Editing Disaster Alert:<em>WaPo</em> Botches Pap Smear Story

Reporters and editors often insert TK's in stories to remind themselves of facts that must be filled in before completion. This is normal. But late Monday, something went awry in WaPo's online editing system (insert joke about that new web redesign here) and an editor inserted all caps critiques in a health story on the gravity of getting a pap smear. And they ran it. The story is by Laura Ungar, a medical writer with The Courier-Journal in Louisville, Ky. Excerpt: "I didn't want to lose my womb. I didn't want to lose my fertility. But I was tossed into this world of cancer," said Felder, now 35. "It changes you in such a profound way. You have to rebuild your whole life." THE QUOTE YOU NEED HERE, GIVEN THE REST OF THE PIECE, IS ABOUT HOW SHE COULDN'T AFFORD THE HEALTH INSURANCE. DID SHE NOT HAVE A PAP SMEAR OR DID SHE ALSO STOP SEEING HER OB/GYN? IF IT'S THE FORMER SHE SHOULD SAY HOW SHE WENT TO THE OB/GYN BUT DECLINEE THE PAP SMEAR BECAUSE IT WAS TOO MUCH AND SHE FIGURED SHE WAS YOUNG SHE'D BE FINE. These sort of remarks go on and on for graphs and graphs. One positive: the editor is thorough. But an obvious negative: As of midnight last night, the story was still a train wreck. As of this morning, too. Read here. Congratulations WaPo! You win our Disaster of the Week award. In case this eventually all gets fixed, see all the gory details... UPDATE: WaPo publishes this update today in the space of the original pap smear story. The time stamp is still from yesterday's piece: "Monday, March 14, 2011; 4:58 PM An incomplete story was published to this webpage. We apologize for the confusion and inconvenience. Please find our latest coverage at washingtonpost.com." Tamika Felder figured she was young and healthy and could skip getting Pap smears for a few years when her job didn't offer health insurance. She was wrong. In 2001, at 25 years old, the television producer from Upper Marlboro, Md. was diagnosed with cervical cancer and needed a hysterectomy, chemotherapy and radiation. She was left unable to bear children. "I didn't want to lose my womb. I didn't want to lose my fertility. But I was tossed into this world of cancer," said Felder, now 35. "It changes you in such a profound way. You have to rebuild your whole life." THE QUOTE YOU NEED HERE, GIVEN THE REST OF THE PIECE, IS ABOUT HOW SHE COULDN'T AFFORD THE HEALTH INSURANCE. DID SHE NOT HAVE A PAP SMEAR OR DID SHE ALSO STOP SEEING HER OB/GYN? IF IT'S THE FORMER SHE SHOULD SAY HOW SHE WENT TO THE OB/GYN BUT DECLINEE THE PAP SMEAR BECAUSE IT WAS TOO MUCH AND SHE FIGURED SHE WAS YOUNG SHE'D BE FINE. THEN THE NEXT GRAF COULD BE THE QUOTE YOU USE ABOVE. THIS GRAF SENTENCE NEEDS TO BE TWEAKED. Each year, about 12,000 U.S. women get cervical cancer and (ANOTHER? OR IS THIS PART OF THE 12,000) 4,000 die. YET DOCTORS VIEW CERVICAL CANCER AS A disease THAT WITH PROPER SCREENING can easily be prevented and treated. Pre-cancerous lesions and early cancer are easily detected through screening. Lesions can be removed in a minimally-invasive procedure before they turn into cancer. And there's a vaccine against the sexually transmitted virus that causes most cervical cancer cases. HOW ABOUT: BUT FELDER'S CASE IS A GOOD EXAMPLE OF WHY THIS MOSTLY CURABLE DISEASE IS STILL A THREAT/IS STILL KILING PEOPLE, DOCTORS SAY. TOO OFTEN WOMEN WHO DON'T HAVE HEALTH CARE COVERAGE OR THOSE WHO,HAVE not HEARD ABOUT THE IMPORTANCE OF REGULAR SCREENINGS--DESPITE YEARS OF PUBLIC CAMPAIGNS--DISCOVER THE PROBLEM WHEN THE DISEASE HAS ALREADY PROGRESSED TOO FAR . YOU NEED A GENERAL QUOTE HERE TO SUPPORT THE GRAF ABOVE. THE KRISHNAN QUOTE BELOW IS TOO SPECIFIC. YOU NEED SOMETHIGN THAT SAYS: THIS IS A