not-too-many-too-few/#comment-70</link>
		<dc:creator>Jerry Meyers</dc:creator>
		<pubDate>Mon, 03 Jan 2011 20:08:46 +0000</pubDate>
		<guid isPermaLink="false">http://www.malpracticelawfirm.net/?p=207#comment-70</guid>
		<description>You are mixing apples and oranges. The reduction in the rate of death is not due to the number of hysterectomies performed.  Pre-invasive cervical cancer and high grade intraepithelial  neoplasia are most often treated with cryo-therapy or cone biopsy, not hysterectomy.  Further, preinvasive cervical cancer and high grade intraepithelial neoplasia are not  benign conditions.  On the other hand, there are benign conditions which justify hysterectomy in women past child bearing age.  Prolapsed uterus, etc.  Please tell us where you obtained a statistic which suggests that 600,000 hysterectomies are performed because of abnormal pap smears where cancer or a high grade neoplasia was not present.  the value of pap smears in reducing death from cervical cancer is real.  Whether unnecessary hysterectomies are being performed  for other reasons is certainly a matter worth looking into.
Thanks for your interest.</description>
		<content:encoded><![CDATA[<p>You are mixing apples and oranges. The reduction in the rate of death is not due to the number of hysterectomies performed.  Pre-invasive cervical cancer and high grade intraepithelial  neoplasia are most often treated with cryo-therapy or cone biopsy, not hysterectomy.  Further, preinvasive cervical cancer and high grade intraepithelial neoplasia are not  benign conditions.  On the other hand, there are benign conditions which justify hysterectomy in women past child bearing age.  Prolapsed uterus, etc.  Please tell us where you obtained a statistic which suggests that 600,000 hysterectomies are performed because of abnormal pap smears where cancer or a high grade neoplasia was not present.  the value of pap smears in reducing death from cervical cancer is real.  Whether unnecessary hysterectomies are being performed  for other reasons is certainly a matter worth looking into.<br />
Thanks for your interest.</p>
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		<title>By: EJ</title>
		<link>http://www.meyersmedmal.com/blog/2009/11/the-pap-smear-not-too-many-too-few/#comment-69</link>
		<dc:creator>EJ</dc:creator>
		<pubDate>Mon, 03 Jan 2011 10:46:56 +0000</pubDate>
		<guid isPermaLink="false">http://www.malpracticelawfirm.net/?p=207#comment-69</guid>
		<description>My other question to you is this - the reduction in deaths - it does not appear that the &quot;74% reduction&quot; includes the increased number of women getting hysterectomies (600,000 a year or 1 in 3 women by age 60) most of which are for benign conditions. I&#039;m an auditor and am very concerned that this numbers aren&#039;t properly being represented to women.</description>
		<content:encoded><![CDATA[<p>My other question to you is this &#8211; the reduction in deaths &#8211; it does not appear that the &#8220;74% reduction&#8221; includes the increased number of women getting hysterectomies (600,000 a year or 1 in 3 women by age 60) most of which are for benign conditions. I&#8217;m an auditor and am very concerned that this numbers aren&#8217;t properly being represented to women.</p>
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		<title>By: EJ</title>
		<link>http://www.meyersmedmal.com/blog/2009/11/the-pap-smear-not-too-many-too-few/#comment-68</link>
		<dc:creator>EJ</dc:creator>
		<pubDate>Mon, 03 Jan 2011 10:44:34 +0000</pubDate>
		<guid isPermaLink="false">http://www.malpracticelawfirm.net/?p=207#comment-68</guid>
		<description>Where did you get these numbers? Colposcopy should only be performed when a high grade lesion or atypical cells suggesting a high grade lesion is found. This is an in frequent event. Further, colposcopy does not result in any biopsy unless evidence of a precancerous lesion is confirmed. 90% of these precancerous lesions will progress to invasive cancer if not treated.
The reason that relatively few cases of cancer are diagnosed each year in America (15,000) each year is because of the success of treating precancerous lesions found by pap smears.

