
Why I'm saying no to a smear test - DanBC
https://www.independent.co.uk/life-style/health-and-families/features/why-im-saying-no-to-a-smear-7577967.html
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aurizon
It is apparent to me that many diseases, like cancer, start small and progress
to the point where they produce systems the patient can see, or feel. These
would be blood in pee, blood in poop, pains in guts/balls etc. Sadly, many of
these symptoms are not felt or seen until the disease is advanced. The less
advanced a disease is when found, the better are the chances of a cure.
Testing where there are no symptoms is THE ONLY WAY to detect them at their
smaller, most curable stage.(some are terminal when found, even when small,
like glioma) In my opinion this lady is making a serious error, a potentially
terminal error. I get these tests for men every year, as my doctor directs,
and I will do this until I get killed by something that loomed out of the
darkness at high speed and killed me, be it a car or brain cancer...

~~~
redis_mlc
Although you're trying to appear logical, you're not. There is no black or
white in health care.

For example, most men who get prostate cancer die of something else first. The
treatment often destroys quality of life, so is worse than the disease.

Also, you can't compare women's diseases to male diseases. Women have all
kinds of body changes that men don't experience.

And doctors generally don't signup for heroic measures after retirement. They
know when your time is up, prolonging life in an ICU is not living.

You're not going to live forever.

~~~
aurizon
In fact as well as appearance I am logical. Screens are just that, they screen
for things, and by their nature some slip through - one hopes later screens
will catch the problem as it gets larger

~~~
DanBC
You're talking about false negatives, but the problem with cancer screening is
the false positive: telling someone they have cancer when they don't.

[https://www.harding-center.mpg.de/en/fact-boxes/early-
detect...](https://www.harding-center.mpg.de/en/fact-boxes/early-detection-of-
cancer/prostate-cancer-early-detection)

One of the reasons cancer screening is pushed so hard is because people use
the wrong metrics. People look at 5 year survival rates, or cancer detection
rates, to judge success.

Imagine 1000 men with aggressive prostate cancer who don't have screening.
After 5 years about 440 of those men will die. That's a survival rate of 44%.

Now imagine those exact same men but pooled with 2000 men who do not have
prostate cancer (because this is what screening does). After 5 years those men
will still be dead. But the survival rate is now 81%.

This is the bias caused by over-diagnosis.

~~~
aurizon
Yes, the flaw is inherent in the accuracy or lack of it of the test method.
Things like needle biopsy of the prostate can miss cancerous cells, unless you
take 100 samples. An ideal tests would detect cancer markers in the blood for
prostate and other cancers. I understand there is progress in that area.

~~~
tcj_phx
> Things like needle biopsy of the prostate can miss cancerous cells, unless
> you take 100 samples.

biopsies can cause a stable tumor to metastasize [0]. Sometimes medical
screenings are useful, but when you’re looking for problems and don’t actually
have symptoms, practitioners have an incentive to find something to treat you
for. Ideally you’ll be fired as a patient, but I’ve heard of doctors who do
procedures and operate every time they can possibly justify it (“he owes money
to everyone.”)

[0]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4015162/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4015162/)

~~~
aurizon
Yes, I have heard stories from a friend who had needle biopsies, he likened it
to being machine gunner by a Japanese Zero in WW2. I am over 80, so I have
chosen the finger for years, and when I became enlarged I took the prostate
shrinking pills, since I was a widower, and I could probably only have sex
with desire with a hooker, as I would not be attracted to an older woman for
the same reason no young woman would be attracted to me, yes the shrink meds
also made me not in the least bit horny, I do not miss it at all.

