Lene, thanks for this information - I never realized that there could be adaptive ways to get a Pap smear/pelvic exam or mammogram.  I just had the latter the other day, coincidentally!  Luckily, I've only once ever found it to be painful and some of that, I think, may be dependent on the skill of the technician.

I never thought before about the difficulty of getting these things done when you have RA, so thanks for making us aware!

Lene Andersen, Health Guide

1/30/12 9:13pm

not a lot of people know about it, including doctors! When I was much younger, I approached my then-doctor about getting a Pap test and asked if she knew of any alternatives to the standard position. She didn't and seem completely clueless and unwilling to do any research, so I didn't get a Pap test until years later when I have found another doctor who was comfortable messing with the standard way of doing things. There is an atrocious lack of preventive/primary medical care in women with disabilities - I wrote about it as related to pap tests and inaccessibility of equipment and therefore services on my personal blog, but decided to keep the politics out of this particular piece.

 

thanks for coming by to comment!

There are far better options to cover the small risk from this rare cancer, there is no need to worry and harm the masses. The Dutch offer 7 pap tests, 5 yearly from age 30 to 60 and will shortly move to 5hrHPV primary tests offered at ages 30, 35, 40, 50 and 60 and ONLY those positive will be offered a 5 yearly pap test. Those negative and monogamous or no longer sexually active can forget all testing - those negative and not monogamous or who'd like further resassurance can follow the HPV program - those positive and at risk will be offered a 5 yearly pap test. By age 40 only 5% of women are HPV positive.

The Delphi Screener is being used by Dutch women - the self-sample HPV device you can use in the privacy of your bathroom. Studies show it's as reliable as a sample taken by a doctor. The mass pap testing of every woman is unnecessary and harmful - it produces large numbers of false positives and sends women for unnecessary and potentially damaging over-treatment and biopsies. Pap testing also misses too many of these rare cancers, at least 50% of adenocarcinoma and 25% (at least) of squamous cell carcinoma. Women should lobby for immediate access to hrHPV primary triage testing and the Delphi Screener. Sadly, over-screeing and over-treating with the pap test is highly lucrative for the medical profession - one billion dollars is generated every year in the States thanks to excess cervical biopsies - to cover a cancer with a 0.65% lifetime risk - that means women will have to fight for something better - it protects the more than 99% who can never benefit from pap testing and is more likely to help the fairly small number who will have an issue with this cancer.

Note: No country in the world has shown a benefit pap testing women under 30, but all have evidence of harm, these women produce the most false positives. Sadly, pap testing young women does not change the very small death rate in those under 30 and may disadvantage them with a false negative result. Young women are advised in the Netherlands and Finland to see their doctor with persistant and unusual symptoms. No woman should ignore symptoms and rely on a normal pap test result - false negatives occur, as well as lots of false positives.

http://www.delphi-bioscience.com/Delphi-Screener/Paginas/default.aspx

http://www.sciencedaily.com/releases/2011/10/111020163909.htm

http://www.gezondheidsraad.nl/en/publications/population-screening-cervical-cancer

Lene Andersen, Health Guide

1/31/12 11:49am

Hearing what other countries are doing and why can be important part of the process of researching what is the right path for each individual. Your comment may help someone start a conversation with the doctor - thank you for posting this.