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September 22, 2010

BehindTheMedspeak: Unnecessary Pap Smears


I wrote this back in 2004 and published it in 2005 on BlogCritics.

It's generated nearly 2,000 comments there over the five years since.

I just reread it and the message seems as valid today as it did then.

Here's the piece.


The current issue of the Journal of the American Medical Association contains an article whose headline is:

Cervical Cancer Screening Among Women Without a Cervix

How can this be?

In almost all hysterectomies, the cervix — which anatomically is part of the uterus — is removed along with the rest of the uterus.

Likewise, most hysterectomies are performed for benign disease, not cervical cancer.

In 1996, the U.S. Preventive Services Task Force stated that routine Pap smear screening is unnecessary for such women

The JAMA study found that:

• 22 million U.S. women 18 and older have undergone hysterectomy (21% of that population)

• In 1992 (before the U.S. Preventive Services Task Force recommendation) 68.5% of women who had undergone hysterectomy reported having a Pap smear in the previous 3 years

• In 2002 (six years after the recommendation) 69.1% had a Pap smear during the same period

The authors of the study estimate that almost 10 million women — half of all women who have undergone hysterectomy — are being screened unnecessarily, as they are not at risk of cervical cancer.

I find that confounding.

If you're one of these 10 million women, perhaps you should ask your doctor why you continue to have Pap smears done.

It's intrusive, costly, and can only lead to misdiagnosis and inappropriate intervention.

Besides which, it's an example of your doctor's ignorance and general incompetence, not to mention fraudulent.

On a related subject, do you know the incidence of cervical cancer in nuns?

It's 0.

Which is why a girl or woman who's not on the pill and is a virgin does not need to undergo a gynecological exam or Pap smear — ever.

I challenge any physician to give me a good reason why this isn't so.

September 22, 2010 at 10:01 AM | Permalink


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Hey Joe - you are THE BEST! I re-posted this on my blog with a note about my experience:
Pambamboo's rogue (ghost) cervix

Posted by: Pamela Daley | Sep 28, 2010 5:58:46 AM

Picky me - ignorance and incompetence does not equal the mens rea necessary to reach "fraud."

Posted by: 6.02*10^23 | Sep 22, 2010 6:43:12 PM

Ummm...define virgin.
Think through the gynecological part again.

Posted by: Carol | Sep 22, 2010 12:43:02 PM

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