   This is false. I had mild dysplacia and my doctor wanted to do a colposcopy and biopsy immediatly. When I refused, she sent me a certified letter demanding I get this procedure even though she admitted this would &quot;probably clear on its own&quot;. This test is over-sold. Doctors are too biopsy-happy. Had I known the overall risk of this cancer, I never would have put myself through this in the first place.</description>
		<content:encoded><![CDATA[<p>Where did you get these numbers? Colposcopy should only be performed when a high grade lesion or atypical cells suggesting a high grade lesion is found. This is an in frequent event. Further, colposcopy does not result in any biopsy unless evidence of a precancerous lesion is confirmed. 90% of these precancerous lesions will progress to invasive cancer if not treated.<br />
The reason that relatively few cases of cancer are diagnosed each year in America (15,000) each year is because of the success of treating precancerous lesions found by pap smears.</p>
<p>   This is false. I had mild dysplacia and my doctor wanted to do a colposcopy and biopsy immediatly. When I refused, she sent me a certified letter demanding I get this procedure even though she admitted this would &#8220;probably clear on its own&#8221;. This test is over-sold. Doctors are too biopsy-happy. Had I known the overall risk of this cancer, I never would have put myself through this in the first place.</p>
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		<title>By: Jerry Meyers</title>
		<link>http://www.meyersmedmal.com/blog/2009/11/the-pap-smear-not-too-many-too-few/#comment-15</link>
		<dc:creator>Jerry Meyers</dc:creator>
		<pubDate>Wed, 31 Mar 2010 19:23:39 +0000</pubDate>
		<guid isPermaLink="false">http://www.malpracticelawfirm.net/?p=207#comment-15</guid>
		<description>I&#039;m very glad that you decided to share with our readers your comments. It is very easy for a woman who has never shared your experience or known anyone in your circumstances, to minimize the importance of early diagnosis of cervical cancer.

I find it interesting that you described negative Pap smears on more than one occasion prior to the Pap smear which led to your diagnosis. In your remarks you refer to others whose diagnosis also followed negative Pap smears and who were less fortunate, and that their disease was advanced at the time diagnosis was made.

Though Pap smears have dramatically reduced deaths from cervical cancer, interpretive errors with respect to the reading of the Pap smears has on occasion resulted in needless delay in diagnosis.

I have represented numerous women who after investigation were proven to have had an avoidable delay in diagnosis. It is my experience in these cases that makes me so sensitive to your remarks.

Thank you again for commenting.

For further information please read the articles appearing at my &lt;a href=&quot;http://www.meyersmedmal.com&quot; rel=&quot;nofollow&quot;&gt;web site&lt;/a&gt;.</description>
		<content:encoded><![CDATA[<p>I&#8217;m very glad that you decided to share with our readers your comments. It is very easy for a woman who has never shared your experience or known anyone in your circumstances, to minimize the importance of early diagnosis of cervical cancer.</p>
<p>I find it interesting that you described negative Pap smears on more than one occasion prior to the Pap smear which led to your diagnosis. In your remarks you refer to others whose diagnosis also followed negative Pap smears and who were less fortunate, and that their disease was advanced at the time diagnosis was made.</p>
<p>Though Pap smears have dramatically reduced deaths from cervical cancer, interpretive errors with respect to the reading of the Pap smears has on occasion resulted in needless delay in diagnosis.</p>
<p>I have represented numerous women who after investigation were proven to have had an avoidable delay in diagnosis. It is my experience in these cases that makes me so sensitive to your remarks.</p>
<p>Thank you again for commenting.</p>
<p>For further information please read the articles appearing at my <a href="http://www.meyersmedmal.com" rel="nofollow">web site</a>.</p>
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		<title>By: Dana Pearce</title>
		<link>http://www.meyersmedmal.com/blog/2009/11/the-pap-smear-not-too-many-too-few/#comment-14</link>
		<dc:creator>Dana Pearce</dc:creator>
		<pubDate>Sun, 28 Mar 2010 05:16:05 +0000</pubDate>
		<guid isPermaLink="false">http://www.malpracticelawfirm.net/?p=207#comment-14</guid>
		<description>I was diagnosed with advanced invasive cervical cancer (squamous cell, stage 2B with metastasis to two pelvic lymph nodes - 50% 5-year survival rate) after having a solid history of negative pap smears.  I became sexually abstinent in 1996, but continued getting routine pap smears.  I may have skipped a year once or twice, but I did have at least 3 normal pap smears in a row in 2003, 2004, &amp; 2005.  Then in 2006, my Dr. found a large tumor.  I believe that if I had not gone to have a pap smear in 2006, I would not be here today.  In fact, although I have been &quot;cancer-free&quot; (no evidence of disease&quot;) for 3 years now, I still have a 50% chance of surviving the next two years.  I want to advise every woman who has EVER been sexually active to continue getting ANNUAL pap smears even if the results are always negative (&quot;normal&quot;).  I know they say that it is rare for this to happen (cervical cancer), but when it happens to you, it doesn&#039;t really matter how rare or common it is.  I know of at least 2 other women who had a history of normal pap smears prior to a cervical cancer diagnosis which was made too late, and those women are no longer alive.  After suffering through chemotherapy, radiation, along with the horrible and some long lasting side effects that come with treatment, becoming infertile, and being put into instant menopause at the age of 38, I can assure you that the discomfort and financial cost of a pap smear pales in comparison.</description>
		<content:encoded><![CDATA[<p>I was diagnosed with advanced invasive cervical cancer (squamous cell, stage 2B with metastasis to two pelvic lymph nodes &#8211; 50% 5-year survival rate) after having a solid history of negative pap smears.  I became sexually abstinent in 1996, but continued getting routine pap smears.  I may have skipped a year once or twice, but I did have at least 3 normal pap smears in a row in 2003, 2004, &amp; 2005.  Then in 2006, my Dr. found a large tumor.  I believe that if I had not gone to have a pap smear in 2006, I would not be here today.  In fact, although I have been &#8220;cancer-free&#8221; (no evidence of disease&#8221;) for 3 years now, I still have a 50% chance of surviving the next two years.  I want to advise every woman who has EVER been sexually active to continue getting ANNUAL pap smears even if the results are always negative (&#8220;normal&#8221;).  I know they say that it is rare for this to happen (cervical cancer), but when it happens to you, it doesn&#8217;t really matter how rare or common it is.  I know of at least 2 other women who had a history of normal pap smears prior to a cervical cancer diagnosis which was made too late, and those women are no longer alive.  After suffering through chemotherapy, radiation, along with the horrible and some long lasting side effects that come with treatment, becoming infertile, and being put into instant menopause at the age of 38, I can assure you that the discomfort and financial cost of a pap smear pales in comparison.</p>
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		<title>By: glasnost</title>
		<link>http://www.meyersmedmal.com/blog/2009/11/the-pap-smear-not-too-many-too-few/#comment-13</link>
		<dc:creator>glasnost</dc:creator>
		<pubDate>Fri, 19 Mar 2010 23:40:47 +0000</pubDate>
		<guid isPermaLink="false">http://www.malpracticelawfirm.net/?p=207#comment-13</guid>
		<description>Well Done! I Like it!</description>
		<content:encoded><![CDATA[<p>Well Done! I Like it!</p>
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		<title>By: Jerry Meyers</title>
		<link>http://www.meyersmedmal.com/blog/2009/11/the-pap-smear-not-too-many-too-few/#comment-12</link>
		<dc:creator>Jerry Meyers</dc:creator>
		<pubDate>Sun, 13 Dec 2009 04:37:15 +0000</pubDate>
		<guid isPermaLink="false">http://www.malpracticelawfirm.net/?p=207#comment-12</guid>
		<description>You wrote &quot;This is an unreliable test that with annual testing sends almost all women for biopsies in her lifetime, with only a very small number having any sign of malignancy. Two yearly testing sends 77% of women for biopsies, three yearly – 65% and even 5 yearly is 55%.&quot;

