i'm sure many saw the issue about the mammograms, recommending that they not start until 50 years old, instead of the now recommended starting age of 40.

now, there are new guidelines suggesting that women should get Paps until they're 21, whether or not they're sexually active.

Quote :

"WASHINGTON (CNN) -- The new mammogram recommendations out earlier this week caused quite an uproar. Now comes another change in screening tests for women -- this one for cervical cancer. The American College of Obstetricians and Gynecologists (ACOG) releases new guidelines Friday, saying women don't need their first cervical cancer screening -- or Pap test -- until they're 21 years old. And, they don't need followup examinations as often as previously recommended. According to the guidelines, women younger than 30 should be screened every two years, instead of annually. Women 30 or older can be examined once every three years. "The tradition of doing a Pap test every year has not been supported by recent scientific evidence," said Dr. Alan G. Waxman, who developed the document for ACOG's Committee on Practice Bulletins-Gynecology. "A review of the evidence to date shows that screening at less frequent intervals prevents cervical cancer just as well, has decreased costs, and avoids unnecessary interventions that could be harmful." The current guidelines, from 2003, recommend that women get a Pap test three years after they begin having sexual intercourse, but no later than age 21. And that women younger than 30 have an annual exam. For women 30 or older, the recommendation was every two to three years, if they'd had three consecutive negative Pap tests."

http://www.cnn.com/2009/HEALTH/11/20/cervical.cancer.guidelines/index.html

Maybe the scientific evidence does support the findings on the Paps, but I wonder if any of this new stuff is coming out because of the health insurance debate.

11/20/2009 1:07:23 PM

Wow, that sounds really dangerous.

11/20/2009 1:14:43 PM

i don't know. i'm not a doctor but i say fuck that to both of those things (i know this is just anecdotal and not scientific but i know SEVERAL young people that have had cervical cancer that was luckily caught early. i'm talking women in their 20s and 30s. i'm not even trying to play that game)

health insurance companies are happy now. hope they're happy when i have stage 4 cervical cancer cause they wouldn't pay for my annual pap smears.

[Edited on November 20, 2009 at 1:15 PM. Reason : .]

11/20/2009 1:14:48 PM

paranoid much?

I'm sure the timing of healthcare changes has nothing at all to do with all the recent "government panel" backed findings regarding women's health.

11/20/2009 1:15:21 PM

yeah, as much as I hate getting my pap...I'd rather be safe than sorry considering my cancer history

11/20/2009 1:16:28 PM

i know! and i thought the new healthcare plug was preventative medicine. sure this cuts out the cost of pap smears NOW but what about when you have to treat people with cancer. that shit ain't cheap.

[Edited on November 20, 2009 at 1:19 PM. Reason : .]

11/20/2009 1:19:11 PM

that's kinda my thing. HPV is in like 1 in 5 women. some strains of HPV can lead to cervical cancer.

that's a problem imho

11/20/2009 1:26:37 PM

right and paps show more than just cervical cancer

i definitely had an abnormal pap once and then they wanted to see me again in 6 months. once it was normal then it went back to a year. i had mild dysplasia. but then it went away. i dunno, these seem like important things to know even if you don't have cervical cancer.

(i have a history of endometriosis in my family)

[Edited on November 20, 2009 at 1:33 PM. Reason : .]

11/20/2009 1:31:02 PM

I know a few women who had breast cancer before they were 50....so I think its crap. I say get the tests when you feel you need them based on your family history and things like that.

11/20/2009 1:33:13 PM

^ what worries me is that with all of these "recommendations" insurance companies will stop covering them.

OH AND there wasn't a single oncologist on the panel that made the recommendations re: mammograms

11/20/2009 1:34:39 PM

yeah you are right, I heard that too

11/20/2009 1:38:03 PM

i know that is my fear too that insurance companies will stop covering them. that is such freaking bullshit.

this is like - kind of exactly what i want to do. i'm in law school (obvi) and i want to get some sort of medical degree (i want to do oncology nurse practitioner). i want to actually practice nursing but would also like to do research on policy, etc and use my law degree + medical knowledge for health policy research.

but i'm totally missing the boat here!

but i'm with you. i really hope insurance companies don't stop covering them. mammograms i think are important too - but we are all young women here so i think our main concern right now is with the pap smears. none of my personal physicians agree with this either.

11/20/2009 1:38:55 PM

I agree that these new recommendations are crap. I MUCH rather play it safe and do self breast exams monthly and get my pap smears regularly than to NOT do it and find out later (or perhaps even, much too late) that I have some abnormality. It seems now that more than ever breast/cervical cancers are affecting women at younger ages, so why change something that seemed to have been working already? I hope most women will ignore these new guidelines and continue to be proactive in their healthcare.

