Since someone just asked, I'm going to write about the performance that opting out of #cervicalscreening is and what this says about the NHS's attitude to women.

Anyone with female on their medical records aged 16-25 is auto enrolled onto the cervical screening programme.

This means you get letters. And if you stop going, as I did after 3 smears you get more letters. And then your GP starts mentioning it every time you go in the surgery because it pops up on their screen. The final straw for me was a 5 minute lecture from a well meaning trainee..

So I decided to opt out. I wrote to my GP's practice manager, stating clearly that I wished to opt out, and got a letter back demanding I sign a disclaimer, part of which said 'most women who die of cervical cancer had not had screening.' I refused and asked the source of the

statistic. They admitted they didn't have a source and agreed to remove it from future disclaimers, and sick no doubt of my dedicated Karening sent my withdrawal letter off to C(r)apita, who at the time ran the programme admin.

I then got ANOTHER letter with another disclaime, which again I refused to sign, on the grounds that I had made a VERY informed decision (I cited sources), but whether or not I had, I could refuse screening for any reason whatever and didn't need to justify it.

Back and forth the argument went, during which time I received ANOTHER reminder letter, finally after several e-mails, phone calls, citing GDPR and general demanding to speak to the manager, they removed me from the register. The whole thing took nearly 2 years.

There is absolutely no need for someone refusing a medical procedure to sign a disclaimer in the UK. If you've clearly expressed refusal, that's it. You don't have to give a reason, or use any particular wording, but it took me a load of argy bargy to get the NHS screening

programme to recognise this. The NHS auto enrolls anyone with woman on their medical records onto two screening programmes, breast and cervical. There are no parallel programmes for anyone registered as a man. Women are infantilised. And the programmes have little value.

Mammography doesn't reduce all cause mortality AT ALL. Figures for cervical cancer screening aren't available, but the best estimate we have is that it prolongs life in 1 in 1000 women screened for 35 years. Whereas there is a 40% chance of an 'abnormal' result requiring follow

up in those 35 years. So yes this IS a feminist issue, but the people, especially men, telling women to 'get screened' need to get in the bin. The screening programmes were largely introduced and are continued for political reasons, the health benefits are marginal

I've got no problems with people who are are worried about cancer having access to screening if they wish, individual risk varies hugely. I've got a lot of problems with women being hounded to have screening and that's what happens with the NHS cervical screening programme

currently. And moreover, far more trouble was taken when I wanted to say NO than to ensure I properly consented to the procedure. On the last smear I ever had, I was dragged into a clinical trial with no proper explanation. Care taken to ensure consent is IME, sketchy, and it's

quite clear that a lot of people who have the procedure don't understand it properly, thanks to the mass of misinformation out there. So stop patronising women, stop telling us what to do and STFU smear evangelists. Especially men.

Postscript: this piece (from 1995!) on how mass breast screening was being questioned even then very much lays bare the political issues surrounding it. https://www.independent.co.uk/voices/when-breast-screening-is-best-1599720.html

Toynbee completely ignores the problems of overdiagnosis. Finding a tumour that would never grow to threaten someone's life isn't always a benefit, rather than reassuring it creates anxiety. Many people will probably end up being pointlessly treated.