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Opting out of cervical screening(92 Posts)
This is not a thread to discuss the benefits or otherwise of cervical screening.
I want to officially opt out of the NHS Cervical Screening Programme. I have looked at the data regarding risk of cancer vs risk of unnecessary treatment and decided that I would rather live with the cancer risk (I have the necessary statistical training to make an informed decision).
However, every time I see the doctor or nurse the appointment is dominated by a lecture about screening, rather than a discussion of my actual health problems. I want to officially opt out of the screening program so that I stop showing as overdue for a test on the doctor's system.
According to the NHS Cervical Screening Programme Good Practice Guide I can opt out by putting my request in writing, but it doesn't say who I need to write to. Is it my local PCT (which is Oxfordshire)? Or is there a national admin center?
Has anybody else successfully opted out? How do you do it?
This is not a thread to discuss the benefits or otherwise of cervical screening.
I opted out of the cervical test, though it was considerably patronising that I had to go through the the GP - ie I don't have the brain-cells to work it out for myself - despite being a graduate from a red brick university, nevertheless I am clearly not very bright - , and furthermore I did not ask to be "opted in" - another intrusion of privacy. The disclaimer is now active and quite honestly I have enough going on without these intrusive and often overly explicit letters arriving. In addition, not everyone is on the spectrum of being vulnerable to what is essentially a sexually transmitted disease.
You won't be surprised to learn that I have also sent in the disclaimer re mammograms - for me this is about taking responsibility for myself, thanks very much, and not allowing intrusive assumptions to be made.
Thankfully when visiting a GP I can now relax in the knowledge that the cervical programme is off limits. However, one can always say no, and I feel that women need to be more emboldened in making their informed choice and recognise low-level bullying!!
Hi, I work for the Victoria Derbyshire programme. I know it's an old thread but we're discussing opting out of smears on the programme tomorrow. I'm on email@example.com if you'd like to carry on the conversation with us.
I'm a bit late to this conversation but it has been very interesting all the same. I think the Aussie poster might be counting the population as a whole to be 10% positive at any one time. I have read that it is estimated that up to 40% of women in their 20s are HPV positive, but that this falls off very sharply from age 30 onwards as women clear the virus. Only a very small minority get the virus persist after this, especially if they smoke or take immune suppressing drugs. These are the women who need to be watched.
sally- are you able to access counselling via your GP?
How would you feel if you were pregnant or had to have examinations for any other kind of gynae issue- not just smears?
I am sure there must be support for women like you including maybe practising with a speculum at home and overcoming your phobia- which is what this is.
Just to interject with the opinion/experiences of someone else who has been following this topic closely:
I was sexually abused as a child and emotionally abuse as a teenager. I am not only afraid of men, sex and relationships, but I am also terrified of anyone talking about, alluding to or going near 'down there'.
When I even get letters about my smear, I get hysterical. I can't control it. No amount of telling me to grow up, get over it, etc, will work, as it is a deeply embedded thing that I imagine only counselling/psychotherapy will fix.
There are people, like me, out there, who are not refusing these tests because they are being childish, pedantic, whatever. It is because of a deep, abiding terror of the test. Whether it be because like me it feels tantamout to submitting myself to abuse (again), or whether it's because of a phobia of another kind. It is possible to want to opt out because you just.cannot.do.it.
Please have a heart when you say you think it is silly not to want to do it.
As it is, I am going to go under general anaesthetic to have it done as I am terrified by everything in the media about cervical cancer.
If it is clear I will be opting out which is what led me to this post.
Yes, dying of cervical cancer would be horrible. But to me, the idea of going through this horrendous test (it is horrendous to me) is worse. It isn't logical, I admit. It just is what it is.
Sorry for the long post.
As for changing GP practices- I have never found that onerous either having had at least twelve in the course of my life due to house moves and other factors.
It is not hard, not for most people anyway unless you live in a tiny village with only one surgery- then you could be stuck. However there are usually other GPs you can see within a practice.