11/20/2009 2:19:38 PM

well said

11/20/2009 2:21:33 PM

Quote :

" I hope most women will ignore these new guidelines and continue to be proactive in their healthcare."

I also hope for this.

However:

Quote :

"^ what worries me is that with all of these "recommendations" insurance companies will stop covering them."

If this happens, what I could foresee happening is some dr's offices (namely, the ones worth a damn and who care for their patients) will have special out-of-pocket pricing for those who choose to pay for the annual exams insurance stops covering. I can dream, at least

I really feel like these two "recommendations" are merely a formality that the gov't is ceding to the insurance industry, as a way for the insurance companies to justify a reduction in services covered. Too bad they are preventative exams

11/20/2009 2:27:56 PM

welcom to Obamaland

11/20/2009 3:03:49 PM

this is fucking bullshit

i hope everyone who is unhappy with this uses their right to vote to make some changes (change we can beLIVE in)

ive been saying it for almost a year now... take good care of yourself, eat right, exercise, get enough sleep etc. because you're on your own and you can't rely on the system. government fucked retirement (ss) and now they're fucking healthcare (eventually). take it into your own hands kids..

11/20/2009 4:04:01 PM

lol what

11/20/2009 4:16:13 PM

News: "Hey, you shouldn't get regular mammograms until age 50"

Response: "FUCKING OBAMACARE LIBERALS WANT TO RATION HEALTHCARE RAAAAAAAAARGH!"

News: "Hey, you should get twice as many mammagrams before age 50"

Response: "FUCKING OBAMACARE LIBERALS WANT TO RAKE IN THE DOUGH FOR HEALTHCARE RAAAAAAAAAAARGH!"

11/20/2009 4:24:26 PM

^where did you hear that second line from?

i for one sorta agree with ncsuwolfy.
i've dealt with too many people that have or had breast cancer to think that limiting checks is a good idea.

so yeah. save a few bucks only to realize that it's stage 4 in a few years.
that'll save money

its appalling.

[Edited on November 20, 2009 at 4:31 PM. Reason : and i come from a family with breast cancer....thisll be fun.]

11/20/2009 4:31:22 PM

Quote :

"now, there are new guidelines suggesting that women shouldn't get Paps until they're 21"

I believe thats what you mean't

Also its quite funny how people get all bent out of shape over the word recommend

[Edited on November 20, 2009 at 4:45 PM. Reason : .]

11/20/2009 4:44:01 PM

Quote :

"^where did you hear that second line from? i for one sorta agree with ncsuwolfy. i've dealt with too many people that have or had breast cancer to think that limiting checks is a good idea. so yeah. save a few bucks only to realize that it's stage 4 in a few years. that'll save money"

I'm saying that whether or not you choose to follow their guidelines, it's ridiculous that this has become part of the healthcare debate. It seems like whatever the results would have been from that study, people would have somehow used it as fodder to attack the healthcare provisions congress is attempting to pass.

And, secondly, people saying "Well, they may have proved that scientifically using research but HERE'S AN ANECDOTE..." .... come on.. really?

EDIT: Additionally, they make special note to say that "Women with a family history of breast cancer or other risk factors are a different story."

If you want to keep getting mammograms, keep getting mammograms, but personal anecdotes don't stand up against research (this isn't directed at you, joie).

Here's the actual study results, if anyone is interested: http://www.ahrq.gov/clinic/3rduspstf/Breastcancer/

[Edited on November 20, 2009 at 4:56 PM. Reason : ]

11/20/2009 4:47:54 PM

yeah, but....correct me if i'm wrong.....but insurance companies will probably go by these guidelines.
right?

^you answered me.......this study doesn't seem to be very conclusive though, but i guess it's proof.


i find it very, very curious that this came out right now.
all of a sudden we are being told now that pap smears AND breast exams are being overdone...
fishy.


i dont trust everything the government tells me.
im probably gonna turn into a conspiracy theorist one day.


[Edited on November 20, 2009 at 5:11 PM. Reason : ]

[Edited on November 20, 2009 at 5:12 PM. Reason : also they decided to NOT teach women to give themselves self exams?! wtf?]

