Women failing to attend smear tests

"The pressure exerted, on women to undergo a procedure with highly questionable benefits must have something to do with the target and funding structure. Or lack of information in the case of some of the non-doctor HCPs
Howzabout hats with "My Twat Is Not Govt. Property" on? Or knickers - which on reflection would probably be more useful.
It is the failure to follow up on symptoms (and ironically the fact that the precious, wonderful test can't be done when the symptoms are going on, unpredictably, for months) that is the cause of cervical cancer mortality or severe morbidity in young women. Not them not going for a smear."

I'm really very tempted to have that tattooed on my bum and then go for a smear, but Iike the idea of the hat very much. Yes, smear tests are a feminist issue - my GP advised me to take statins, but immediately backed off when I said no. No such luck with smear tests, when they only backed off when I sent a strongly worded complaint and took myself off the list.

This is partly a problem of the NHS being a behemoth that once it's got an idea in its head is hard to turn round, it's partly a problem of 'cancer prevention' being seen as politically popular, it's very much a problem of scientific illiteracy, but also hugely, it's down to sexism and misogyny. Women are treated as vain, silly creatures who can't make a decision about their own bodies.

"Hear hear U2 the pressure on women to have mamograms is immense and after reading the Cochrane report I too decided not to have a mammogram, "

Betty - I have taken myself off the mammogram list, like I've taken myself off the smear test list. Same reason - if you look at the cochrane review, there is absolutely no overall reduction in mortality with mammograms. So a mammogram MAY prevent breast cancer, however you may also end up having treatment for a cancer which would never have become life threatening and the treatment itself will actually kill you!

That's not to say that some individual women may not have their life prolonged by a mammogram, but at a population level, in terms of reduction of mortality there is no benefit whatsoever. I happily say this to people, though I'm obviously a bit wary about launching into the discussion with people who have had breast cancer themselves or lost a close relative to it unless I was very sure it wasn't going to upset them. You have to be sensitive to other people's circumstances, but I don't see any problem with telling the truth. Only about 50% of women go for mammograms, but they will probably never be stopped because of political pressure from interest groups.

The woman I know who is undergoing breast cancer treatment has two young daughters. She went for BRCA screening which was negative, and the nurse said they didn't know, in the absence of a positive result, why she had got early cancer, but not to worry because when her girls were grown up, they'd have a cure.

The nurse obviously intended to reassure her, and was probably trying to be kind - but all I can think is that she is now being put through endless anxiety (on top of cancer treatment) about not only why she got the cancer (answer - we don't know) but that her daughters may get it. Is this helping anyone?

Because I've got a strong family history of heart disease, I was told to go to a lipid clinic at the hospital (my doctor did a cholesterol test without consent, but that's another story). I trotted along and discovered they didn't offer genetic testing because it's too expensive. So having been put in the position of wondering whether I had a gene mutation which raised my risk of heart disease or not, I then had to go through a stressful and prolonged complaints process to get the test done. It was negative.

Three years of anxiety and stress (which have probably raised my risk of heart disease) for nothing at all. That's why I give screening a wide berth these days.

What is totally neglected with health screening programmes is the psychological harm they cause.

I've not had time to read the whole thread yet, I plan to at the weekend, but does anyone else hate the name 'smear' test? To me it sounds quite insulting and degrading.

As a noun: 'a sample of tissue or other material taken from part of the body, spread thinly on a microscope slide for examination, typically for medical diagnosis'

As a verb: 'coat or mark (something) messily or carelessly with a greasy or sticky substance; "his face was smeared with dirt", or: 'damage the reputation of (someone) by false accusations; slander, "someone was trying to smear her by faking letters'

I attend for the god awful test, but I just cringe when I have to phone up and say the word. Much like I do when I have to say the word moist!!!!!

The pressure exerted, on women to undergo a procedure with highly questionable benefits must have something to do with the target and funding structure. Or lack of information in the case of some of the non-doctor HCPs
Howzabout hats with "My Twat Is Not Govt. Property" on? Or knickers - which on reflection would probably be more useful.

It is the failure to follow up on symptoms (and ironically the fact that the precious, wonderful test can't be done when the symptoms are going on, unpredictably, for months) that is the cause of cervical cancer mortality or severe morbidity in young women. Not them not going for a smear.

Has anyone mentioned that nasty scratchy brush that they use now? Surely only a man would develop a tool that is more effective (I believe) but significantly more uncomfortable to the patient

I have to say that I don't fail to attend, but I choose not to.

I'll have good read of the thread tomorrow.

Yes it’s like it’s my dirty little secret terfinator it’s been good to come on here and talk about it as I don’t feel quite so alone in my decision.

Betty it's shocking that you feel that way. It really highlights to me that these screening tests are not optional for women. Not medically and not socially.

I just watched a thing on the BBC - apparently it's not finding the time, it's being embarrassed about having not waxed the bikini line, or about any possible smell.

This is true, and makes me remember a well-known poster on here one time, on one of the regular pubic hair-removal threads saying that her friend who was a midwife, thought full bushes were hilarious. The Mner also thought it was funny - they obviously had a laugh over it together.

