To highlight that up to 8% of Cervical Cancers are HPV-independent?

I've followed a lot of cervical screening posts. I'm not saying who's right or wrong, but I do disagree with posters saying stuff like, " if women say they don't screen, or that the test is worthless now it only checks for HPV it will make others decide it's fine not to go."
Actually, women aren't stupid. I've never actually seen anyone out and out saying, don't go, you shouldn't go. If anyone tried to post this I suspect moderators would remove. I've seen women say , I don't screen, and sometimes they explain why, and embarrassment and being scared of the pain isn't as frequent as might be expected. I personally don't screen and have opted out completely. I'm not about to suddenly opt back in and have a smear because people I don't know on Mumsnet tell me I should, and I'm sure it's vice versa too.
Also, the smear test was never put through random controlled trials, it was just rolled out. I read that if it hadn't been invented at all, but was suddenly invented now it wouldn't have passed the criteria to become a screening programme. Also that any screening test should be acceptable to the target population in this case women. Now we have a self test why not offer to non screeners? Surely anything is better than not screening at all, and some non screeners might accept a self test

I too had CIN 4 non HPV pre-cancerous cells and had part of my cervix removed. This was about 17 years ago and it still bothers me that I no longer have regular smear tests but HPV tests.

Well seeing as I don't have a cervix anymore ( due to my insides ripped out to remove cervical cancer) I won't try. It's a lot more hassle than a smear test every few years and less reliable id say.

My doctor told me that you can test negative but still have the virus, and just not be "shedding" it.

Selfie stick? If you took
a video you can create stills from that.

Id never be able to bend myself into the correct angle

Just done a bit of Googling and came across a website which is actively promoting checking out your own cervix. The pictures are very clear and there is a gallery of photos with various conditions.

https://www.beautifulcervix.com/see-your-own-beautiful-cervix/

I expect you could get a decent enough photo nowadays using your phone with a video and torch setting. Obviously you’d need a speculum too.

This is an excellent and very necessary thread. Thank you OP.

@Sidgeall my “smears” have always been clear. Last one was a HPV one. Have not had sex since. Am 51. Is there any point in me going for another HPV “smear”. Just received text from dr that I am due one.

if there is any point, please can you tell me what the point is? Is it that the nurse will do a visual examination of cervix to look for any changes? If so, surely this is prone to missing important changes that are hiding or next yet visible?

I hadn't realized it was as low as that.

The error rate for smears is higher than that

I guess they will phase them out.

Very traumatic for a lot of women with past trauma for very little return

I think a home swab for HPV is better than nothing at all. And I like the idea of women having the choice of either standard cervical screening as it is, or a self swab for HPV as long as they understand if positive, they’ll need cytology I.e. a standard sample.

And yes I could see that woman had cancer. It’s very distinctive.

I’ve also referred probably hundreds of women to colposcopy alongside their screening due to my concerns at the appearance of their cervix, or because they had polyps.

So would you say that a home test swab would be more beneficial than women having to go for a smear which is only tested for HPV now?

For that one case of yours, did you detect abnormality visually?

Yeah this isn’t a thing. Crikey it’s hard enough sometimes to visualise a woman’s cervix with a speculum and directed light, left alone expecting women to examine their own cervix! Half of my patients probably can’t touch their toes, let alone fold in half enough to find their cervix. And if you can feel a growth you’re probably in trouble. Also how will women know the difference between a polyp, an ectropion, a transformation zone and an abnormality.

Many of you seem to be forgetting that a cervical screen is just that - a SCREENING tool. It is NOT a test for cervical cancer, it is a tool to detect earlier cell changes that if left unchecked may one day become cancerous.

In all my years of taking smears, and I’ve taken about 10,000, when audited only one of mine had a cancer result. Anecdotal yes, but there just aren’t hundreds and hundreds of undiagnosed cancers out there especially in women attending for screening. There have been hundreds of referrals to colposcopy though. The system isn’t failsafe of course but as a screening tool it’s valuable and viable.

If you have bleeding between periods, and bleeding after sex, you need swabs for infection, investigation and referral to colposcopy. What you don’t need is a “smear” which is a primary HPV screen.

Women could be taught how to check their own cervix visually with a mirror and feeling for any unusual growths etc. This, alongside self swabbing at home for HPV would be a far better way of detecting any cancer early.

You know " putting " someone through a smear whilst uncomfortable and unpleasant is a lot less nasty that putting someone through a radical hysterectomy, radiation and chemotherapy

My daughter was called for a smear recently- she has been vaccinated against HPV already so I’m not sure what the point is of putting a young woman through it?

I’ve also just attempted to look up deaths (UK) due to non HPV cervical cancer and I can’t find any statistics. I would quite like to know those rates as opposed to statistics on women with abnormal cells which may not go on to be cancerous.

I completely agree. I asked the nurse at my last smear what the point of doing it was as I have definitely not got HPV. She couldn't really answer. It needs more publicity.

I disagree - of course it’s invasive!

Have you read Margaret McCartney’s The Patient Paradox - Why sexed up medicine is bad for your health?

Yes - I definitely agree.

It would actually pick up more women who don’t routinely go for smears due to the invasive (and sometimes painful) procedure.

I actually thought they were considering this?

Smear tests are meant to pick it up when there are no symptoms.

if you have symptoms it’s developed too much!

This is a concern for me too frankly

I hardly think a smear test is invasive. A colonoscopy, an ERCP maybe which DH has to have every 3 years. For many years smears have saved the lives of thousands of women. It's been a godsend and was a game changer. Can we not vilify it please. Posts like this encourage women to not bother going and take up rates of smear tests are a record low.