Do I really need a smear?

[humblesims]

Its that time again. The letter has come to make an appointment. I have always been responsible and had the smear test even though I hate it like everyone does.
But I'm fifty two. I dont want to go anymore. I'm menopausal. I have piles. My fanjo is not as neat as it was (I know that counts for nothing).
When does the risk of cervical cancer reduce? Will I still have to have smears when I'm in my dotage?
I know I'll go but...I'm tempted not to.

[PollyPerky]

You need them until you are 65 and for longer if you have a new partner in between smears, as you are then exposed to a new risk for HPV, which causes cervical cancer.

[MajorClanger123]

My mum got to 60 & decided she couldn't face smears anymore, she found them so painful. She does, however, always go to her mammograms when invited.
Personally I wouldn't turn down any free cancer screening, 10mins of discomfort every 3 years is nothing really.
But it's up to you - you don't have to go. No idea about when or if the risk decreases - I thought risk increased for most cancers with age.

[humblesims]

yeah i guess. I didnt useed to be bothered about having them but these days find them much more intrusive. But...you're right I should (and will) go.

[BumWad]

Yes.

[terrylene]

Incidence increases with age, same with all cancers.

[dudsville]

I felt like you but I'd be dead if I hadn't gone. It's not about how pretty but about healthy. You've already decided to go, I'm just hoping to help you steel your resolve!

[Delilah1234]

Yes, but on the bright side, if all is OK, your next one won't be due for 5 years. Screening stops at 65 if your smears have been normal.

[Wolfiefan]

Yes. Every five years. I bloody hate them but they're better than the alternative.

[terrylene]

Not having a smear does not result in cancer though.

Not having a smear means you don't pick changes up early that might become cancer, if you have them.

[SayNoToCarrots]

www.independent.co.uk/life-style/health-and-families/features/why-im-saying-no-to-a-smear-7577967.html?amp

[Wolfiefan]

I'm aware it wouldn't stop me getting cancer. I would much rather detect any changes as early as possible and greatly increase my chances of survival.
Still hate them though!

[PollyPerky]

Screening does stop at 65 (NHS guidelines) but my consultant did say that there is a caveat to this in his opinion; women who have new sexual partners post 65 (or after a run of normal smears in their late 50s - 60s) should continue with them because of the risk of new infection with HPV. I personally think the 5 yr rule for older women is too little and always have mine done (privately) every 2- 3 years. I've known quite a few younger women who had abnormal results long before the 5 years.

[PollyPerky]

Sayno I think that feature is quite badly written tbh. Ok she's a GP, but so what? She doesn't make the argument against screening that effectively in my view. She admits that cervical smear screening saves lives, but only a few. From a financial point of view you could argue that it was a waste of NHS cash. But for the individual women, it's not a waste. The point of screening is that something which is or may become cancer is picked up early so the treatment, if any, is less invasive than if it were delayed. The end result- number of deaths - may be no different, but the impact on individuals may be different. eg with mammograms, a woman may have a small tumour found and treatment started, and she may live just as long as someone who did not have screening and who had a much bigger tumour . Both may still be alive 5 yrs later but woman A may have only had a lumpectomy whereas woman B may have had major surgery, radio, chemo and ongoing medication for life. But all the stats show is 'number of deaths'.

[PurpleDaisies]

The point of screening is that something which is or may become cancer is picked up early so the treatment, if any, is less invasive than if it were delayed.

Screening leads to over treatment of changes that if left to their own devices would return to normal.

It's not as clear cut as you've described it here.

[LunaTheCat]

Yes definitely. Women at most risk are older women who have not had regular smears. It can take cervical cancer many years to develop.
The doctor or nurse won't care about the state of your nether regions - has seen heaps before.

[PollyPerky]

Screening leads to over treatment of changes that if left to their own devices would return to normal.

it's not as clear cut as that!

SOME changes may return to normal. Some may not. You need to be more specific .

Many cervical changes are left and 'watched'. Breast changes may never develop.

The point is that women can choose. Whatever the results of screening, we have the option to say 'no' to treatment. The important thing is to have the facts. No one is forced to have treatment if screening throws up changes. But knowledge is power. Use that knowledge to make an informed choice. A dr may recommend treatment but there is nothing to stop anyone saying they prefer to wait and see.

[CherryLip]

I say yes definitely. I am fifty three and have just had my first abnormal smear resulting in colposcopy and cone biopsy this week. I'm waiting for the results. My previous smear was only two years ago which was done privately as I am not in the UK. When I left the UK I had been moved onto every five years (sixteen years ago!).

[humblesims]

Thanks for the replies. I realise that I do need to go and I will. Cherry I hope everything goes OK for you. I'll book the appointment now.

[CherryLip]

Thank you humble. You've made the right decision.

[BradleyPooper]

And in most counties I've lived in, smears are recommended annually so yes, definitely do your every 3 years!

[Puggsville]

Annual smears for women who haven't had any abnormalities previously detected are unnecessary. Even the USA has changed from annual smears to every 3 years.

[Kat786]

Actually menopausal women stand a big risk of producing a false positive result as a result of hormones. It's also harder to collect the sample. Cancer research UK says our chance of developing cervical cancer is just 0.65%. The vast majority of older women are HPV_ and cannot be helped by smear testing. However they can be damaged by over treatment. Even CIN 3 changes can go back to normal with no treatment. I decided 17 years ago I wasn't going to put myself through any more smears . I'm 53 now and very healthy. The Dutch and Finnish women have been offered A HPV self test for quite a while now. We still have the outdated speculum exam. I'm not telling anyone what they should do. It's your decision. But women have been misled for years about smears. Doctors get incentive payments for smearing a certain percentage of their women patients@

[tribpot]

HPV primary screening is in the process of being rolled out. For the reason you give, Kat786, that it reduces the amount of unnecessary treatment given for cervical changes.

[Kat786]

Tribput I get your point. Indeed primary HPV is being rolled out. As the same speculum test we have now. And most women hate the test and it can be agonisingly painful. Our NHS is still dithering about self testing. I am happy to live with a 0.65% of developing this disease by not having smears. Other women might choose to have the test. That's their call. I've also opted out of breast screening. It makes no sense to me to crush delicate tissue and bombard them with radiation and I'll also be declining flexi sig.

[terrylene]

I have been following the HPV developments since they were in New Scientist in the 1980s. It is a shame that they will do the same old smear test, then only test for HPV by using primary screening. It would be much better to find and easier test for people to take. It is the faffing about with the speculum and the awkwardness of the whole thing that people hate.

I am also fed up of the mammograms. They must be short of people to have them round here as I never get the whole 3 years. At the age of 53, they have just called me up for the 3rd, and I was extensively mammogrammed and US'd when I was recalled after the 2nd. You can go off them .........

With the flexible sigmoid thing, I would much rather have a full colonoscopy as I have a long history of bowel stuff, but there is no flexibility in the screening system for individuals.