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Conference turris::womannotes-v1

Title:	ARCHIVE-- Topics of Interest to Women, Volume 1 --ARCHIVE
Notice:	V1 is closed. TURRIS::WOMANNOTES-V5 is open.
Moderator:	REGENT::BROOMHEAD

Created:	Thu Jan 30 1986
Last Modified:	Fri Jun 30 1995
Last Successful Update:	Fri Jun 06 1997
Number of topics:	873
Total number of notes:	22329

595.0. "Excerpts from an article on the Pap smear" by WCSM::PURMAL (Oh, the thinks you can think!) Mon Dec 14 1987 14:32

      I read  an article in  this Sunday's San Francisco Chronicle  that
      some of you  might be interested in.  I am a poor typist (slooow),
      so I am just typing in a few excerpts from the article.

      The author  of the article is Walt Bogdanich and a little blurb at
      the  bottom  says  it  was  reprinted  with permission of the Wall
      Street  Journal.  I imagine that you might be able to find it in a
      back issue of the Journal.  If anyone is interested in getting the
      entire  article, but can't find  it in the journal I'll mail it to
      the first person requesting it.

                                     
      THE PAP SMEAR

      Over the  past  three  decades, it has sharply reduced deaths from
      cervical  cancer.  Women  and physicians trust it, so much so that
      the  Pap  smear had become one of the most common laboratory tests
      in America. It is also on to the most inaccurate. No one knows how
      many  women  die  because  a lab botches the analysis, or a doctor
      takes an inadequate specimen. The test, as it is being done today,
      fails  to  detect  roughly  one  in every four cases of cancer, or
      precursor cell abnormalities.

      . . .
     
      To find  out  why  the Pap test falls so short of its promise, the
      Wall   Street   Journal   visited   labs,  inspected  records  and
      interviewed  doctors,  lab  workers and government officials. What
      emerges  is  a  picture  of  Pap-screening industry kept afloat by
      overworked,  undersupervised,  poorly  paid  technicians. It is an
      industry  that  often  ignores what few laws that exist to protect
      women from slipshod testing.

      Across the  nation,  high volume, cut-rate laboratories, sometimes
      called Pap factories or Pap mills, allow technicians to analyze up
      to  four  times  as  many  specimens  per  year as medical experts
      recommend  for accuracy. Many of them pay screeners on a piecework
      basis that encourages them to rush the analysis.

      Some technicians  work  two  or  more jobs earning as little as 45
      cents  to  do the key analysis on a test that may cost the patient
      $35.  In some cases they say they are penalized if they resist the
      pressure to screen more slides in a day.

      . . .

      The consequences  of  faulty testing pose disturbing questions for
      the medical establishment. An estimated 60,000 women this year are
      expected  to  develop  cancer  of  the cervix. If caught early the
      disease  is  nearly  always  curable.  Yet  it  kills  about 7,000
      American women a year.



      The article  goes  on to describe cervical cancer, how the test is
      performed,  the  labs  and  their  workers, what federal and state
      governments  do concerning the laboratories, and steps being taken
      to identify 'bad' laboratories.

      ASP

T.R	Title	User	Personal Name	Date	Lines
595.1	More incompetency!	RUTLND::TROCONIS		`Mon Dec 14 1987 15:09`	37
	This very disturbing information reminds me of two episodes I have experienced. The first one -- my regular Pap screening -- that I faithfully go and have done annually. The usual comment "if you do not hear from us you can assume that everything is ok". NOT SO! I did not hear from the doctor's office -- assumed everything was ok. Several months later began to have some strange bleeding, pain, etc. Called the doctor for an appointment (had to wait two weeks) when I finally couldn't stand it any longer and couldn't wait two weeks, I went to the emergency room and insisted that my doctor meet me there. He said that my Pap smear was abnormal at my last visit and wanted to know why I hadn't come in to see him sooner! When I told him that I heard nothing and assumed nothing -- he said "You must have slipped through the cracks!" Needless to say, I switched doctors and am fine now. Another episode -- went for the smear - got a call at work from a RECEPTIONIST who said I am sorry to inform you but you have had and abnormal Pap test. When I asked to speak to the doctor, she told me that I could make an appointment in 3-4 weeks. When I insisted, the doctor came on the phone, wanted to know what I was making a big deal about -- turns out I had a yeast infection. A far cry from ABNORMAL. I gave him hell about having his receptionist call with test results, he was not sympathetic. I have changed doctors again. Now whenever I go for a smear - I give them twenty four hours and then I call them and keep calling them until I get the results. I also insist on a copy of the lab report, which I leave a stamped, self addressed envelope for them to mail to me. I don't fool around anymore. But then again, I can only pray that the lab is competent.
595.2	WS Journal 2 Nov. 87	ULTRA::WITTENBERG	The rug is not an inertial frame.	`Mon Dec 14 1987 15:50`	5
	The article is much scarier than the extract indicates. It appeared in "The Wall Street Journal" Monday, 2 November, 1987 --David
595.3	My Experience	BARAKA::POGAR	Ann Pogar	`Mon Dec 14 1987 15:59`	18
	re .1... I too don't fool around anymore. This note really hit home with me. I had cervical cancer 11 years ago and since that time, call regularly to get MY test results. I never wait for the doctor to call me. My advice to all women: NEVER, EVER wait for the doctor to call you with the lab results from a pap smear, and have a pap smear done at least once a year. Although I find the base note somewhat frightening as to the accuracy with which these smears are analyzed ... The good news: Caught in the early stages, cervical carcinoma has a very high cure rate. This is why having an annual checkup is so critical. I went on to have two children (despite certain doctors recommendations to yank out the 'inners'). ap
595.4	A couple of other things from the article.	WCSM::PURMAL	Oh, the thinks you can think!	`Tue Dec 15 1987 11:53`	37
	The American College of Obstetricians and Gynecologists puts the Pap test's 'false-negative' rate - the failure to report abnormalities at 20 to 40 percent. WHAT TO ASK YOUR DOCTOR Women concerned about Pap-test accuracy might consider asking their doctors questions such as these: o What is the name of the lab, and is it accredited by a professional group? (Accreditation offers no guarantee, but at least it means someone is looking over the lab's shoulder.) o What are the workloads at the lab? Are the screeners salaried, or paid on a piecework basis? o Can I get a copy of the lab report? (Don't assume that if you don't hear from the doctor the test must have been negative. There are such things as mix-ups, oversights and lost reports.) o Is the lab nearby? (If a doctor sends the specimen to a lab far away, he should have a good reason.) I strongly urge all women to read this article. I am going to distribute copies to all of the women at my office (Mountain View, CA.) If I were a better typist I'd enter the whole thing here, but that would take me at least one full day. ASP
595.5	But keep having the test!	CSSE::HIGGINS	Party Girl	`Tue Dec 15 1987 12:22`	12
	Thanks for the information. But let me say that I hope this isn't stopping women from having a regular pap smear. You have to have it done. I never thought that my test would come back saying that I had pre-cancerous cells, but they did! And thank God that I did have it done, because those pre-cancerous cells turned out to be cancer. I do agree, call your doctor to find out the results instead of waiting to get a letter, or a phone call saying the results are a class two or three.