11/20/2009 4:58:01 PM

Hey God, read the description of their data:

Quote :

"Results Description of Trials The eight randomized trials of mammography identified in our review12-23 varied in recruitment of participants, mammography protocol, control groups, and size (Table 1; Printable Version: PDF File, 22 KB). Six trials examined the effectiveness of screening among women between 40 and 74 years of age; one trial enrolled women in their 40s, and one enrolled only women in their 50s. Four trials from Sweden tested mammography only,14-17,23-26 and the other four, from Canada, New York, and Edinburgh, Scotland, tested mammography and clinical breast examination.12,13,18-22,27"

Gee, I wonder how they concluded that you don't need to get breast examinations before age 40 without examining the effectiveness for women younger than 40.http://www.ahrq.gov/clinic/3rduspstf/Breastcancer/bcscrnsum1.htm

[Edited on November 20, 2009 at 5:13 PM. Reason : url]

11/20/2009 5:13:19 PM

^the debate is whether you should get them at 40 or at 50.

according to that study....yes there is some benefit to getting them at 40, but not enough to substantiate recommending at 40.

11/20/2009 5:16:04 PM

disco stu, self pwnt.

Quote :

"yeah, but....correct me if i'm wrong.....but insurance companies will probably go by these guidelines. right?"

Perhaps. But there's plenty of situations that are like this. There are people who have higher risks for certain medical problems than the rest of the population, and sometimes their procedures aren't covered. C'est la vie. However, the reform of the insurance industry is an attempt to stop the insurance companies from denying you care. And the head of Health and Human Services made a public announcement that they wouldn't be denying these procedures for women under 50.

Quote :

"i find it very, very curious that this came out right now. all of a sudden we are being told now that pap smears AND breast exams are being overdone... fishy."

See, this is what I don't understand, though. On one hand, Conservatives appear to be arguing that the federal government spends way too much. We hear it all the time, about all the debt, the "tax and spend" label, etc. How can they then argue the complete opposite, that the Federal government is not going to spend enough or cut back on providing services? The reason is because they're just using any excuse to attack the federal government now that they're not in power anymore.

Quote :

"i dont trust everything the government tells me. im probably gonna turn into a conspiracy theorist one day."

You should always be skeptical, but just consider why you would have a reason to be. What do they have to gain?

[Edited on November 20, 2009 at 5:42 PM. Reason : ]

11/20/2009 5:41:59 PM

for the record, i'm not conservative and i think it is bullshit so you should probably work on that argument!

11/20/2009 6:16:32 PM

The new pap guidelines make sense. Cervical cancer takes several years to develop, so you're not really changing the outcome by screening at very young ages or more frequently than every other year.

Quote :

"Additionally, they make special note to say that "Women with a family history of breast cancer or other risk factors are a different story.""

That's always been part of the consideration in screening, but keep in mind that most women who develop breast cancer have no identifiable risk factors.

Quote :

"I wonder how they concluded that you don't need to get breast examinations before age 40 without examining the effectiveness for women younger than 40"

Mammograms are generally not helpful in people under 40--younger women tend to have dense breast tissue that interferes with finding lesions. Also, most of the things you can identify turn out to be benign, but you may put patients through unneeded biopsies just to find that out.

[Edited on November 20, 2009 at 6:19 PM. Reason : ]

11/20/2009 6:17:16 PM

i like that the recommendation is also based on "the worry factor"

Quote :

"The guidelines discuss an important downside of screening: the anxiety caused by an abnormal test result. "The emotional impact of labeling an adolescent with both a sexually transmitted infection and a potential precancer must be considered because adolescence is a time of heightened concern for self-image and emerging sexuality," write the guideline authors. The worry factor is one of the arguments made in favor of delaying mammography screening until age 50, which is what the United States Preventive Services Task Force this week (controversially) recommended that women consider. "

11/20/2009 6:23:00 PM

this is joie btw

Quote :

"See, this is what I don't understand, though. On one hand, Conservatives appear to be arguing that the federal government spends way too much. We hear it all the time, about all the debt, the "tax and spend" label, etc. How can they then argue the complete opposite, that the Federal government is not going to spend enough or cut back on providing services? The reason is because they're just using any excuse to attack the federal government now that they're not in power anymore."

no i understand you.
are you assuming i'm conservative?

i will give you this little bit of conservatism in my head....if we're a bout to drop billions of dollar that my kids and your kids will have to pay...they better make it worth it.

Quote :

"You should always be skeptical, but just consider why you would have a reason to be. What do they have to gain?"

i honestly do not know.
i just find it incredibly suspicious that in the midst of healthcare reform they decide to unleash these two.
something doesn't sit well with me about that.
i guess it could be coincidence...but damn.


