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To think smear test should be available to women at any age ( sensitive)

(46 Posts)
HadABadDay2014 Sun 16-Mar-14 21:55:05

I know that under 25 it is rare, but if a women request a smear test due to showing some symptoms or just for peace of mind should a smear test be done.

I think I had my first when 20 after DH seen the letter and encourage me to go. Then at 27 after again DH encouraged me to go.

HadABadDay2014 Sun 16-Mar-14 21:56:24

EBearhug Sun 16-Mar-14 22:03:56

I had my first when I was 21. I may have then gone longer than 3 years, as I moved towns and health authorities at least annually over the next 3 years, but once I was a bit more settled, I've been going regularly ever since, including at one point after some borderline results, annually for about 5 years.

Rare isn't the same as never, and I think they should be available on demand, even if you're not yet part of the regular recall cycle.

LittleprincessinGOLDrocks Sun 16-Mar-14 22:05:47

I think a woman who has valid concerns, such as the young lady in the article, which have a possible link to cancer should definitely be allowed to have one. That should be regardless of age.
Although it is rare in women under 25, it is not unheard of, and GPs should be allowing for the fact that their patient may well be that one in a million.

BiddyPop Sun 16-Mar-14 22:06:43

I first got the pill prescribed by Uni docs, rather than own go (too bloody friendly with my mum and no way would he not have told, even if he did actually prescribe). They said at first script that I should start getting smears now as I was thinking of becoming active, and at second visit, reminded me of at advice and offered to do it there and then. Had another 2 years later still at Uni, so ended up in a cycle and insisting on it with new go when I moved into own house after Uni. So I've been getting them since age 21 with no questions asked.

mumteedum Sun 16-Mar-14 22:07:46

Yanbu they used to be from much younger. I'm sure I was 19 or 20. Somebody close to our family died of cervical cancer when she was barely 30. If you get in habit if going from being younger it is a good thing. It is just cost cutting.

TreeFuMom Sun 16-Mar-14 22:07:59

YANBU. I agree. I had CIN3 diagnosed age 22. If it had been left undetected for another 3 years, I dread to think what the outcome might have been hmm

KittyAndTheFontanelles Sun 16-Mar-14 22:09:12

I thought you were supposed to have smears once sexually active. I didn't realise there was an age limit. At least that's how it was when I had my first smear but that was some years ago.

BiddyPop Sun 16-Mar-14 22:09:23

Bugger. Go = GP. As in doc.

Actually, that 1st "real life adult" GP was elderly gent, so sent me off the gynae clinic at local mat hosp. When we moved almost 3 yrs later, new GP clinic had a few docs and most do smears, and want to do them there as inner city clinic means many slip out of system if referred but will get things done "in house". I use tat clinic as it's close to work and suits m.

Sidge Sun 16-Mar-14 22:11:23

What a sad story.

Cervical cytology IS available to women of all ages, when carried out as part of a clinical investigation. If a woman of any age presents with unusual symptoms she should be fully investigated which may include a smear test.

That doesn't mean all young women should be offered routine cervical screening.

Screening is not the same as carrying out a smear that is clinically indicated.

HadABadDay2014 Sun 16-Mar-14 22:11:28

I don't even know why cost is an issue, they nurse who takes the sample will be paid as he or she is contracted x amount of hour so would the pathologist who views the sample, as is the person who sends the letter, the person who transports the sample.

To me the only cost is the spectrum and swab.

Binkyridesagain Sun 16-Mar-14 22:11:48

It did used to be when you became sexually active, I think my first was when I was 17yrs old when I first went to a family planning clinic for condoms and to talk about the pill.

KittyAndTheFontanelles Sun 16-Mar-14 22:13:51

I was 25 TreeFuMom

Purplepoodle Sun 16-Mar-14 22:14:17

I was told to have it done as soon as I became sexually active

Mintymoomoo Sun 16-Mar-14 22:15:02

Totally agree my neice has just had treatment for cancer aged 27 because of cancer, she was refused a smear until only last year because they claimed she was 2 young, she had her first child 2 days after her 16th birthday, one at 17 and her last at 19!

Sidge Sun 16-Mar-14 22:17:29

The decision to raise the SCREENING age to 25 is explained here

Doing a smear because of symptoms is NOT age dependent.

Hadabadday2014 of course cost is an issue. A screening programme is going to have costs associated with it.

