So, if you’ve even breathed next to me in the past week, you’ve probably had the pleasure of hearing how unhappy I am with the new breast and cervical cancer screening guidelines issued by the US Preventative Services Task Force (USPSTF) and American College of Obstetrics and Gynecology (ACOG) in the past week.
The new breast cancer screening guidelines came first, with a recommendation to start regular mammograms a decade later than previously recommended, at age 50, and less often, at once every two years. Oh yeah, and they recommended that doctors should stop teaching women to self examine themselves on a regular basis.
Excuse me for the colloquialism of my generation, but – WTF?
The reason for these new guidelines being, of course, that the USPSTF’s research indicates that the benefits of cancer screening before the age of 50 do not outweigh the harms – that is, the anxiety and inconvenience regular testing gives women.
I’m sorry, is this implying that the anxiety caused by awaiting test results that reveal you may or may not have cancer is actually a greater harm than having undetected cancer itself?
And sorry, another question – would you rather examine your breasts yourself regularly, find a suspicious lump, see a doctor about it, and find out it was nothing? Or would you rather never examine your breasts yourself and when you see a doctor a year later, find out you have a malignant tumor in your breast? Which would cause you more anxiety, just out of curiosity? And would you have considered the first scenario an “inconvenience”?
Breast cancer is the second most common type of cancer in the world, but it is also one of the most treatable with early detection. To remove the possibility of early detection – even if statistics show that breast cancer is less likely to occur in women aged 40-49 – is completely ridiculous. Throwing the alleviation of anxiety idea out the window (which, by the way, is totally patronizing), what could possibly be the benefits of such a recommendation?
And then the shit really hit the fan when the ACOG released the new cervical cancer screening guidelines.
These new guidelines recommend that cervical cancer screening (aka Pap tests) should not be administered until the age of 21, regardless of sexual history. It is also recommended that, under the age of 30, these tests should only be performed once every two years, and over 30, once every three years.
Now, the reasoning for these new guidelines was slightly more forgivable than those for breast cancer screening. The ACOG change in guidelines, they believe, will reduce the risk of harm associated with treatments for abnormal Pap smear results. Generally, young women may receive abnormal results on their Pap tests multiple times, that will pan out to be nothing. The problem is that when doctors take measures to remove abnormal or possibly precancerous growths, they can cause harm to the cervix that can lead to problems later in life, especially during childbirth.
I absolutely agree that this is a legitimate problem. I have a personal connection to it because my mom lived through it – after having portions of her cervix removed over a decade due to HPV, she was forced to have a total hysterectomy when her cervix closed up completely and she was not able to menstruate properly. I don’t doubt that other woman experience complications due to treatments for abnormal Pap smears.
However, is this the best solution to this problem? To decrease screening significantly?
Early detection is important in the diagnosis of all cancers – the earlier you catch cancer, the better your chances of beating it. If we push back the age for women to begin cervical cancer screening, and increase the amount of time in between screenings, there is a greater potential for cancer to develop and do irrevocable damage to the body before it is detected, and then require more severe measures for treatment after it is detected.
If we know this, than instead of decreasing testing for cervical cancer, why not keep those guidelines the same, and then institute a watchful waiting policy. If a woman receives an abnormal result on her Pap smear, and has not had a previous history of them, her doctor could suggest waiting a month, or maybe even three, before performing another Pap test and then determining if action is necessary. This would likely decrease the unnecessary measures that are taken to remove those growths that the body would fight off on its own, while still carefully monitoring a woman’s health in case the risk of cancer is present.
Also, this crap about waiting until 21 regardless of sexual activity? That’s bullshit. If you’re having sex, you have the potential to contract STIs, and therefore you should be seeing a gynecologist annually as well as getting a Pap smear. Period.
Thankfully, many doctors are resisting these new guidelines, or choosing to ignore them completely. Specifically with the mammograms, even doctors that understand the USPSTF’s risk-analysis feel that their patients would not see it that way.
“My patients tell me they can live with a little anxiety and distress but they can’t live with a little cancer,” said Dr. Carolyn Runowicz in an article for the New York Times.
After the news on the new cervical cancer screening guidelines broke on Friday, I got so fired up that I had to call my gynecologist and see what she thought about all this. I wondered if maybe, not being a doctor, I wasn’t fully understanding the reasoning for these new recommendations, and possibly overreacting.
“We think they’re insane,” a nurse at my doctor’s office informed me. “We do not support them, we will not be following them, and our patients’ care will not change!”
And with that, I breathed a huge sigh of relief.*
For more information and reactions to the new breast cancer screenings guidelines, please see this very helpful and well-written post from the Feministing community.
*If you aren’t happy with the new guidelines, contact your doctor’s office and see what their response is to them, and how they will be proceeding. If you don’t agree with their position, you should let them know!
Please Help Ammre
On a side note, my friend Ammre (you may remember her from A Day in the Life of a GTA, and as an oft contributor of squid-related content to Cephaloblog) – one of the most active, talented, inspiring people I know – has been rendered virtually bedridden for several months now because of a back injury. Because of the incredible pain resulting from her injury, she is unable to work, and because she is unable to work, she doesn’t have the insurance or funds needed to receive proper medical care. It is a terrible situation, and she really needs help. If you’re able to spare anything at all to donate to her PayPal fund, I know she’ll be overwhelmingly appreciative. Every little bit helps – so help Ammre if you can!