[Edited on November 20, 2009 at 7:00 PM. Reason : fhgfhg]

11/20/2009 6:51:23 PM

Quote :

"no i understand you. are you assuming i'm conservative? "

Oh, no. I wasn't saying that you were. That's why I said, "This is what I don't understand." Sorry for the confusion.

Quote :

"i will give you this little bit of conservatism in my head....if we're a bout to drop billions of dollar that my kids and your kids will have to pay...they better make it worth it. "

I completely agree. In fact, I've been upset at how this whole process of passing reform has been going as well, just probably for different reasons than GOP party members.

Quote :

"i honestly do not know. i just find it incredibly suspicious that in the midst of healthcare reform they decide to unleash these two. something doesn't sit well with me about that. i guess it could be coincidence...but damn."

I see your point. But you have to think that releasing something like this would only hurt their case for healthcare, because it's being used as "proof" that Democrats are planning on rationing care. If the President or Congress had any control over it's release, why on Earth would they release it now when it would only give ammunition to Conservatives against healthcare? Wouldn't they just release it after the bills have been passed?

[Edited on November 20, 2009 at 8:31 PM. Reason : ]

11/20/2009 8:30:16 PM

well there could be a number of underlying reasons. like you said earlier :

Quote :

""FUCKING OBAMACARE LIBERALS WANT TO RAKE IN THE DOUGH FOR HEALTHCARE RAAAAAAAAAAARGH!""

if thats the case of what would happen if it were the other way, and with all the money we're spending it would be somewhat better to say:
"See, look we're not going to spend nearly as much money on these exams and we think the whole nation should abide by these rules." (to make it look like we're doing the right thing)

This is a far fetched scenario, maybe, but I don't know....this news seems a little "too good to be true" at the edge of the reform.


and i knowwwww this whole post was clumsy as shit, but sometimes its hard for me to express all the stuff that goes on in my head

11/21/2009 9:31:37 AM

Yes. We should all vote out and protest against private insurers who may or may not drop certain preventative health care benefits.....wtf?

11/21/2009 9:57:12 AM

a lot of stuff i've read has said that the incidences of cervical cancer are much lower in the US than the rest of the world and it is attributed to frequent pap smears

additionally its something like 50% of the people who get cervical cancer never had a pap smear or like haven't had one recently or something (i don't remember exactly).

i dunno. it seems sketchy to me

i also read that "experts" also question the effectiveness of prostate exams in early detection of prostate cancer so maybe just to even the score we should recommend limiting these to every few years, too.

11/21/2009 1:23:11 PM

http://www.cnn.com/2009/HEALTH/11/18/mammogram.guidelines/index.html

this seems to have been blown way out of proportion.

Quote :

"Washington (CNN) -- A federal advisory board's recommendation that women in their 40s should avoid routine mammograms is not government policy and has caused "a great deal of confusion," Health and Human Services Secretary Kathleen Sebelius said Wednesday. "My message to women is simple. Mammograms have always been an important life-saving tool in the fight against breast cancer, and they still are today," Sebelius said in a statement. "Keep doing what you have been doing for years: talk to your doctor about your individual history, ask questions and make the decision that is right for you." With her statement, Sebelius waded into the controversy over Monday's announcement by the U.S. Preventive Services Task Force that women in their 40s should not get routine mammograms for early detection of breast cancer. Sebelius' statement is aimed at "making it clear these recommendations are not ours," a White House source said. The report "shouldn't be dismissed," Sebelius said on CNN's "The Situation Room." But she added, "There are other groups who have disagreed with this information." The task force is "making recommendations, not coverage decisions, not payment decisions." Government health programs such as Medicaid will continue to cover routine mammograms, she said. "We will continue to recommend it, and the health plans have indicated that they will do the same," Sebelius said. "If the health care provider recommends a mammogram for a patient, they intend to cover that payment." Though the Preventive Services Task Force is independent, the Department of Health and Human Services' Web site calls the panel's recommendations the "gold standard," and insurance companies look to the panel for guidance on which preventive care practices they should cover. With the Obama administration fighting to push a sweeping overhaul of U.S. health insurance through Congress, Republicans quickly jumped at the chance to attack the mammography report. "This is how rationing begins," said Rep. Marsha Blackburn, R-Tennessee. "This is the little toe in the edge of the water. And this is where you start getting a bureaucrat between you and your physician." The White House disputes that, saying the recommendations "cannot be used to deny treatment" on their own. Sebelius said the task force won't make coverage decisions. "Mammograms have been a huge step forward for millions of American women, but we still have about 21 million women and girls in America who don't have a doctor, who don't receive any kind of mammogram screening on any kind of basis regardless of their age," she said. "The health reform debate is about closing that gap." Criticism of the recommendation has come from quarters other than opponents of the Democratic health care bills. The American Cancer Society said it disagrees with the findings of the task force and continues to recommend annual screening, including mammograms, for all women beginning 40 and over. "With its new recommendations, the [task force] is essentially telling women that mammography at age 40 to 49 saves lives, just not enough of them," said Dr. Otis Brawley, the group's chief medical officer. And Rep. Debbie Wasserman-Schultz, D-Florida, who was diagnosed with early stage breast cancer at 41, called the panel's recommendations "really disturbing" and "absolutely irresponsible." "It's a very patronizing attitude that these scientists have taken," she said. "It's pretty outrageous to suggest that women couldn't handle more information." Rep. Frank Pallone Jr., chairman of the House Energy and Commerce's Subcommittee on Health, has announced that he will lead hearings into the advisory board's recommendations. Wasserman-Schultz said those hearings "will help us reach the appropriate policy conclusion, which I believe is that these recommendations should be set aside." Breast cancer is the most common cancer for U.S. women, with nearly 200,000 women expected to be diagnosed with the invasive form of the disease this year, according to the American Cancer Society. For women 50 to 74, it recommended routine mammography screenings every two years. Risks and benefits for women age 75 and older are unknown, it said. While roughly 15 percent of women in their 40s detect breast cancer through mammography, data show that many other women experience false positives, anxiety, and unnecessary biopsies as a result of the test, according to the task force. The Preventive Services Task Force reviews medical data and bases recommendations on effectiveness and risks involved. It is composed of 16 health care experts, none of whom are oncologists, though a team of cancer experts presented its findings to the group. "

