Smear tests pointless now?

[hedgehogger1]

On my last smear test I was told they no longer look at the cells if the sample tests negative for HPV. As I've tested negative for HPV and have no way to catch it does that mean further smears are pointless and I don't need to go any more?

Sorry, that isn’t very clear. I should have said...It isn’t HPV only, it’s HPV first, then cytology (looking at the cells) if the hpv test is positive.

I was supposed to have a smear annually because treatment I had for MS increases the risk of cervical cancer. I can't get it done as they won't do them more often than the NHS protocol. So the hospital had to change their protocol as well. So I do find this concerning as I tested negative last time.

@PurpleDaisies no mine was definitely HPV only. I was told in the appointment and in the letter

[quote hedgehogger1]@PurpleDaisies no mine was definitely HPV only. I was told in the appointment and in the letter [/quote]
That was because the hpv test was negative. If it was positive, they would have looked at the cells taken.

That’s how the new system of primary hpv testing system works.

Well they literally told me they will only look for HPV.

I was told the opposite when I had mine done at the start of the month. HPV first and I’d get the letter about that within two weeks, then they’d look at the cells and that letter would arrive a week or so later.

I wonder if it’s regional, or if someone has misunderstood.

Pretty much everyone is exposed to HPV. Most people clear it but it can lie dormant and reactivate for various reasons (pregnancy, illness, medications etc). Just because you test negative doesn’t mean you will always test negative. Testing positive doesn’t necessarily mean you will be re-exposed.

Have been*.

But others have said they were HPV negative and had cells that needed dealing with. Hence me hoping the policy changes

@hedgehogger1

But others have said they were HPV negative and had cells that needed dealing with. Hence me hoping the policy changes

I would really recommend going and looking at the evidence this policy change is based on. It really does lead to better outcomes for women.

I find the new policy really difficult to understand. I also had CIN3 and LLETZ when I was 28/29, and have since needed a punch biopsy to check a dodgy looking area. HPV negative on my last smear.

Last time I went (Dec 2019) the nurse said in future they would only be checking for HPV as this was the main cause of abnormal cells. They also explained that by the next time I was due a test it would likely be home tests which would result in a far higher uptake.

I would still encourage everyone eligible to attend their smear tests, regardless of their HPV status etc. As well as sampling the cells, abnormalities of the cervix can be seen by the nurse or whoever is doing the smear, and these may require follow-up.

@okilydokily

I find the new policy really difficult to understand. I also had CIN3 and LLETZ when I was 28/29, and have since needed a punch biopsy to check a dodgy looking area. HPV negative on my last smear.

Primary hpv testing is actually more sensitive at detecting CIN than looking at the cells. It’s also got a better false negative rate. That’s why this change has been made. It’s not a cost cutting exercise, it’s based on what will save the most lives.

It’s probably important to think about what the purpose of a screening programme is. It’s to pick up the greatest number of people without symptoms and treat them so fewer deaths happen. This way of testing is better at achieving that than the old way. Unfortunately, there are going to be some people who aren’t picked up by the screening programme but maximising the number of people who are is the priority.

My Dr mentioned at my last smear that they have now started testing for HPV and if you don’t have it they will vaccinate you and then you can elect to only have a smear if you have unusual symptoms. This is Australia though, might be different in the U.K. but she said that 95% of cervical cancer cases were caused by hpv and so it wasn’t worth screening everyone who is asymptomatic.

My mum mentioned this after her last smear, she couldn't understand it.

Years ago she had abnormal cells. She was fine but obviously for some people that's not the case.

Her more recent smear they said she was only tested for HPV, which she doesn't have. They'd only test for abnormal cells if HPV is positive.

If they had only tested for HPV all those years ago, they never would've found those abnormal cells, which could be fatal for some.

Or am I understanding it wrong?

If they had only tested for HPV all those years ago, they never would've found those abnormal cells, which could be fatal for some.

Yes, there is that risk but if they were testing using the new way, overall there would have been fewer deaths from cervical cancer. There’s also the possibility that those cells would have just gone back to normal and not caused problems.

This is the future I'm afraid. It will never go back to looking at the cells of every sample. PHE decided 18 months ago to centralise the screening program and English laboratories went from over 60 down to 8!
There is no longer the amount of screening staff with their wealth of knowledge and experience left to look at cells.
Like a poster said above its a numbers game, maximising the number of samples with the highest risk and saving money in the process.
I sincerely hope they have it right and we don't take a step backwards from the progress that has happened in the last 50 years but only time will tell (and if it does go tits up the knowledgeable & experienced screeners won't be there to help)

www.jostrust.org.uk/information/cervical-screening/primary-hpv-testing

This should answer any questions.

It's not a cost cutting exercise, it's a more effective way of detecting cell changes that might if left untreated develop into cancer.

No screening programme is infallible but this one is better than the previous one.

@Themostwonderfultimeoftheyear

As long as they are not testing the cells if HPV negative then I will not be attending smears and instead will pay to take a HPV test in the privacy of my own bathroom. If I test positive (unlikely as have very limited sexual history, have never tested positive and now married) then I will go for further testing.

Absolutely this

I don't go, I've been celibate for over ten years and tested negative for hpv.

I’ve had mine today and got the same story, they only test for HPV, and will only look for abnormal cells if you have it. If you have HPV and no abnormal cells they will then test yearly for 2 years as a “watch and wait” policy.

She said generally women kill off HPV within 2 years so then they will stop looking.

I asked why they don’t vaccinate everyone negative but they are working on the policy that vaccine only works BEFORE any sexual activity so as they vaccinate at 12 in the future smears will be obsolete.

As I had a negative HPV test post rape a few years ago, but abnormalities of the cervix which required further investigation (turned out to be a polyps and something else benign), then it seems to me this policy is bloody insane!!

And what kind of vaccine knows and only works if you haven’t had sex yet?..

Science has gone nuts In 2020 I swear.

Could you not just buy a HPV test from Superdrug? Surely it would just tell you the same thing as a smear if they are only looking for HPV first now?

I started a thread about this a number of years ago for the exact same reason and was told much of what you're being told - that this is a more effective test. Nobody likes to question the NHS.
But it's just a HPV test, it's not a cervical cancer test as it used to be.
I had unusual cells removed about 2 years ago and was put back onto the 3 year test list despite being HPV positive, so even if positive, no you're not put onto a yearly test list - it's 3 years in my case.