Without any community consultation, radical changes were made to cervical screening in Australia last December. The Pap smear is no longer the “front line” tool in preventative cervical cancer screening. We believe this will put women’s lives at risk.

Without any community consultation or in fact without the community even being aware of the proposal, radical and sweeping changes were made to the National Cervical Screening Program (NCSP).

Introduced in 1991 the current NCSP offers routine biennial Pap smear screening for all women aged 18-69 years. The program has had great success. As a result of its introduction, both the incidence and mortality of cervical cancer has halved to one of the lowest in the world.

Now this has all changed. Rather than focus on cervical cancer detection, and thus, prevention, with biennial Pap smears; the new program relies primarily on human papillomavirus (HPV) vaccination and triage HPV testing. This strategy is untested; unproven; and will put the lives of women, particularly young women, at risk.

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“We don’t know the reason for this increasing incidence of cervical adenocarcinoma…”

Melbourne Colposcopist Dr Ross Pagano stresses the importance of Pap smears, recommending that all young women have an annual Pap smear due to the increase in incidence of glandular cell cervical cancer in young women.

When I first began practice as a Colposcopist 32 years ago, the incidence of cytology detected glandular cell abnormalities of the cervix, namely Adenocarcinoma -in-Situ (ACIS), was very low, approximately 3% of all abnormal smears. The malignant cervical adenocarcinoma and the precancerous ACIS were very uncommon in women under 30 years of age.

Recently there has been a disturbing increase in the number of young women presenting with these glandular cell abnormalities of the cervix.

Based on this clinical observation, I recommend all young sexually active women to have an annual Pap smear. This would pick up this abnormality (as well as the usual type of cervical pre-cancer) earlier and hence at a more easily treatable stage. This would result in the need for less destructive treatment to the cervix and hence help avoid future child bearing difficulties.

We don’t know the reason for this increasing incidence of cervical adenocarcinoma. We know that it is wart virus (HPV) related but why it has become more common is a mystery. Hence the most sensible and safest option for all young women is to be screened annually.

 

Dr Ross Pagano, February 2014

Published in our newsletter DESPATCH in 2014

At a recent meeting, it was announced by a high level doctor that under the new program "some women will die! It is a screening program, not an absolute and women will die!"

Wouldn't you love to know which women that will be?

[Back in February 2017 the Change.Org petition, Mr Turnbull: Stop May 1st Changes to Pap Smears – Save Women’s, attracted over 70,000 signatures within 2 weeks. Included among the thousands of comments was the following superbly balanced argument that provides clarity to the many issues at stake.]

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