11/21/2009 6:44:27 PM

All these guidelines are hopefully just guidelines and will not impact how insurance chooses to cover procedures.

I'm for the general tone of the new guidelines: personalize healthcare and stop doing unnecessary, knee-jerk tests.

But to truly personalize it, they shouldn't have released a guideline at all. The new policy should be to discuss your risk factors (age, smoking, family history etc...) or (age, previous screenings, number of sexual partners, etc...) with your doctor and decide from there.

11/21/2009 7:04:49 PM

Quote :

""My message to women is simple. Mammograms have always been an important life-saving tool in the fight against breast cancer, and they still are today," Sebelius said in a statement. "Keep doing what you have been doing for years: talk to your doctor about your individual history, ask questions and make the decision that is right for you.""

from the SECRETARY OF HEALTH AND HUMAN SERVICES

11/21/2009 7:48:59 PM

OMG THEN IT MUST BE CORRECT!

11/21/2009 8:09:12 PM

This change in guidelines is stupid. As if we need to be discouraged any more from going to the doctor.

I will be getting my Paps along with my exam annually, due to a family history of potentially malignant ovarian and uterine cysts. I don't plan on using my uterus for its intended purpose, but I'd rather it not kill me in the process.

11/21/2009 11:34:02 PM

Quote :

"I will be getting my Paps along with my exam annually, due to a family history of potentially malignant ovarian and uterine cysts."

Pap smears don't test for uterine or ovarian abnormalities.

[Edited on November 22, 2009 at 12:11 AM. Reason : by "uterine," I'm referring to the upper non-cervical uterus]

11/22/2009 12:10:02 AM

Quote :

"OMG THEN IT MUST BE CORRECT!"

what must be correct? that doesn't even make sense.

11/22/2009 12:47:17 AM

can you crazies stop pretending like this has to do anything with the health care debate. the panel was formed by the previous administration and has been working on this for years. turn off glen beck for a little while and use your head.

11/22/2009 9:29:42 AM

when i made the thread, i didn't think it had anything to do with healthcare debate specifically. my concern (in the context of the healthcare debate) is that insurance companies will think it's okay to drop coverage for these types of exams across the board.

11/22/2009 11:25:53 PM

Quote :

"I know a few women who had breast cancer before they were 50....so I think its crap. I say get the tests when you feel you need them based on your family history and things like that. "

yeah.... and that's exactly what the recommendation is.
It suggests waiting until 50 only if you didn't have any risk factors already.

11/22/2009 11:34:59 PM

^logical arguments do not appeal to your target audience

11/23/2009 1:03:45 AM

Quote :

"disco stu, self pwnt."

How exactly? The conclusions were made by doing effectiveness studies on women 40+. How can you reasonably make any conclusions about effectiveness for women younger than 40 without studying them?

11/23/2009 9:01:05 AM