Following my earlier post about GP Dr Margaret McCartney’s article “Why I'm saying no to a smear”, in the Independent in March, I’ve had some interesting correspondence and feel it’s definitely in the public interest to share this information, sent by a reader, about the new Dutch cervical testing programme. Over to her....

“It's called hrHPV primary triage testing - the Dutch and Finns have 7 pap test programs, 5 yearly from age 30 to 60 (the Finns have the lowest rates of cc in the world and send far fewer women for colposcopy/biopsies/fewer false positives)

1. -but the Health Council of the Netherlands has recommended a new program - 5 hrHPV tests (similar to a pap test) will be offered to women at ages 30, 35, 40, 50 and 60 and only those HPV positive (roughly 5%) will be offered a 5 yearly pap test.
   

1. -The negative women can follow the HPV program or they can test themselves using the Delphi Screener - this device was also recently released in Singapore and Indonesia and is being considered by several other countries.
   

Those women negative for HPV and confidently monogamous or no longer sexually active can forget all testing and revisit the subject if their risk profile changes (they take a new partner).

This program is more likely to catch/prevent these rare cancers, it consistently picks up around 98% of high grade lesions (the pap is much lower and varies country to country, but the best rating I've seen was around 80%) and it offers much better protection for women not at risk, who can never benefit from pap testing - this means far fewer women having pap tests, getting false positives and enduring excess biopsies and unnecessary laser treatments and cone biopsies - these things can damage the cervix and lead to cervical stenosis, infertility, cervical incompetence, premature babies, the need for c-sections, high risk pregnancy and cervical cerclage etc...

You're welcome to add this information to your site, but sadly, if you have anything informative to say on this topic, you can be subjected to lots of abuse....sadly, most women have never managed to get to the facts and there is zero respect for informed consent.

The high emotion that accompanies this subject makes it even harder to get information out to women - especially when so many women "think" they've had cervical cancer or were "saved" by pap testing - invasive cervical cancer is rare, always was - lifetime risk is 0.65% - while false positive pap tests and over-treatment is common - very common in countries that over-screen and those that test women under 25. (lifetime risk of referral here - 77%)

Here are some references for you:

http://www.delphi-bioscience.com/Delphi-Screener/Paginas/default.aspx (Self-test HPV device being used in the Netherlands and elsewhere)

http://www.sciencedaily.com/releases/2011/10/111020163909.htm (women can self-test safely)

http://www.gezondheidsraad.nl/en/publications/population-screening-cervical-cancer (Health Council of the Netherlands - recommend new HPV primary triage testing program)

http://www.hpvtoday.com/webEng/material.html (lots of information on HPV primary triage testing)

Dr Joel Sherman's medical privacy forum is also a great source of information - under the section on women's privacy concerns Parts 1 to 7 - lots of posts from women harmed by screening or angry at the lack of respect for informed consent - this Dr also wrote,

"Informed consent is missing from cervical cancer screening" - published at the Kevin MD site and in the WSJ...it's also on his website.

Women have to watch out for each other, IMO, the govt and doctors are not acting in our interests, that is certainly the case here in Australia and in many other countries.”

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Thanks to this reader for sending this information to ANM.  I hope others will find it useful.