I'm not surprised that (especially younger) women are being put off, if you suspect the HCP is judging you, or even worse, laughing at you.

Hear hear U2 the pressure on women to have mamograms is immense and after reading the Cochrane report I too decided not to have a mammogram, however it’s not something I dare say out loud to any of my female friends, they would be utterly horrified at my decision I have done a huge amount of reading on the pros and cons of mammograms and my decision is an informed one, if I have symptoms I would get them investigated straight away of course, my doctor is none to pleased with my decision either.

I just caught up with this from the Independent - and unfortunately the MP shows the depth of confusion over this subject.

www.independent.co.uk/voices/theresa-may-smear-tests-pmqs-cervical-cancer-screening-nhs-womens-bodies-health-a8175846.html

The 25 year old woman who tragically died did NOT need a smear test, she needed a gp who listened to her and referred her appropriately for investigations. Smear tests are not offered to under 25 year olds because in this age group there are so many cell abnormalities that would resolve themselves spontaneously, the test is useless.

However under 25 year olds can , very rarely, get cervical cancer or pre cancerous cell mutations - Jade Goody was first treated for abnormal cells aged 15. The answer however is not to extend smear testing to under 25s, it's to stop GPs fobbing off women who go to them with actual symptoms that need investigating. One problem is that GPs are so underfunded these days that they're very reluctant to refer anyone, though we can't really say what happened in this case. But the answer was never a smear test, which many people don't seem to understand is a screening test for asymptomatic women, not a test for cancer.

I've tried diazepam to no avail, although stumbling about giggling afterwards, while still off my face on a high dose of Valium, was quite amusing.

I also wonder about being medicated for it. Its tempting, My doctor has never offered that though bu apparently a few of my friends are given diazapam or something like that for their smears. I would prefer that but am unsure how to ask tbh

I am genuinely very sorry when someone dies, believe it or not I had a traumatic major bereavement recently and someone in my family died from breast cancer under 50. One of the saddest funerals I have ever attended. I also have someone relatively close to me having treatment for breast cancer at the moment.

None of this changes my mind on screening, any more than the fact that large numbers of my family have dropped dead of cardiovascular disease at young ages and my brother two years older than me just had a heart attack will make me take statins.

Because we are talking about preventive medicine. All preventive medicine has some benefits and some risks.

For me the benefits (small chance of avoiding illness or prolonging life) do not outweigh the risks (much larger chance of taking a medicine/having a treatment that will not benefit me at all).

I do use some preventive medicine - I have a flu jab annually. That's because a flu jab literally takes seconds, and has only very minor, if any, adverse effects. I am so far from being a tin foil hat conspiracy theorist I positively love my flu jab, that lessens my chance of getting flu, a horrible illness I've already had twice in my life. Chances are I won't catch flu, but the point is the risks with a flu jab are negligible so benefit outweighs risk for me.

I'd never tell a woman not to have a smear test, or a mammogram, or anyone not to take statins. But I choose not to do these things myself. All I'm saying is understand the benefits and risks before you have any medical treatment.

And emotional blackmail using dying women is not a good look.

Yeah I did know they cannot strike me off for not rebooking. I have huge issues with them threatening me all of the time, and its really bad as the surgery I am at currently is actually the only one I can register with. I tried switching a while back and was told that its all down to certain areas and mine is the only one I can use. I have been trying for 4 months now to get my implant removed as I don't think its working anymore (long story short, it stopped my periods, and now they are back with a vengeance after none for 2 years) and they keep telling me its fine, doesn't need removed yet and such. But I want it out and want to go on the pill. I actually want to be sterylised but apparently I may decide I want more children...even though I know I won't. Been tempted to tell them I am actually a transman so I can get the treatment I want, but don't want to be on testosterone lol

.perhaps take yourself off to a hospital with terminal cervical/breast cancer patients, perhaps look at the faces of these women who are dying and also look at the sad, petrified faces of their children....ffs!!!

I admit I haven't rtft but I got this far and had to respond. This post is disgusting. I do have smears but I am thinking of leaving it longer in-between each one in future, due to all the reasons already stated. Or I might decide not to go again. I am actually fine with smears, they don't hurt me or bother me in any way. I just don't like the idea of treating something that may never lead to cancer, something which the body very often deals with itself. I have also decided that I won't have mammograms.

I have cared for many people dying from cancer in my old job. My children lost their father to cancer. I have looked at their petrified faces. I simply don't believe a smear is very likely to save my life at all, especially when I am low risk of getting cervical cancer in the first place.

I have to die at some point, there are many things I could die of that can't be screened for. If I have worrying symptoms I will get them checked out, but I am not going to be guilted into any preventive testing from anyone.

People need to back the fuck off women who decide not to have them and worry about their own cervixes.

If women aren't attending screening tests due to embarrassment then that needs to be looked into, guilting them isn't going to help.

Thanks for the link - it's a great read.

I just love Margaret McCartney and also Ben Goldacre for the way they explain the muddled thinking of so many medics.

