Women failing to attend smear tests

'I did the old NCT classes where it was all about relaxing and breathing and it can make a difference, again maybe doesn't work for everyone but I know if I can get my breathing going and relax it can make some unpleasant procedures more bearable, last year having a colonoscopy was a case in point.'

That comes from within you, though. I've been practising yoga for 20 years now and have used it quell panic attacks, get through some medical procedures, etc. But someone telling me to do it won't work, it'll probably ramp up my anxiety because I have PTSD. I try to, anyway, and I'm one of the fortunate ones who doesn't experience painful internals or smears (I've also had colpo and LEETZ when I was 30 and I do have HPV) because by the time someone is ordering me to relax I have already tried.

It's better to tell people that there's a range of experience and some people find it painful and if you do then to not hesitate to say so and they will stop what they are doing rather than bark at someone to relax.

Also, I come out of the dentists with shiny teeth - not keen on getting my fanjo polished

Everyone will have problems with their teeth. Cervical cancer is a lot rarer than dental caries and gum disease.

I've not got much further through the thread than the comparison to going to the dentist. In fact I think there are similarities , lots of people are scared of going to the dentist. Some for obviously understandable reasons relating to past dentist experiences , others for less easy to pin down reasons and feelings of anxiety. Both procedures can leave you feeling like an object being prodded and made to do things that don't feel natural or possible. The difference is culturally we all know and accept, even expect people to be scared of the dentist and an industry is building up of dentist who brand themselves as skilled in dealing with nervous patients. For a smear test instead we are branded as 'embrassed', 'unwilling to make time' , 'risking our children being motherless' How about a bit of acknowledgement that there are valid reasons for not being comfortable with the procedure, that it can be difficult and that staff will accept that and treat you with that in mind. 'Embarassed' trivilialises our feelings and experiences.
It's the same as breast feeding where they constantly tell us is easy it is and won't acknowledge or help when we experience the many potential difficulties.

"Offering BRCA screening to all women has been suggested recently"

I agree that this is unlikely to be affordable right now. I think it'll continue to be only those likely to be in high risk groups from family history (and perhaps extend next to those whose family history is unknown).

And also perhaps if there is a need to run a gene test on a woman (for any reason) there could be a way to add on BRCA (as the cost of growing the cell line would be incurred anyhow)

Ovarian cancer is much commoner and more deadly than cervical, yet there is no screening for it and limited awareness of its symptoms.

"In order to save one life from cervical cancer, the research found, 1000 women would need to be screened for 35 years. Worse, the researchers suggested that testing might do "more harm than good": women born after 1960, they found, have a 40 per cent chance of having a smear test labelled abnormal at some point in their lives"

a) 35 years is the standard time for screening in UK., from 25 to about 60. So they are saving one in one thousand women who follow the normal schedule I've run their lifetime. Sounds a bit different put that way, doesn't it?
b) when they say 'labelled abnormal' what did they mean? All CIN? If so, what proportion of those were CIN1 and had no intervention other than a time in enhanced recall?

There seems to be a fair amount of confusion about what the test results can mean. Perhaps more education on this, and how CIN1 does not need treatment, is a step that could usefully be taken. I think it's a good thing in itself to have more and clearer information readily available for medical matters and NHS protocols.

You realise telling the true means saying, that women experience a range of possibilities from no pain to lots of pain, don't you? If that was to me then yes I have said that. I don't think we should assume everyone will find it painless any more than we should assume everyone will find it painful.

there's a general taboo around the refusal to have screening of all kinds because we're not allowed to say "hey, I've got to die of something" anymore. I am absolutely terrified of long life. My family has a huge problem with longevity before any of this medical intervention even happened - many relatives living to 90 when 70 was considered amazing. Maybe that explains different attitudes, in my family some of the men are long lived, plenty of the women died in their 40s of breast/ovarian cancer. Some of my cousins were children when their mothers died and some just babies. Nothing to do with smears, ovarian cancer is much harder to screen for. I think our experiences will colour how we look at the benefits and risks.

For women in general the risk of breast cancer is estimated at about 12%, if you have the BRCA1 gene it is somewhere between 70 and 90%. Ovarian is under 2% for general population but about 40% with BRCA1and the risk starts earlier. Very different if you are comparing risk v benefits.

Offering BRCA screening to all women has been suggested recently but I imagine the cost will mean it won't happen. I know for me to have the tests privately would cost £1,300 and they know what to look for with me. I assume if you are looking for 1 and 2 and no guildance on which mutation it would cost more.

"they just said no not really and changed it back to a 3 year recall"

I'm not surprised it they were a bit non-plussed. Staying on annual recall should expire - it used to be 3 years normal after CIN1 (wait and watch, as those are the changes which are often self-correcting. Not sure how long they go for CIN2 - prob the same

I'm a long-term smear refuser. I've tried in the past, but it doesn't work.