Where did you get these numbers?  Colposcopy should only be performed  when a high grade lesion or atypical cells suggesting a high grade lesion is found.  This is an in frequent event.  Further, colposcopy does not result in any biopsy unless evidence of a precancerous lesion is confirmed.  90% of these precancerous lesions will progress to invasive cancer if not treated.
The reason that relatively few cases of cancer are diagnosed each year in America (15,000) each year is because of the success of treating precancerous lesions found by pap smears.</description>
		<content:encoded><![CDATA[<p>You wrote &#8220;This is an unreliable test that with annual testing sends almost all women for biopsies in her lifetime, with only a very small number having any sign of malignancy. Two yearly testing sends 77% of women for biopsies, three yearly – 65% and even 5 yearly is 55%.&#8221;</p>
<p>Where did you get these numbers?  Colposcopy should only be performed  when a high grade lesion or atypical cells suggesting a high grade lesion is found.  This is an in frequent event.  Further, colposcopy does not result in any biopsy unless evidence of a precancerous lesion is confirmed.  90% of these precancerous lesions will progress to invasive cancer if not treated.<br />
The reason that relatively few cases of cancer are diagnosed each year in America (15,000) each year is because of the success of treating precancerous lesions found by pap smears.</p>
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		<title>By: Elizabeth</title>
		<link>http://www.meyersmedmal.com/blog/2009/11/the-pap-smear-not-too-many-too-few/#comment-11</link>
		<dc:creator>Elizabeth</dc:creator>
		<pubDate>Wed, 02 Dec 2009 01:19:39 +0000</pubDate>
		<guid isPermaLink="false">http://www.malpracticelawfirm.net/?p=207#comment-11</guid>
		<description>Pap smears are not harmful - what a statement!
Many women find a pap smear an ordeal and some women refuse to have them at all. Aside from that, pap smears are unreliable and lead to over-treatment with LEEP and biopsies. The risk of this cancer and the benefits of this testing have been completely misrepresented to women.
I think this shows a disgusting lack of regard for women and their rights.