I am curious as to why receiving these letters is so traumatic. They are easily recognised and binned. I don't go for pap screens because I too have weighed up the risks (am a HCP and medical writer) but to be honest the rigmarole to be taken off the recalls as described by yourselves is a lot more trouble than the few seconds it takes to bin.,
And if your doctor pesters you, change them! I have NEVER once been pestered or questioned by mine or any practice nurse. If you took the time to choose a GP more carefully, you'd not have this problem.
But littleme61, your very first post was inflammatory - it came 4 months after the last post on this thread, and yet you came out arguing. I'm not sure who with, but from the start you were angry and provocative in your choice of language. Does that make you a troll?... As for "Every response was aimed at you"?... What's that supposed to mean? Your response to angeltulips was calm, polite and measured, was it?
And in regard to your comments, it is never acceptable to call someone a schoolyard brat or lacking in brain cells. Look up the definition of "offensive" why don't you?
In reguard to the above comment from rabbitstew.....please check ....WIKIPEDIA
In Internet slang, a troll (/ˈtroʊl/, /ˈtrɒl/) is a person who sows discord on the Internet by starting arguments or upsetting people, by posting inflammatory, extraneous, or off-topic messages in an online community (such as a newsgroup, forum, chat room, or blog) with the deliberate intent of provoking readers into an emotional response or of otherwise disrupting normal on-topic discussion.
Every response was aimed at you....if you want to post comments to people that you know will get a negative response then this is an accurate description of you.....if you don't like receiving a negative response perhaps you should choose your words more carefully!
I have ignored the last 2 letters they have sent me, luckily I don't go to the GP much. With the breast screening I just rang up and cancelled the appointments so they weren't wasted and someone else could use them.
I'm just waiting to be told it would be best to take statins daily, as I'm over 55, that seems to be the current thing now.
I agree that a GP should not put pressure on patients in that way, that talking about someone to a nurse while in front of that person is very rude, that it is not easy just to ignore letters telling you that you should have a screening test, and it is not always easy to explain at the time to someone why you feel they are putting undue pressure on you and that you do not appreciate it. Sometimes it is easier and better to set all this out in a letter, afterwards.
However, I disagree that it is acceptable for someone who specifically said they were "furious" in their first post and whose every other post has attacked anyone who disagreed with them in any way, to subsequently claim that they hadn't started out angry and that their offensive use of language is all the fault of someone they have so far called a troll, schoolyard brat, having no brain cells and this "rabbit" person. littleme61 -if you did not come onto this thread to be attacked for your comments, you have no right to be so unbelievably offensive yourself!!!
I must agree that ignoring the letters isnt that easy. I ended up being tested before i was even sexually active. I got sick of the letters being sent. I was still living at home and got embarrased that i was constantly being sent letters from gp. I tried telling them to stop but they just ignored me and co tinued harrassing me.
Thank you Redtoothbrush....all the above agreed with and any agression or nit picking it totally uncalled for! I hadn't started out angry but after this 'rabbit' person finding something to be snidey about in everything I have posted I can only feel sorry for them to feel the need to do so instead of being constructive! I don't go online to pull someone else apart and don't expect others to do so either!
You can't just ignore everything, because when you are in the surgery for another reason they will try to get you at that point. And changing surgeries is not a quick fix answer either if doctors are told at every surgery to fill their quota.....I would have the same problem again. This is down to choice and not feeling harrassed....some interesting points made here!
I had an interesting chat with my consultant gynae about screening. He is one of the top consultants in the UK ( voted by other consultants) and as it's totally private he doesn't stand to gain anything financially from me being screened- I pay to see him for something unrelated and pay the hospital /lab for screening.
I trust him 100%.
His opinion on screening and 'over screening' is that it is beneficial to the individual who can then make an informed choice as to the next- if any- step.
Personally, I don't understand why anyone would opt out of cervical screening unless they are a nun or a virgin. I have 3 friends who had the worst level of pre cancerous changes picked up by a smear. It's clear what the outcome would have been otherwise.
There is no evidence that having these check ups regularly will help the general population.