PREVENTABLE DISEASE, BUT WHEN PEOPLE DON'T OR CAN'T GET SCREENING, IT BECOMES A DEADLY ONE. I THINK THE STATS IN THE NEXT GRAF ARE CONFUSING AND UNPERSUASIVE BECAUSE YOU'RE MAKING BROAD ASSUMPTIONS (BLACKS ARE POOR FOR ONE) AND ASSERTIONS THAT YOU DON'T BACK UP FOR READERS. I THINK WHAT YOU REALLY NEED ARE STATS THAT SHOW THAT WHERE THE POVERTY LEVEL IS HIGHER, THERE IS A CLEAR RISE IN CERVICAL CANCER THAT DOCTORS ATTRIBUTE TO LACK OF GOOD HEALTH CARE. yOU COULD ATTRIBUTE THIS TO A STUDY OR THE CDC OR WHATEVER. AND THEN MAYBE STILL ADD: FOR INSTANCE, IN APPALACHIA, WHERE THE INCOME LEVEL IS XXX, THE RATE IS ETC... (((ACCORDING TO XXX, rates of disease are highest in communities. African American women like Felder, get cervical cancer at a rate of 10.1 per 100,000, 25 percent higher than the national average; they die at a rate of 4.4 per 100,000, 83 percent higher than the national average. And in the Appalachian region of Kentucky, one of the hardest-hit IN WHAT WAY? locales, women in general get the disease at a rate 33 percent higher than the national average and die at a rate 37 percent higher. Some women there go decades without getting screened SAYS WHO?))) Shobha Krishnan, a gynecologist at Columbia University's Barnard Health Services and president of the Global Initiative Against HPV and Cervical Cancer, SAYS THE BEST WAY TO REDUCE CERVICAL CANCER RATES WOULD BE BY bringing help, screening and education to vulnerable women instead of waiting for them to seek it out. "There are uninsured and underinsured who lack access to care. There are people living in rural areas without access to care....If we can adapt what we do in the developing world, we might make more progress. Four thousand deaths is four thousand too many." Subhead Cervical cancer used to be a much bigger scourge in America. In 1973, federal statistics show, the incidence rate was 14.2 per 100,000. YOU NEED SOMETHING HERE LIKE: THE RATE FELL BY ALMOST HALF AFTER DOCTORS BEGAN ROUTINELY PERFORMING PAP SMEARS, A QUICK SCRAPING OFF OF VAGINAL CELLS WHICH ARE THEN EXAMINED FOR ABNORMAL CHANGES, WHEN WOMEN CAME IN FOR ANNUAL GYNECOLOGICAL EXAMS (HOW COME THEY DID THIS? WHAT'S THE HISTORY OF PAP SMEARS? DID THEY GET EASIER TO DO OR WAS THEIR SOME STUDY THAT FIGURED OUT THAT PAP SMEARS WOULD REALLY MAKE A DIFFERENCE). AS A RESULT, THE RATE FELL TO 8.1 per 100,000 in 2003-07. Seven in 10 cases OF CERVICAL CANCER are caused by two types of the sexually-transmitted viruses, the human papillomavirus, or HPV. Roughly half of all sexually-active people get HPV at some point in their lives, but relatively few develop pre-cancer or cancer. DO THEY KNOW WHY?For those who do, it's typically slow-growing, AND THERE EASILY DETECTABLE BEFORE THEY HAVE BECOME DANGEROUS BY ANNUALPAP SMEARS. A 2008 CDC survey said about 83 percent of American women 18 and older got a Pap smear within the previous three years. Studies show that 50 percent to 70 percent of women who develop cervical cancer haven't had a Pap test in at least five years. CAN YOU GIVE ME A URL TO HYPERLINK TO FOR THIS? A. Bennett Jenson, a University of Louisville physician who has researched cervical cancer for decades and helped invent the HPV vaccine THAT IS NOW RECOMMENDED FOR TEENAGE GIRLS AND BOYS?....., said even though the disease spreads slowly, it's important to get yearly Pap smears. The tests have a 30 percent false-negative rate, he said, meaning abnormalities can be missed 30 PERCENT OF THE TIME THEY COME UP WRONG??. He said YOUNGER women canSHOULD?? also protect themselves by getting vaccinated against HPV before becoming sexually active, and ALL WOMEN SHOULD CONSIDER getting HPV tests while sexually active. SO LET ME MAKE SURE I GET THIS: PEOPLE SHOULD