This cancer is uncommon, always was - look at the figures. Don&#039;t talk in terms of &quot;75% reduction&quot; or &quot;deaths halved&quot;, talk about absolute risk.
This is an unreliable test that with annual testing sends almost all women for biopsies in her lifetime, with only a very small number having any sign of malignancy. Two yearly testing sends 77% of women for biopsies, three yearly - 65% and even 5 yearly is 55%.
Your chance of unnecessary and potentially harmful biopsies is FAR greater than the low risk of cancer. (near zero for a low risk woman)
Some of those women will be left with continuing health problems.
Overscreening and screening women under 25 causes lots of damage for very little benefit. Young women produce VERY high numbers of false positives simply because their bodies are changing and these changes are interpreted as abnormal - these young women don&#039;t need medical intervention. it is to protect these young women from harm that countries like the UK don&#039;t screen before 25 and the Netherlands and Finland, not before 30.
Finland has the lowest rates of cervical cancer in the world and sends the smallest number of women for biopsies - they offer screening from age 30 and then 5 yearly to 60. My low risk Finnish friend does not have screening at all.
Angela Raffle, UK cancer screening expert released some figures that puts the risk into perspective - 1000 women need regular screening for 35 years to save ONE woman from cervical cancer.
When the risk of this cancer in an unscreened population is about 1.58% and a low risk woman has a near zero chance of getting this cancer AND this test so often leads to over-treatment...only one person can make the decision to accept those odds - the woman herself.
Of course, the benefits of screening have always been exaggerated as well as the risk of this cancer &amp; the risks have been concealed...
There is no respect for a woman&#039;s right to choose - whether she wants testing. Informed consent is totally disregarded and more than that, women are pressured and coerced into testing. Coerced by the unethical tying of birth control with cancer screening. They have nothing to do with each other - this is a tactic to FORCE screening. Even the medical associations, WHO and the USF&amp;DA all say this test is not needed for the initiation and continuing use of the Pill. Can you imagine compulsory rectal exams for all men wanting Viagra or antibiotics?  No say in whether they want testing. Yet that is accepted in women&#039;s health - screening is demanded with no risk or unbiased information, it is never offered...
We need a major change in women&#039;s health - it&#039;s time for honesty and some respect.</description>
		<content:encoded><![CDATA[<p>Pap smears are not harmful &#8211; what a statement!<br />
Many women find a pap smear an ordeal and some women refuse to have them at all. Aside from that, pap smears are unreliable and lead to over-treatment with LEEP and biopsies. The risk of this cancer and the benefits of this testing have been completely misrepresented to women.<br />
I think this shows a disgusting lack of regard for women and their rights.</p>
<p>This cancer is uncommon, always was &#8211; look at the figures. Don&#8217;t talk in terms of &#8220;75% reduction&#8221; or &#8220;deaths halved&#8221;, talk about absolute risk.<br />
This is an unreliable test that with annual testing sends almost all women for biopsies in her lifetime, with only a very small number having any sign of malignancy. Two yearly testing sends 77% of women for biopsies, three yearly &#8211; 65% and even 5 yearly is 55%.<br />
Your chance of unnecessary and potentially harmful biopsies is FAR greater than the low risk of cancer. (near zero for a low risk woman)<br />
Some of those women will be left with continuing health problems.<br />
Overscreening and screening women under 25 causes lots of damage for very little benefit. Young women produce VERY high numbers of false positives simply because their bodies are changing and these changes are interpreted as abnormal &#8211; these young women don&#8217;t need medical intervention. it is to protect these young women from harm that countries like the UK don&#8217;t screen before 25 and the Netherlands and Finland, not before 30.<br />
Finland has the lowest rates of cervical cancer in the world and sends the smallest number of women for biopsies &#8211; they offer screening from age 30 and then 5 yearly to 60. My low risk Finnish friend does not have screening at all.<br />
Angela Raffle, UK cancer screening expert released some figures that puts the risk into perspective &#8211; 1000 women need regular screening for 35 years to save ONE woman from cervical cancer.<br />
When the risk of this cancer in an unscreened population is about 1.58% and a low risk woman has a near zero chance of getting this cancer AND this test so often leads to over-treatment&#8230;only one person can make the decision to accept those odds &#8211; the woman herself.<br />
Of course, the benefits of screening have always been exaggerated as well as the risk of this cancer &amp; the risks have been concealed&#8230;<br />
There is no respect for a woman&#8217;s right to choose &#8211; whether she wants testing. Informed consent is totally disregarded and more than that, women are pressured and coerced into testing. Coerced by the unethical tying of birth control with cancer screening. They have nothing to do with each other &#8211; this is a tactic to FORCE screening. Even the medical associations, WHO and the USF&amp;DA all say this test is not needed for the initiation and continuing use of the Pill. Can you imagine compulsory rectal exams for all men wanting Viagra or antibiotics?  No say in whether they want testing. Yet that is accepted in women&#8217;s health &#8211; screening is demanded with no risk or unbiased information, it is never offered&#8230;<br />
We need a major change in women&#8217;s health &#8211; it&#8217;s time for honesty and some respect.</p>
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