Saturday, October 31, 2009

Medical Testing Monopoly?

Most women refer to their annual cervical cancer screening as their Pap test. IN fact, most of us are no longer having the traditional test that was created just after the Second World War. We are instead being tested with the Thin Prep. The main difference between the two tests appears to be how they are read in the lab. Also, the sample taken from the woman for the ThinPrep can also be used to test for human papillomavirus or HPV, but a second sample would be needed if the traditional test was used.

The problem is that the new test is much more expensive to use and not more effective in detecting precancerous cells. Many labs in the US have stopped accepting the traditional test samples because it is more difficult to examine them, forcing many providers to use the newer, more expensive, but not more effective test. This is unfortunate but what’s worse is what the medical director of the company that makes the newer test had to say in an USA Today interview. And oh do let me quote Mr. (doctor) E. Evantash, “I’m not sure cost was such a great consideration in this country.” Dr. Evantash works for Hologic. And his statement is just what one would expect in a country where medical testing is OUT OF CONTROL and a health care crisis looms.

The newer test is said to be used 70% of the time in the USA. The National Cancer Institute still endorses the older test, which is actually called the Papanicolaou test (that has to have been someone’s name) and a study now released from some Dutch scientists supports that the less expensive test is still a good buy. The Dutch government has been far more reluctant to switch to the new test because of a lack of evidence, but it is allowed for use in Holland. Our NCI notes that research on the two tests has not yet told us if one of them prevents more deaths from cervical cancer than the other, which is of course, a good measure of a tests worth!

It is not clear why our FDA allows Hologic to market their product as better at detecting the abnormal cells, it has to say that or else we wouldn’t NEED another test would we.

But here is a question for you… Which test puts the woman at the most discomfort? I searched for that answer and found that the procedure used to collect the cells is the same for both tests. I don’t know which test I had recently, but according to Mr. Hologic – only 10% of the US market is for the traditional test. I bet that makes his stock holders happy, eh? The stocks, BTW, sell for around 15 bucks each.

BTW, the Pap part comes from the developer’s name, but the smear part comes from the smearing of the cells on a slide to be viewed under a microscope. Both tests collect the cells the same way and smear them on a slide, so as I said at the beginning, the difference really is in the lab.

I wrote about this because I am always questioning the HPV vaccine promotion as I believe most ardently in the Pap test for prevention of cervical cancer. I had no idea that there was competition in the test market as well. I believe I am going to become cynical. And yet, PLEASE women, if you are or have been sexually active, an annual or every three year test is recommended. Check with your doc for specifics.

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