want to be startin’ something

When a government panel released a statement a few weeks ago recommending fewer beast cancer screenings for women under 50, the blogosphere exploded with testimonials from outraged survivors. Many had found their cancers early, thanks to yearly mammograms, and they wondered what the new guidelines would mean for others who might find themselves battling the beast.

Then, as if purposely adding fuel to the anti-early-screening pyre, within days of the announcement, the American College of Obstetricians and Gynecologists suggested that women delay their first Pap test until age 21 and forgo yearly screenings in favor of every other year.

The timing may have been coincidental, but it was certainly unfortunate.

Two seemingly reputable groups challenged almost everything women have been taught about screening methods. Both cited unnecessary testing, false positives, and anxiety-inducing procedures as the reasons behind the amended guidelines, but it appears they’ve caused more harm than good.

Last Thursday, a separate panel of doctors and radiologists blasted the new breast cancer recommendations, claiming they represented “a major setback” and would wipe out decades of progress. They were right.

Since 1990, breast cancer deaths have dropped 30 percent as a result of early detection. And although the physicians had little to say regarding the cervical cancer recommendations, primarily because less than 1 percent of cases occur in women under 21, statistics show that early detection in the form of yearly Pap tests has been equally effective in combating that disease, too.

For experts to suggest that women wait until their twenties to get their first Pap then ditch their annual exam is problematic for several reasons. Forget for now that the Pap is how doctors find sexually transmitted diseases and most women are sexually active way before they turn 21. Paps are also how doctors find precancerous cells, and women under 21 represent the highest cases of HPV, the sexually transmitted virus that causes cervical cancer. Seems like there’s a serious lack of congruity here.

I’m thinking that if the population of women at highest risk for cervical cancer gets fewer screenings that could potentially be life-threatening. According to U.S. News & World Report, 50 percent of women diagnosed with cervical cancer have never had a Pap before.

Furthermore, none of the medical professionals behind the updated guidelines mentioned varying demographics. Women of color, particularly black women, are diagnosed at the later stages of pretty much every reproductive cancer. It’s clear that a one-size-fits-all approach isn’t a smart way to practice medicine. Some groups should be encouraged to pursue early screening methods, not forgo them.

The general consensus among the government panel, however, is that for the large number of women tested only a small amount end up being diagnosed with cancer. But this idea is symptomatic of everything that’s wrong with health care in America.

Preventive care is about more than just tests; it’s an approach to wellness. As Americans, we end up playing catch-up when it comes to our health when we should be ahead of the curve.  When a woman is diagnosed with HPV that’s not preventive. When a woman feels a lump in her breast, that’s not preventive either.

Let me explain what is. When I was laid up in the hospital after my surgery, one of my roommates was a Jewish woman in her late fifties. She’d gone in for her annual, and her GYN suggested that she start getting ultrasounds as a regular part of her exam. Well, guess what they found when the results of her test came back? Ovarian cancer, stage I.

Luckily, the disease was caught early, when it’s highly curable. And it’s all because of her doctor’s foresight. Whatever the cost of her ultrasound, I can guarantee that it was infinitesimal compared to the costs of the chemo drugs she would’ve required had the disease advanced.

It makes me wonder whether my own cancer would’ve been caught earlier had I undergone regular ultrasounds to monitor my ovarian cysts.

Even more dangerous, though, is that these misguided guidelines have the potential to slow the momentum of awareness campaigns. By discouraging younger women from undergoing regular testing, such as mammograms and Paps, reproductive cancers could be framed as an “older woman’s disease.”

That’s been the case with ovarian cancer, yet I’ve met a community of women diagnosed in their thirties and forties. To raise awareness, all women, regardless of age, have to be involved. Cancer doesn’t discriminate.

Finally, lessening the importance of critical exams would give insurance companies yet another reason not to pay for a procedure. That would go a long way toward saving them money — all the while endangering women’s lives.