GET PAP SMEARS AND HPV TESTS? WHY HPV TESTS WHEN RELATIVELY FEW PEOPLE WHO ARE INFECTED WITH HPV ACTUALLY GET CERVICAL CANCER. THAT SEEMS LIKE UNNECESSARY AND EXPENSIVE TESTING IN THIS DAY AND AGE.... ALSO, WHICH OF THESE TESTS ARE COVERED BY INSURANCE. i THINK THE VACCINE IS NOT, RIGHT? OF COURSE FOR WOMEN WHO DO NOT HAVE HEALTH INSURANCE OR FOR WHOM THE COSTS OF THESE TESTS, EVEN WITH THE INSURANCE, ARE TOO HIGH, THESE SUGGETIONS MAY BE DIFFICULT TO FOLLOW. HOWEVER, There are programs that can help, including the CDC's National Breast and Cervical Cancer Early Detection Program, which screens under-served WHAT DOES UNDERSERVED MEAN women. Still, "there are a lot of people who fall through the cracks," said Suzy Madden, who works with women in HEALTH/SUPPORT/WHATEVER program in rural Kentucky WHERE RATES OF CERVICAL CANCER ARE PARTICULARLY HIGH BECAUSE OF LACK OF PREVENTATIVE SCREENING. said. "They make too much to qualify, but not enough to pay for a doctor visit themselves." In Felder's case, said she got Pap smears regularly in college WHEN COVERED BY HER SCHOOL HEALTH PLAN? OR HER MOTHER'S?. But when she went off her mother's insurance, she skipped screenings for three years SINCE THEY COST XXX. She wasn't too worried when she began having bad menstrual cramps and lower back pain. After landing a full-time job with insurance she went in for a REGULAR GYNECOLOGICAL CHECKUP.. She could hardly believe the cancer diagnosis, and sought several other opinions. "I was thinking I was in some bad movie," she said. Subhead Felder said three things would have made a difference to her--being better educated about cervical cancer and its causes, having insurance at a critical time, and not taking chances with her health because she felt young and invincible. But experts said changing attitudes, getting health messages out to everyone, and especially improving access to health care are some of the thorniest challenges in health care. Krishnan said the new health-care law should eventually mean fewer uninsured women. "We hope that...providing coverage for millions more will reduce the number of cervical cancer cases in this country," she said. Felder is committed to doing her part. In 2005, she started a nonprofit group called Tamika & Friends, which seeks to raise awareness of cervical cancer and its link to HPV. "I don't know if we'll ever eliminate it completely. But I think we can lower it," Felder said. "This is a preventable cancer." THIS SHOULD BE IN THE SIDEBAR: According to the CDC, about 33 million doses of Gardasil were distributed nationally as of mid-February, and 18,354 reports were made to the Vaccine Adverse Event Reporting System about problems following inoculation. Most involved problems such s fainting and pain at the injection site that were not considered serious, but 8 percent were considered serious, involving problems such as blood clots and Guillain-BarrÃ© syndrome. The CDC stressed that problems reported after the shots may or may not have been caused by them, and recommends vaccination. "If everyone had the vaccine, that would stamp it out," Jenson said. "We could cure it like polio." Felder agreed the problem is daunting, but said she's also committed to doing her part. In 2005, she started a nonprofit group called Tamika & Friends, which seeks to raise awareness of cervical cancer and its link to HPV. "I don't know if we'll ever eliminate it completely. But I think we can lower it," Felder said. "This is a preventable cancer." Laura Ungar is the medical writer with The Courier-Journal in Louisville, Ky.

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Editing Disaster Alert:WaPo Botches Pap Smear Story

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