Tuesday, July 10, 2012

DHHS: Does this lie make me look stupid?

Update, July 12, 4:30 PM Eastern:
Just got this extra lame reply from healthfinder:

Dear Ms. Zilberberg, Thank you for contacting healthfinder.gov.  healthfinder is a government Web site featuring prevention and wellness information and tools to help you and those you care about stay healthy. At healthfinder.gov, you will find:
 ·         interactive tools like menu planners and health calculators
·         online checkups
·         printable information that you can share with a family member or take to the doctor.
 healthfinder.gov is coordinated by the Office of Disease Prevention and Health Promotion (ODPHP), U.S. Department of Health and Human Services and the National Health Information Center (NHIC). NHIC links people to organizations that provide reliable health information. All of healthfinder.gov’s topics and tools go through subject matter expert reviews. As a result of these reviews, sentences and wording sometimes get updated and/or changed. This particular topic has already been reviewed, and the content team will be rewording the language; the word “best” will be removed from that sentence. This change will be reflected on the site in the next scheduled healthfinder.gov update. Sincerely, 
healthfinder.gov TeamNational Health Information Centerhealthfinder.gov is coordinated by the Office of Disease Prevention and Health Promotion (ODPHP), U.S. Department of Health and Human Services and the National Health Information Center (NHIC).


Update July 11, 10:50 AM Eastern
I have just sent the following e-mail to healthfinder.gov at the address healthfinder@nhic.org. I urge everyone who reads this to send them the same or a similar message. And if you do, please, leave a comment below to let everyone know.
I wanted to let you know that the information you posted on this web page on Pap testing is erroneous and misleading. Telling women that the "best" way to prevent cervical cancer is through a regular Pap test is not supported by evidence. The "best" way is to prevent HPV infection by engaging in safe sexual intercourse. As a public health communicator you are doing a tremendous disservice to the public.  
I urge you to change this message to reflect reality. 
Thank you. 
Marya Zilberberg, MD, MPH, FCCP 

There is pounding in my temples, my back muscles are in a spasm, and I might even be turning green and busting out of my clothes. What caused all this? This innocent-looking tweet from the Department of Health and Human Services:

I had to do a double take. My blood started to boil almost immediately. But I persisted, clicked on the link, and saw this:

The first sentence really says "The best way to prevent cervical cancer is to get regular Pap tests." Jaw, meet floor. What does the word "prevent" really mean? I went to The Free Dictionary for enlightenment:

Just as I had suspected: to avert, to keep from happening. And how does a Pap test keep the cancer away? It finds "abnormal cells before they turn into cancer." And where do abnormal cells come from? God, right? Well, no, they are mostly associated with an HPV infection, which comes from exposing yourself to unprotected sexual intercourse, usually with someone whose HPV status you don't know. You see where I am going with this? The message here is that there is nothing more effective at preventing cervical cancer than having a Pap test to detect early changes and lop out the misbehaving piece of your cervix. Are they serious? Is this really the "best way"? Let's examine the meaning of "best":

I guess beauty (and value) are in the eye of the beholder. Does subjecting yourself to a surgical procedure that may leave your cervix unable to help your uterus to maintain a pregnancy qualify as "surpassing all others in excellence" or as "most desirable"? Not in my book, not when a little advanced planning and a nickel for a condom could could keep that horse from leaving the barn in the first place. True prevention does not take place in a doctor's office, and it is a mistake to equate screening to prevention.

Come on, DHHS, who writes your stuff? Fire them! You are risking your credibility. What's next? "Bulimia is the best way to prevent obesity"?    

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  1. I'm with you.

    I suppose they probably meant "The best way to PREVENT DEATH from cervical cancer."

    But even that's not true.

  2. Diana, yes, thank you for your comment. I could argue that even for that outcome this may not be the bet strategy (know your partner and use protection may still be better), though I can agree that this does not constitute misinformation. I am not willing to give the DHHS a free ride on this because they are supposed to be a source of credible public health information. Precision is very important, don't you agree? They should say what they mean and what evidence supports.

  3. Michael Mirochna, MDJuly 11, 2012 at 10:23 PM

    I've been following @healthfinder as well and am a bit startled by the propaganda and disease mongering.

  4. There is a *massive* difference between DETECTION and PREVENTION. Cervical cancer can most certainly be detected by Pap tests. Preventing it requires safe-sex practices. Is our culture *so* puritanically sex-averse that we're willing to let people get exposed to STDs (including HPV) as punishment for sexual activity? Really?

  5. You can detect precancerous cells in a Pap Smear although many times, its more about detecting the cancer, rather than preventing the cells from becoming cancerous.

    I do agree that the reply is fairly lame, simply choosing to "reword" their statement over actually fixing the problem.....great job at improperly informing the masses!