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Rationing? First, they came for Mammograms...

Now are they coming for your pap smear?

Guidelines for getting annual mammograms have been recommended to be changed.  Now the same thing seems to be happening for pap smears.

Ironically, both sets of recommendations are being justified by a reduction in the amount of breast and cervical cancer over the past few decades.  I say ironically because one of the reasons these rates of cancers has gone down is due to increased screening for them.  Now new guidelines recommend fewer tests and more time between tests.

A pap smear test saved my wife's life.  It didn't prevent her from getting cancer, but it allowed early detection of the cancer.  Subsequent pap smears and other cancer screening resulted in early detection of other incidences of cervical cancer as well as uterine cancer.  The early screenings, following then established guidelines, resulted in my wife's cancer being discovered and treated before it had time to metastasize,

I find the following paragraph utterly amazing:

For that reason, she said changing the screening interval will not mean more cervical cancers will be missed. She said most deaths from cervical cancer in the United States happen in people who are screened infrequently, or not at all.

Like, um, every three years as your new 'guidelines' suggest?

I have never known a doctor to 'over-treat'.  I'm not saying it doesn't happen, but in my experience (and I have a lot) doctors simply go for the most conservative treatment options first (naturally barring some mega-revelation like a huge cancerous tumor just discovered).  When I was diagnosed with malignant melanoma in 1998, my doctors first instinct wasn't to send me right off for radiation and start me on a chemotherapy regimen.  A surgical excision was enough.

When my wife's first pap smear came back showing some "abnormalities", the doctors first instinct wasn't to go right for the hysterectomy.  She had the cells 'burnt' off.  This happened a few times.  Only after this line of treatment didn't really work, and actual cancer showed up were other lines of treatment taken.

I don't know if I buy the whole 'over-treatment' line used to justify these new guidelines.  I also find it just a little suspicious that these guidelines come now with the emphasis on nationalizing health care and the discussions on rationing care, favoring cost over care, etc.  Talk of 'Death Panels' and rationing don't seem so hyperbolic with these kinds of recommendations.

I fear that these recommendations, if adopted, will result in a return to the increase in the incidences of cancer and resultant cancer deaths down the road. 
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