Before you get twisted about pap smears and mammograms…

Understand that the recent “news” about screening recommendations for them is being used as a tactic against health care reform.

Let’s talk about Pap smear recommendations first. They have been evolving for years. In 2006 the first major revision was introduced, calling for Pap smears at age 21 or 3 years after a woman is first sexually active. This was based upon provable statistics indicating a realignment in the effective use of Pap smears for diagnosis.

I did a quick search on WebMD and found the first revision in 2003 with a second in 2005, and another in 2006. The 2006 guidelines kept the age 21/3rd year after first sexually active, but spread the number of years between pap smears for older women. The recent update simply sets the first pap smear at 21 and is supported by research and actual numbers.

In other words, it isn’t some sort of evil rationing and it certainly isn’t political.

And yet, we’re in the midst of a heated health care debate, so it must be political, right? RIGHT?

It’s certainly being played that way by those opposing reform. The righteous grandstanding was nearly unbearable today. Evidently, doctors have become Democrats who not only want to kill Grandma, they want to take away her mammograms, too.

I’m sure they will continue the narrative with the claim that it’s not enough to off Grandma, they’re rationing women’s right to have a cold speculum inserted into their vagina once a year. How conveeeeenient.

Well, there are some inconvenient facts in the way. The age for annual screening has been in dispute for some time. There is a very real risk to being radiated, and the question has always been whether the risk justifies the reward (early detection). The numbers seem to indicate that they don’t.

Like it or not, a part of health care reform is going to be getting our heads around the fact that much of what we accept as preventive medicine, isn’t. That’s not a political statement. It’s a paradigm shift from the world of excessive and unnecessary testing to a world where we take hold of our health, get fact-based information, and actually start applying it.

Let’s turn around the debate for a minute. Try shedding your preconceived notions for a minute and consider this hypothetical question: Would you embrace a doctor telling you that despite the fact that the professional breast exam you just received indicated no lumps or cause for concern, he would like you to step up to that machine over there and spend a couple of minutes having your breasts subjected to radioactive isotopes “just to be sure”?

Or another scenario: Knowing that pap results can return false positives, how would you feel having that kindly OB/GYN invite your daughter in to undress and put her feet in the stirrups after letting you both know that it’s not really necessary or even recommended, but let’s do it anyway… “just to make sure she’s not that 1 in a million teen”? Would it be worth it to you? To her?

Part of what we need is an honest debate about what screening is effective and lowers risk and what screening is not effective. In those areas where screening is less effective, perhaps there should be research toward better screening techniques and tools.

It frustrates me to see women’s health tossed onto the floor of Congress like a football on the 20-yard line. We are not pawns and we don’t have to be so reactive to these issues. Let’s just come at the whole debate from a rational, reasoned, fact-based place and see if we can sort it all out instead of allowing every procedure relating only to women be turned into an emotional screaming match.

Tagged as: health care reform, mammogram, News, pap smear, Politics, women's health