Ms Gallagher should do some more research and change her inappropriate language. A word like “must” is inappropriate for elective cancer screening that comes with risks and benefits. It is an offer, nothing more…
The fall may reflect the fact more women are waking up our program is excessive, harmful and more than a decade behind the evidence. Perhaps Ms Gallagher could find out why our program has been allowed to operate without proper scrutiny and regular and independent review. No woman needs an absurd 26 pap tests, it just leads to huge numbers of false positives and potentially harmful over-treatment and excess biopsies. We have one of the highest referral rates in the world…a whopping 77% lifetime risk of referral for colposcopy/biopsy to cover a rare cancer with a 0.65% lifetime risk. Of course, this program is fabulous for vested interests and profits.
The Finns and Dutch have 7 pap test programs, 5 yearly from 30 to 60 and the Finns refer far fewer women and have the lowest rates of cc in the world. The UK test 3 yearly from 25 and 5 yearly from 50 to 60.
The evidence has moved on though and the Health Council of the Netherlands have recommended a new program…5 hrHPV primary triage tests offered at ages 30,35,40,50 and 60 and ONLY those women HPV positive will be offered a 5 yearly pap test. Those negative can follow the HPV program or test themselves using the Delphi Screener in the privacy of their own bathroom. This device is also being used in Singapore and elsewhere.
This will further reduce pap testing, false positives, over-treatment and it is more likely to prevent these rare cancers. Damage to the cervix can lead to infertility, premature babies, c-sections etc Only 5% of women are HPV positive at age 30…these women have a small chance of benefiting from pap testing every 5 years. (until they clear the virus) There is no difference in terms of benefit between 2 and 5 yearly pap testing…but annual, 2 and 3 yearly testing produces lots of false positives. The more often you test, the more false positives you produce for no additional benefit. Less is more with pap tests….and only HPV positive women can benefit from pap testing.
Sadly, no country in the world has shown a benefit pap testing those under 30, but this group produce the most false positives. HPV testing is also not recommended as 40% of women under 30 would test positive, almost all are harmless and transient infections.

A review of our program has only just started, a report is due in 2013 and then women must wait for changes to be made….this is very concerning when the evidence is so clear…we’re basically spending millions to worry and harm women. It is also disrespectful of our bodily privacy to recommend excessive pap testing, many women find this test a negative experience. I’d urge all women to do some reading and decide for yourself…sadly, Australia has no advocates for informed consent in women’s cancer screening and this is the result…our program does not operate in the interests of women.
See: Dr Joel Sherman’s medical privacy forum under women’s privacy concerns…in the side bar see research by Dr Raffle….there are also many posts from women concerned at the lack of respect for informed consent and many who’ve been harmed by screening.
Beware of breast screening as well…Breast Screen chose not to tell us of a serious risk factor, over-diagnosis. Thankfully, the Nordic Cochrane Institute have produced a review of all of the evidence and concluded breast screening is of no or little benefit and causes significant over-diagnosis. I’m not sure what’s happening in these cancer screening programs…but it is unethical to make decisions for women and accept risk on our behalf…these programs need a major shake up, paternalism is still clearly a factor. Men got balanced and complete information for prostate screening and there is respect for informed consent, while women are still waiting after decades of testing.
You’ll find the NCI summary at their website, “The risks and benefits of mammograms”.