Belalug0si Sun 16-Mar-14 22:18:18

If someone has symptoms then a smear isn't appropriate as it's for screening not diagnosis. Investigations include speculum examination, exclusion of infection, and possible referral to gynaecology and/or colposcopy depending on the symptoms.
As it is a national programme then screening is based on evidence of how often and when women should be screened for the most effective prevention of cancer developing. This means that the screening programme has a known number of women that should attend each year for screening, and a known likely resource required.
If women were able to request screening for their peace of mind, it would (1) cost more (2) most likely not prevent a significant number of cancers (3) mean everyone's tests would take longer to process (4) mean that minor cell changes which usually go away on their own would be over investigated.
From the 1960s to 1980s women were able to request screening ad hoc. This did not reduce the cervical cancer incidence any further as there was a relatively small number of women frequently having screening. The big reduction came from 1988 onwards when a call/recall system was started. This means that women are invited for screening regularly, and that there is a failsafe system to pick up non-attenders and those who haven't been for investigation.

It is very sad when anyone develops a cancer particularly when there is a screening programme. However screening programmes are designed on a population basis not individuals. Link to NHS CSP page with info and references about screening ages.

Theas18 Sun 16-Mar-14 22:20:25

There is a balance though. Smears used to be done much earlier.

The trouble is Hpv causes changed in the cervix cells when you first get the infection. These abnormalities look "pre cancer like" but clear spontaneously in 6 month or a year or so. A lot of very young cervixes were treated as this was found. Treating cervixes isn't risk free. Over all the risk if treatment was thought to be much greater than the risk if cancer in this age group and the testing was stopped as it was resulting in harm overall.

They may look again with Hpv vaccination and the fact that smear tests are now checked for Hpv virus and decide to change the age limits again, but it's putting issues like cervical incompetence and stenosis against very very rare cancer risk . Treatment of cin is also probably less risky I guess.

PiperRose Sun 16-Mar-14 22:22:55

Yes. Just as the HPV vaccine should be given to all women regardless of ge.

Belalug0si Sun 16-Mar-14 22:26:17

OP the more samples there are to be screened means either (1) wait longer for your results or (2) pay for more staff. Pathologists (and consultant scientists) view about 10% of the samples.

There are a lot more cost ps than a speculum and cervex broom (swabs are used for investigating infections). All samples are screened by a primary screener, then quality checked. About 20% then go onto to a senior scientist, then half of these go to a consultant for reporting. All the staff have at least two years of intensive, expensive training. Consultants have a lengthly process to go through. Everyone then has regular performance assessments, update training. Plus there is the processing equipment in the lab (not cheap), the support staff, the HPV testing equipment, the microscopes (at least £3-4k each). And additional colposcopy staff.

MissieEverdeen Sun 16-Mar-14 22:30:39

Don't assume if you have symptoms you'll be given a smear no matter your age.

I am phobic about doctors and have not had a smear due to that. It stems from a childhood incident with a nurse.

I had unexplained bleeding three years ago (aged 30) took a pregnancy test, negative, DP made me go to hospital.

Hospital did an internal (I was very distressed but allowed it) so I asked them to do a smear at the same time. They REFUSED. Said it wasn't allowed but dr said my cervix "looked fine" but that's all they could tell me.

Belalug0si Sun 16-Mar-14 22:31:16

Littleprincess "Although it is rare in women under 25, it is not unheard of, and GPs should be allowing for the fact that their patient may well be that one in a million."
How do you know if that patient is the one in a million though? Pre-cancerous changes don't cause symptoms. Symptoms should mean investigation, not a smear because they should not be used for diagnosis - because they may give an incorrect answer and delay more appropriate investigations.

ThePinkOcelot Sun 16-Mar-14 22:34:14

Yanbu. The age should be brought down.

VisualiseAHorse Sun 16-Mar-14 22:39:46

In Scotland, the age is 21 (I think, it's certainly younger than 25). My Scottish GP was very surprised when she learnt I hadn't had a smear aged 22, even thought I'd been sexually active for several years by that point. (Born in England, now living in Scotland).

The age should be bought down - and certainly for girls that are getting contraceptives, it should really be talked about when they start, to get them on the list so to speak.

TreeFuMom Sun 16-Mar-14 22:46:00

Hmmm it's a difficult one isn't it. Interesting link from Sidge. I had no symptoms when I was diagnosed with CIN3. It was first picked up through routine screening when I was 22 (15 years ago now), and then again when I was 28. As a result, I had two lots of laser treatment and my DS1 was born at 33 weeks - probably due to cervical incompetence hmm

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