I cannot even have sex lying on my back with my legs bent, and that's when I am aroused. It's nothing to do with "relaxing", it's physiological and violating that causes me great pain and distress.

I've had other types of internal exam that were easier. A swab for a vaginal infection that I could self-administer and was the width of a cotton bud - that was very simple and painless. No being violated with metal objects, no lying on my back while a medic pushes and scrapes away at my genitals.

Thank you Ihave I really appreciate that info. Sadly, the 700+ mile round trip and my stupid periods make it difficult, but I will try. I am in the middle of intensive C-PTSD therapy, which will also hopefully help.

Women are things to be processed in healthcare. That's about the sum of it.

You realise telling the true means saying, that women experience a range of possibilities from no pain to lots of pain, don't you?

You said we should just be positive or it will scare poor little women like it scares them with childbirth.

A lot of women just want honesty and acknowledgment that a range of possibilities is possible rather than being spoon fed sugar coated inaccurate crap.

UpAbitLate "Anyway so I was on a 1 year recall after that until a few years back when I said look I've been coming every year for 20 years and it's really difficult to organise and do I really need to and they just said no not really and changed it back to a 3 year recall"

box ticking exercise. Ridiculous doesn't even begin to cover it.

isn't there something going on at the moment with mammograms picking up alleged "problems" which are actually just "changes" that are totally harmless?

Xenophile -

www.mybodybackproject.com/services-for-women/mbb-clinics/

Massive waiting list but worth the wait.

xx

It must've been the first one mustn't it.

I remember it well as I got the pill in 5th year school (GCSE year) and then had to go for this colp and my boyfriend rather than saying oh no hope you are ok, said could I have caught it, and that really fucked me off.

If you don't tell the truth and lie to women it can be distressing when their experience doesn't match the reality. But don't you think that works both ways, the reality is that some women find it uncomfortable, some women find it painful, some women find it agonising and some women find it easy. Why is it only OK to tell them one side of it, and I mean that for the people who think it is easy for everyone as much as the people who think everyone needs to be scared about it.

Obviously shouting relax at anyone isn't going to work, I did the old NCT classes where it was all about relaxing and breathing and it can make a difference, again maybe doesn't work for everyone but I know if I can get my breathing going and relax it can make some unpleasant procedures more bearable, last year having a colonoscopy was a case in point.

The first one or second one came back CIN2 so I was sent to GUM clinic central london where I had a colp.

I didn't really know what was going on and did as I was told TBH.

Since then they found that is is normal for young girls to have changes and that's I think the reason they increased the age. I smoked as well and so apaprently young + smoker = funny cells but highly unlikely to be cancer.

Anyway so I was on a 1 year recall after that until a few years back when I said look I've been coming every year for 20 years and it's really difficult to organise and do I really need to and they just said no not really and changed it back to a 3 year recall

Fucking ridiculous the whole thing.

Also when I was pg they said that having a colp can give risk of miscarriage but actually most of them were sceptical that this had even happened and 1 said she didn't believe me because it was so young WTF

Most were women so it just goes to show how little even female HCPs trust the word of their female patients.

Snowdrop I wanted the pill.

well I was sexually active from 17 and on the pill but I had moved out of my parents the first time I was asked so must have been 19. Asking someone to have it immediately they go on contraception seems a bit odd.

I've found all of them, except for the one I paid a consultant gnae to do, painful. One nurse castigated me for not relaxing and said she didn't know how I managed to have sex if I was like that. The practice nurses at my GP are both off hand and obnoxious, I won't have one again. Personally I find it patronising to be given a mammogram appointment - as if I could move everything to go. They won't remove you from the system unless you sign a disclaimer so after numerous requests and telling them I have no intention of having the screening I now just don't bother to go and telephone them afterwards to tell them why.

And it's even worse in the US where girls as young as 12 are routinely having gyno exams. I dread to think how many times I've been unnecessary examined like this and I didn't consent to any of it. I'm still alive and my vagina didn't kill me

I have had had 3 unnecessary utterly pointless and useless breast exams (sitting up through clothes and a bra in 2 cases) and one unnecessary internal (quick stick the finger up - yes its a vagina type) so that I could stay on the pill.

I had one thorough exam when I went on the pill, done correctly and explained by a competent doctor. This may not have been necessary but it was considered good practice in 1984. (the year, not the book).

I had smears from 16 as well.

I started having sex at just 16 and went to get contraceptive pills from brook in london (anonymous service). Back then, anyone who was sexually active was supposed to get smears. So they said I should and I said OK.