Incredible how we confuse the issue when medical profits might be at stake, almost all women are HPV- and cannot benefit from pap smears, but can be harmed by false positives, excess biopsies and over-treatment. It's shocking that screening for a fairly rare cancer has had such a huge and negative impact on the lives of so many women.

I'm Australian, 57 and have never had a pap test, an informed decision.

I'm one of the rare women my age who hasn't had anything "done" to her cervix. Our program is excessive and so we have very high referral rates for excess biopsies and over-treatment. Great for vested interests, a lousy deal for women. It was the numbers I didn't like, near zero risk of cervix cancer or a 77% lifetime risk of colposcopy/biopsy, now I understand that most women are HPV- and cannot benefit from pap testing.

Those who want to screen and yes, it's a choice and should be an informed decision, take a look at the new Dutch program. This program is based on evidence and attempts to protect all women, the roughly 5% at risk of cc and the vast majority who cannot benefit from testing. Australian and American women will never see this sort of program, the huge industries built around population pap testing and over-treatment make a fortune for so many that they'll fight to keep excess/non-evidence-based testing in place. Most women are in the dark when it comes to the evidence, so it's easy to continue with excess. Many women are also, coerced into pap testing and excess with some doctors "requiring" a pap test for the Pill, note screening can never be required for anything, it's elective and needs your informed consent.

The Dutch will offer 5 HPV primary tests or HPV self-testing at ages 30,35,40,50 and 60 and a 5 yearly pap test will ONLY be offered to the roughly 5% who are HPV+.

This program will save more lives and takes most women out of pap testing and harms way. The American practice of doing both HPV AND pap testing on women over 30 is about profits, this combination produces the most over-investigation for no additional benefit to women. HPV testing should always stand alone and never be used before age 30. (pap testing does not benefit those under 30 either but leads to lots of false positives and over-treatment).

Most older women are HPV- and cannot benefit from pap testing. Also, pap testing can be very painful after menopause, it can be intolerable for some women. ALL completely unnecessary and plain cruel - allow women to test themselves for HPV, only a very small number will be HPV+...these are the only women who should be offered a pap test.

ROUTINE pelvic, rectal, recto-vaginal, clinical breast exams, visual inspections of the genitals - they are NOT evidence-based, not recommended, and are FAR more likely to harm you. The American well-woman exam is about medical profits, it will harm you sooner or later.

Mammograms - be careful, I've declined, head over to the website of the Nordic Cochrane Institute, an independent, not for profit, medical research group and read their excellent summary of the evidence. About 50% of screen detected breast cancers are over-diagnosed and any benefit of screening may be wiped out by those who die from heart attacks and cancers after treatments so the risks of screening may exceed any benefit.

Women need to be careful, do their own research and make informed decisions about screening and yes, we can say NO.