Pap smears: no longer a thing in Australia from 1st December 2017 [1], and a recent example of over treatment due to early detection capabilities getting ahead of early prediction capabilities, as highlighted by Mukherjee in his "Cancer's Invasion Equation". [2]

A whole generation of young women underwent unnecessary operations due to a limited understanding of cellular changes in the cervix coupled with - perhaps - an institutional bias to intervene. The new changes will avoid this, as AMA president Michael Gannon emphasised in a post [3] this year:

"The old system was never particularly good in detecting Cervix Cancer in women under the age of 25."

"...it will mean that thousands of women will avoid surgery historically performed (in good faith) to reduce the risk of progression to severe pre-cancerous changes or Cervix Cancer."

Thoughts:

  • the Medical Service Advisory Committee recommended these changes at the start of 2014 [4]. Why has it taken four years (and how many unnecessary pap smears and operations) for these changes to be implemented?

  • where is the institutional analysis on how a faulty test managed to run for two decades giving false positives and causing significant stress, anxiety and unnecessary intervention? At the very least you would expect institutions to do a post-mortem on this and come back to society with a course of action to more rigorously vet national programs before they are rolled out.

[1] http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/future-changes-cervical
[2] https://www.newyorker.com/magazine/2017/09/11/cancers-invasion-equation
[3] https://ama.com.au/ausmed/cervical-cancer-screening
[4] https://ama.com.au/gp-network-news/msac-recommends-hpv-tests-replace-pap-smears