Not only is there no evidence, but no research has even been commissioned. They just implemented the idea without assessing its value based on the assumption its beneficial which is shocking. It could be costly, mean that people end up on medication without improving their health but putting them at risk of side effects, it could feed anxiety, it could restrict access to care for people who have conditions which do need monitoring by taking up appointments, it could even in theory have a negative effect on life expectancy through side effects of over diagnosis. The point is we just don't know. Its a live social experiment which we are unwitting guinea pigs.
In response to everyone saying "just ignore the letters" or "just change surgery" I think you don't fully understand the problem.
If you go to the doctors and you are being harassed in person it is very difficult for some people to assert themselves. I have previously been reduced to tears by on GP over it, and she still kept pushing. It destroyed my confidence in her. Thats NOT MY FAULT. That is the fault of the doctor for applying undue pressure which is totally unethical. So I can completely understand someone "sneaking out" as someone on this thread has delightfully put it. I can't abide that attitude as it assumes everyone feels able to do that and its just not the case and doctors have a professional duty to understand this.
As for "just changing GPs". Ever tried it? I have. Lets just say its not exactly easy and I encountered obstacles in doing this. The result is I avoided the GP completely and used other NHS service providers were necessary. It is fortunate I did not develop a health problem during this period.
I have opted out of my new GP's surgery. They don't bother me in appointments now unless its relevant. However, it has not stopped centralised letters coming.
Opting out is more than just ignoring letters. Its about feeling comfortable about going to the doctor, without fear that you are going to feel pressured to make an appointment and that your decision will be respected not constantly questioned.
The NHS doesn't seem to do joined up thinking when anyone does have these tests elsewhere. I have had 3 routine mammograms referred privately via my gynae and 2 smears. The results clearly go back to my NHS practice as the letters I get are ccd to them. However this must not be entered into the 'right' data base because I've since had 2 letters asking me to have a smear and mammogram, within months of having them privately. I have so far ignored them, tough did ring up about the mammo as they had given me a day and time for it at a local portable screening centre and I wanted someone else to have the option.
Once you are over 40 something, they will send you letters for a health check where they will do these, along with a basic cholesterol test.
I have not found it useful, as I have had all those tests done recently for other things, so have not gone for it. There is no evidence that having these check ups regularly will help the general population.
At my gps, I saw the doctor and asked for a cholesterol test as I was worried about it and had it done. I am sure you could ask for a nurse appt and they would do a BP and urine test, if you wanted.
I've had three letters from the GP for cervical screening.
Never been given a blood pressure check or test for diabetes.
I would have, with this situation sprung on me unexpectedly, been too cross and humiliated to reply sensibly, and it would have resulted in me being very rude to the receptionist and walking out in tears. It is made all the worse if it is something I feel strongly about. Leaving and complaining by letter is probably far better, and less likely to get you removed from the GPs list.
It is nice if you can complain correctly at the time, but I need more time to think things out and express them properly, and can understand littleme's situation.
littleme61 - perhaps you should consider the tone of YOUR comments before your accuse others of being unconstructive. You have been a combination of whiney, aggressive, defensive and downright rude from the moment you posted. You reacted badly in the GP's surgery, yet you accuse others of having the problem.
My understanding is that they need an opt out form so that the surgery can reach the target which triggers the payment - the target % is a % of all eligible women minus any opt outs - hope this makes sense. So it s for their financial benefit
It would be nice to have had some constructive replies but I must have mistaken this thread as a place where adults posted comments, not school yard brats! Anyone with a brain cell like to continue this thread?
Rabbitstew.....I didn't realise there was a troll waiting to pick on my every word...!!! Next time I will save my conversations for nicer people! Get a life!
It is true, littleme61, that we all act differently in life, and some actions and reactions are more effective and constructive than others.
If you only wanted to know where to find a template for opting out, you shouldn't have posted a diatribe about the inadequacies of your GP's surgery and your personal reaction to it.
I still don't get the 'opt out'- we are not compelled to go- we haven't signed up to it, or 'contracted in' though I suspect a GP could - worst case- ask you to leave the practice is you were not willing to participate in preventative screening especially if they lose funding through it.
They will have a target- if the practice is in an area where uptake is low, then you are likely to be called/ pressured into having it done. If they already reach their target then they are likely to ignore the few women who don't turn up.
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