Doctors are just people and statistics is damn complicated stuff - Goldacre is an absolute genius, not only in the way he takes stuff apart, but in the way he explains it to a general audience. Dunno how much they go into it at medical school, but I suspect it's not in depth. McCartney is also very good on the pressures on yer average GP - which she obviously knows all about being a GP.

Theresa May has just acknowledged smear tests can be uncomfortable in PMQs"

Hangs flags out Or maybe she just had a bad experience herself?

I apprectiate that's a complex argument, but it seems even women can understand ti!

A few years back there was some research done in how risk well doctors understood risk.

It found was that the vast majority of doctors were pretty much statistically illiterate and didn't understand how risk worked. And these are the very people who are supposed to be able to explain it to women!

www.bbc.co.uk/news/magazine-28166019
This is an utterly fascinating article about it. Its eye opening.

"Outside the developed countries, many women are dying from cervical cancer. In the UK our rates low, because of screening."

Evidence for that statement please?

If you go to this link, and open the document you can see a graph showing rates of cervical screening over time.

<a class="break-all" href="http://webarchive.nationalarchives.gov.uk/20160107053639/www.ons.gov.uk/ons/rel/cancer-unit/cancer-trends-in-england-and-wales/smps-no--66/index.html" rel="nofollow" target="_blank">webarchive.nationalarchives.gov.uk/20160107053639/www.ons.gov.uk/ons/rel/cancer-unit/cancer-trends-in-england-and-wales/smps-no--66/index.html

If you go to page 14 in that document, there's a graph showing rates of cervical cancer before and after screening. They fluctuated screening was introduced and - it's true - fell afterwards to a lower rate, but we cannot say that that is due to screening alone. Because there are many other factors affecting cervical cancer risk, such as smoking rates and how many children you have. We have to factor in these - and many other - confounding variables which is very hard to do in an observational study. Correlation isn't the same thing as causation

The graph covers the period between 1950 to 99. The incidence graph however only covers approximately 1970-1999. The lowest incidence pre screening was approx 14 cases per 100,000, the lowest post screening approx 10 cases per 100,000. Not that great a difference really.

Moreover however we didn't have rampaging cervical cancer before screening started. As I mentioned above one risk factor is children - the more children you have the greater your risk. Childbearing rates are usually higher in economically deprived countries, but are tending to drop in developed countries (like the UK).

Re women who've been raped/abused. I've spoken to enough women who've been raped - both in my personal life and as a rape crisis volunteer, to know it's an incredibly hard thing for many women to talk about. Even to an anonymous volunteer on the end of a telephone line. You often got slient calls, where women just couldn't speak. Or ones where they were talking about something that had happened years earlier they'd never told anyone about.

I wouldn't want any of those women to have to discuss their experience with some of the characteers who've taken smears from me. I'm a relatively robust, gobby woman, but I'm not going to start disclosing every single bad thing that's ever happened to me to every random medical professional I meet. I was sexually assaulted as a child, I've never told my GP., I've never told a lot of people I know, only those I really trust. It's not the reason I don't have smear tests, I don't have smear tests for the same reason I don't take statins - the very small chance my life will be prolonged is not worth the risk of overtreatment.

I am so, so f*ing angry about the way Jo's trust and the NHS treat women. (dunno if that''s coming across or not). I see someone has started a thread on the Jo's trust board abou this thread. My plea to them - listen to what we are saying, if you don't want to completely alienate us. We are real women telling the real truth. You don't get people on side by patronising, belittling and insulting them. Women aren't stupid and we aren't infants.

sorry typo - understand it ...

Yes I'm a man....yawn....... I just like to look at information from medical professionals rather than some tin foil hat conspiracy theorist........."

Well try reading Margaret McCartney, GP, author, broadcaster, columnist for the BMJ, doesn't have smear tests.

margaretmccartney.com/2013/02/05/women-cervical-smears-and-manipulation/

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

Smear tests - along with mammograms - started out life as a political initiative under the dreaded Edwina Currie. She saw cancer screening as a politically popular thing because everyone loves something that 'stops' cancer that saves lives

But as DR McCartney points out, no life is ever 'saved' unless you make someone immortal - it's just prolonged. One of the problems with any cancer screening progamme. is 'lead time bias'. If you identify a cancer 'early' in the year 2000 and a patient dies in 2020, then the patient will have 'survived' for 20 years. If the cancer is found in 2010 and the patient dies on exactly the same time they have 'survived' 10 years. So the 'early' screening appears to have prolonged the patients life but didn't.

Cancer survival is measured in years from diagnosis, not years from when the cancer first grew. That's lead time bias

I've quoted numerous statistics from cancer research and the ONS, presumably you think they're just silly women making stuff up as well?

Cervical screening is not valueless. It can reduce the already very small chance of getting cervical cancer somewhat, but we don't know by exactly how much because there hasn't been a randomized controlled trial in the UK. Against you have to set the likelihood of overtreatment if you have screening, much higher than the chance of getting cancer.

I apprectiate that's a complex argument, but it seems even women can understand ti!

Use some of the money that gets spent on guilt-tripping ad campaigns to develop a less intrusive method of cervical screening, rather than mess about with more adverts.

If it was as simple as POAS or giving a little blood, everyone would do it.