To not understand smear tests.

I agree there’s been a lot of misinformation about smears recently and its worrying that 17yrs after Jade Goody’s death that initial increase in smears seems to have long dropped off. Before posting worrying stats online you really do need to check your evidence as is scare mongering. If having a private smear makes you feel better then pay for them as peace of mind is invaluable.

@Moltenpink I perform cervical screening as part of my role. Part of our training is to recognise visual signs which are suspicious of cervical cancer. So you not only have the sample taken but you also have someone who is qualified to do a basic assessment actually visibly checking your cervix.
another thing to consider is the fact that once HPV has persisted for a period long enough to cause cancerous changes then a swab test could actually come back negative as by the time cell changes have occurred and become actually cancerous (usually 10yrs plus so typically someone who doesn’t
attend for regular screening) then the virus has actually become undetectable again.
Hope that makes sense?

I believe it's because if it's positive they can perform the cytology report without recall. Does make a certain degree of sense. Also, it doesn't hurt to have someone look at your cervix. I was sent to colposcopy because the nurse that did my smear thought something didn't 'look' right - not because I was hr-HPV positive

The 99.7% predates HPV vaccination, though. In countries with a long standing vaccination campaign (such as Australia) the percentage is smaller and dropping. We haven't had it as long but most of the body of research in the UK predates us having vaccination in place. While the incidents of HPV-independent may not increase, the % has and is decreasing.

OP - you may have to go private. I had an HPV-independent Adenocarcinoma In Situ removed by the NHS. The test of cure was an HPV test. I've been on 6 months recall for nearly 5 years. They take extra swabs every time because the type of growth is aggressive and easy to miss (prone to skip lesions so clear margins aren't as reassuring etc). They're binned every time without testing as I'm (still) hr-HPV negative. The moment I'm discharged (likely after my next colposcopy) and haven't got someone looking at my cervix every 6 months I'll be going private for full cytology.

I asked the same questions as you until the consultant wrote to the lab asking them to test cytology regardless of HPV result. They refused due to HPV primary testing.

There seems to be a lot of knowledge on this thread- does anyone know the reason why they continue with the invasive test, when HPV testing can be done with a swab?

I fear the same OP. I also had cell changes (and LLETZ treatment) whilst testing negative for HPV and have exactly the same worries. I think for people in these situations they should test for both HPV and cell changes.

I refer many women with asymptomatic polyps than can become cancerous.

Lots of misinformation on this thread.

Most research agrees that 99.7% of cervical cancers are caused by HR-HPV. This is high risk HPV strains, which are totally different to other strains of HPV (and there are hundreds) which can cause simple warts, verrucas, skin tags etc.

There are not 11% of cervical cancers being missed by primary HPV screening.

Lower grade dyskaryosis can occur without HR-HPV (rarely) but these are not cancers and are very unlikely to ever become cancerous.

The poster who thinks she doesn’t need a smear because she’s had warts as a child is dangerously mistaken.

@BooksandCats123 you don’t need a smear now, as that’s a screening tool not a diagnostic procedure. You need review at colposcopy. Oh and don’t ask the GP about private smears as they are unlikely to recommend anyone.

That is absolutely not correct.

Having a wart as a kid does not mean you're immune to HPV. Just because a viral wart clears up, that doesn't mean your body has rid itself of a virus. It can just mean the virus is dormant.

Also, there are multiple strains of HPV. The one that caused a wart on your hand isn't necessarily the same strain that's associated with cancer. Go and book a smear test.

Kindly where are you getting this 11% from? Except for AI?

I understand from your history you're anxious but you will scare yourself and others by overestimating the risk of HPV testing. Studies of the rates of HPV negative cancers have shown they're even less common than previously noted because often the diagnosis was wrong in that their cancer wasn't cervical in the first place so you'll find very few reputable data sources that will place HPV negative cancers anywhere near as common as 11% especially in the UK. Also, unless you have any of the risk factors for the very rare non HPV related cancers (DES exposure or immonocomprimised) for example, your risk is very low. Were you treated in the UK before or are you comparing UK screening to elsewhere?

You can pay to have a private smear test or course but the NHS process is based on evidence that wouldn't put more women at risk than the previous screening protocol and you can read through the studies behind.tjr rationale on the cervical screening website which might help your anxiety..

Wishing you all the best at your Gynae appt but I do worry about the increasing amount of misinformation about smear tests on here lately and I hate to think of anyone reading who has a HPV negative test thinking there's anywhere as high as 11% risk that they're going to be missed for a cancer.

Is there a non invasive way instead of a smear test?

(For a physical reason the traditional smear test is problematic)

Most sources agree is 99.7% are related to HPV. They're also not "only checking for HPV" because they do go on to test the cells in those that are HPV positive and this method is picking up all the women who traditionally slipped through the net because their cells were negative (cytology testing is far less sensitive and can depend on accuracy of the sample taker) yet have persistent HPV which is referring them for further tests and diagnostics compared to the old screening methods.

I had thought it meant your body had encountered and cleared the virus and so had antibodies to it. However have had that cleared up via pp. I will be getting a smear test I think

I always thought that the presence of warts/verruca etc meant that you did have HPV and so were more at risk of the dangers of it?

I agree OP.

The original smear tests had a lot of false positives leading to unnecessary further testing and stress for women. I think the change in testing method makes sense.

"you are correct - the 3-11% of cervical cancers that are not associated with HPV will now be missed and not detected until they are symptomatic and probably too late."

"About 99% of cervical cancers are linked to high risk strains of HPV."

So which is it? Up to 11% of cancers linked to HPV or 1%?

The cynical side of me suggests that this 11% are worth sacrificing for the financial gain of degrading the smear tests (from checking for cell changes to only checking for hpv).

I had mine last week and although mine was negative for HPV it said in the results to see a doctor if you have any unusual bleeding (including after sex), changes in discharge, pain during sex, or lower back/ abdomen pain. I think between the screening and that advice they’re probably doing as much as they can - no screening can be 100% accurate.

@BooksandCats123 As you have bleeding symptoms a cytology test is irrelevant. You need to be referred for a gynaecologist to examine your cervix, and take a biopsy. If a gynaecologist is concerned about your history they can keep you under review with them.

Agreed on all of this. Some people are assuming lesser because it's not testing the cells if you don't have HPV are forgetting that many women in the past were having their cells cytology tested negative and getting put back on routine 3 year recall whereas with HPV testing these women are being picked up for more regular screening.

It’s not a ‘lesser test’; it’s been proven to be more accurate than traditional cervical cytology. About 99.7 % of cervical cancers are linked to persistent HPV infection, many to specific high risk types. The HPV test has a greater sensitivity than traditional screening and less risk of ‘human error’ in taking and reading it.

Thanks for the info x

HPV can be dormant in the body for years so it’s still worth getting a test. If you don’t want to have a ‘smear’ then you can get a home HPV test privately, which you do yourself.