To ask if smear tests are as worth having anymore?

[sandradailys]

Not saying they're not worth having, but wondering if they're worth having as much as they use to be

Before I get shot down, this is because -

I have read they don't actually send of cell samples anymore, they're just checking for HPV?

So they're not the same anymore. It just checks for HPV?

And if you didn't have it the last time, and haven't had sex or still married, it isn't going to suddenly come up on the next one if it was negative last time?

I'm really trying to debate if it's worth getting. For very private reasons that are extremely painful.

Thank you to anyone who can clear my lack of knowledge up! Or point me in the right direction

Raddix:

"The “smear” test is pointless now. It’s impossible to access an actual smear test unless you’re infected with HPV. They just check you for HPV and if you’re clear they put your sample in the bin.

I’ve had cervical cancer in the past and I’m terrified it’ll return. But I can’t get a smear test because I don’t have HPV. Cant even pay privately because they do the same. If anyone knows of a way to access an actual smear test when you don’t have HPV, please let me know because I’m shitting myself in case my cancer comes back."

This is disgraceful. It comes down to money. This is NHS cost cutting at its very worst.

You should at least be able to get an old fashioned smear, and a proper examination, to examine the cells, if that is what is needed.

Disgusting. Why is this not available for those that want/need?

Another one here with concerns about this.

I've had precancerous changes across 2/3 of my cervix without HPV present the last time I got checked; the doc at the time was even convinced it was cancer when I went through the whole 2-week referral cycle, then had re-tests, several minor procedures on my cervix (scraping bits off, cauterising) and eventually a laproscopy.

I was being checked again at the 6-month (to see whether it had been sufficient) point after this, but by then the process had changed to just testing for HPV, and even though I tried to argue my way against this with my medical history I was told there was nothing the doc could do as labs will refuse to test properly.
I was HPV negative and got put back on the 3-year cycle. I believe they are now considering 5 years.

It's honestly disgraceful that what was useful prevantative care is now much less so.

So the 1% may not have their cancer caught before symptoms present, which could mean far more radical treatment or a terminal diagnosis. They would have been found under the old system.
I believe it’s a money saving Initiative that will cost some women their lives

It does seem like they are throwing the 1% under the bus in order to save money.

I think the HCPs need educating as well. This is partly to blame for misinformation. I clearly asked the nurse, if I’ve never had HPV before on a smear and nothing has changed sexually since, I will be clear today. Yes, she replied.
well that wasn’t right, I was HPV positive. A quick google on NHS website told me differently.

Maybe someone should start a petition or something to bring back the old smear tests. I’m sure most women would sign it.

You can get private smears where they look at the cells. You can get them at my local private clinic. If I had had cervical cancer previously but negative HPV I would do this every three years.

I still don't quite understand some of the NHS reasoning. Surely you could be hpv positive for a year or two between the 3-5 year smears, but clear during the smear. But surely cell changes/ cancerous cells could have taken hold during that time? To have cervical cancer, does HPV always need to be active at the same time? Could your body clear the virus but be left with the beginnings of CC? And why a 5 year gap, instead of 3, for older women, if the virus can 'lie dormant' and then flair up at any time? I will be using a Superdrug hpv test for now as find smears uncomfortable and invasive. By this reasoning (the domant hpv reactivating) we should checking for hpv more regularly, regardless of sexual activity? It sounds like the NHS is assuming that it will always take a few years for the dangerous hpv strains to turn cancerous? If you have several negative hpv tests over a 5-15 year period, I'm guessing your risk is much lower, but a single positive hpv test would make me want to test more regularly.

I read an article today in good housekeeping. By that annoying Dr Sarah Jarvis. She said that it takes 10-20 yrs from HPV to CC. I have no idea if she’s right, she isn’t always right. But maybe that’s why they are leaving it 3-5 years?

I was invited to an 'extra' test about 5 years ago - solely for HPV. It came back positive- I was sent to the gynecologist. She did a smear and it turned out I was stage 4 - and she did a biopsy in my.. (tbh- not quite sure where .. she told me to cough while her probe was up my vagina so I'm not sure of the exact location.. )Then I was asked to come back in a year. I was tested again. Smear / HPV and all was clear...
Im glad Im not too much of a worrier or that would have been a mega stressful year...
if they'd not tested me - everything would have cleared up by the time I had my smear anyway... and I wouldn't have known anything was wrong!

Anyone any thoughts on mammograms - I check my self regularly- but have heard mammograms can also cause problems because of the sheer Damage they can do to cysts/ tissue etc..

No point. I was negative hpv. I had grade 3 changes and lost half my cervix. Despite my history they only look for hpv. Can’t be bothered anymore.

I’ve been having yearly mammograms as part of a long term study for around 10 years and will participate for another 10 years before being transferred to the usual scheduled screening programme.

It’s a bit weird as I have relatively small boobs and quite a large ribcage and started having them at 35 when the breast tissue is still quite dense.

I’ve found the clinic and radiographers to be utterly marvellous which is just as well as I find the process to have more potential for triggering a trauma response than a smear (because you can’t see the HCP the whole time, and you are momentarily ‘stuck’ in the machine) so I can see why some women would choose to skip it (especially if their personal risk factors are low and they are confident in their ability for self examination). However, I am of the understanding that participation in the standard 50-70 screening is low risk compared to potential benefit.

Standard breast screening takes place between 50 and 70 and I think if a woman were to attend all offered it would be 7 in total (I should end up having 25 in all). Obviously I have decided that participation in the research is worth the extra risk of tissue/radiation damage, but I lost my mum to a non breast BRCA2 cancer when she was 54 and I’m doing in her memory. Hopefully the research will results in better outcomes for women like my mum.

In years to come hopefully screening will be improved by the addition of genome sequencing to better identify women who are high risk (I’ve had genetic testing and did not inherit BRCA2 from my mum, which is presumably why I was asked to participate in a research study rather than join the elevated risk screening programme, I’m guessing I’m part of a control group!)

I think this is the most recently published NHS review on all the screening programmes, so likely the best place to find accurate info for informed choices:

www.england.nhs.uk/wp-content/uploads/2019/02/report-of-the-independent-review-of-adult-screening-programme-in-england.pdf

(The same document has a section on HPV including the rationale for the change in smear strategy)

Hi, in the NHS that's not correct. The same sample is used for HPV testing then if high risk HPV is detected, a cytology slide is made from the same sample to assess if there are also cell changes present. You don't need to go back to have a second sample.
Women who've been part of the self sampling study will be called to have a smear if HPV positive, because self sampling is with a swab.