Less is more: How can we apply this concept to standards of proper health care and prevention methods? Stein’s article about pap smears and screening for human papillomavirus (HPV) examines guidelines for testing, concluding that doctors should recommend less frequent screening tests—every three years, instead of annually. According to Stein, doctors and preventive health care organizations have found that frequent screening is less beneficial and can actually cause damage to the cervix, complications during birth, premature birth or low birth weight in infants.
The idea that women are to get tested less often for HPV seems backwards. HPV can lead to cervical cancer, which kills nearly 4,000 people every year, according to the article. Hence, this doesn’t seem to make much sense to an ordinary patient. The public might have difficulty understanding how prevention screening can be more harmful than beneficial, when in our minds prevention screening is supposed to do exactly what it implies in the name—prevent, not harm. Moreover, there lays the fear any one of us could be that small percentage who develop the virus within the three year period without testing.
Patients may experience a number of possible reactions. Some may be ecstatic about the opportunity to avoid invasive screening. On the other hand, there will be patients who ignore the recommendations and still get testing annually. Some people will remain confused and fail to fully understand the recommendations, whereas, others might disregard screening altogether because they interpret the recommendations incorrectly. Juan Felix of the National Cervical Cancer Coalition comments on this point in the article, stating that the reduction in screening should not translate to avoiding regular well-being check-ups. I am inclined to believe that this means public health officials and preventive forces really need to hone in on how they relay information to patients in order to avoid confusion and possibly more harm.
Not only is the concept confusing for patients, but we face different positions from those primary doctors who administer care. Not all doctors agree on the issue of cutting back screening. Unfortunately, there may also be doctors who fail to educate their patients whether they disagree or not! This is an extremely important aspect because it helps the patient make an informed and educated decision whether they are in favor or opposition to recommendations.
Stein’s article mentions that pap smears often result in “false alarms.” From an epidemiological standpoint, doctors are trying to avoid screening problems, such as ‘false positives,’ because many patients are screened and told the test is positive when they actually don’t have the virus. False positives can cause risks from testing, result in unnecessary expenses, and increase the burden of evasive procedures for the patient—not to mention, anxiety from such an experience can cause emotional trauma. Furthermore, as far as public health is concerned, false positives negatively affect the prevalence of disease in a population.
Regardless of the screening problems doctors are trying to avoid, they cannot ignore that there may be a rare percentage of people who get HPV within the years without screening. In my eyes, the goal should be less than one. If studies have shown that damage to the cervix and other birthing complications may result from screening, wouldn’t it make more sense to change the way screening is done in order to reduce hazardous screening methods? Instead of limiting screening, and running a low risk of a missed diagnosis, make screening less invasive and safer to reproductive health.
I recommend the article to readers because although the article is beneficial mainly for women’s health, awareness is also important amongst men since HPV affects their sexual health as well.
Original Article: Doctors Revamp Guidelines for Pap Smears by Rob Stein