GP is trying pressure me into smear test. Is this acceptable?

[Enfys1982]

A fortnight ago I had a UTI which was treated with a short course of antibiotics. It cleared up but then came back again so I was prescribed more AB’s and did a sample, they couldn’t grow a culture from the sample but I did have raised white blood cells. When the GP rang me to discuss it she initially asked if I could repeat the test and we’d take it from there she noticed on my notes that I was a due a smear and said she wanted to check my cervix as well. For reasons I don’t want to go into I don’t want a smear test, but she went on and on me and basically pushed me into making an appointment with a nurse rather than rechecking my wee sample. I didn’t feel I could say no or explain my reasons why, she didn’t ask me why I felt the way I did either.

Honestly I feel much better now. The unpleasant symptoms have gone so I cancelled the appointment and she’s now phoned me up and asked why I cancelled. I said I felt better and I was busy when my appointment was booked for (both true) but she continued to push and implied that she wouldn’t run any further tests until I’d had my cervix examined. Just thinking about it is making me have a tight chest and panicky I really don’t think I could face it unless I was knocked out. I don’t have any gynae symptoms, my periods are normal etc. I had a fucking UTI! Why is she pushing me to have an invasive test I don’t want or need abs which isn’t relevant to what was wrong with me? She’d already asked if I was currently sexually active and I said no.

The more I think about it the more feel angry. I’ve had similar before from other staff at the practice when I’ve gone in for other things not relevant. Do they get commission for every smear they do or something?

Put asleep ? The NHS is on the floor and you’re suggesting being anaesthetised . If you don’t want a test which could potentially save your life opt out but this is ridiculous! Nobody likes smears 😩

I don't think anyone should be coerced into a smear but I also think having an honest chat with the GP about why you don't want it is the best way forward.

I am surprised by the general consensus here that anyone who doesn't have a smear is stupid / immature / naive etc. Margaret McCartney (a GP) evaluates the stats behind smear tests in her book The Patient Paradox (see also: www.heraldscotland.com/news/13054346.cancer-screening-no-thanks-says-gp/)

As she says in the article (academic evidence is in the book),

"We know from research if you take 1000 women and screen them for 35 years, you can prevent one death from cervical cancer. However.. to get that reduction, around 150 women would also get "an abnormal result" which could be false positive or require repeated smear tests. Another 50 women would require treatment for cells deemed abnormal but which might not develop into cancer."

I do have smears (and they picked up CIN3 once which I had treated) but I have thought carefully about the risks of false positives versus the benefits of it actually saving my life. Smears can cause a lot of anxiety (about having it done, getting the result, and having treatment for CIN) - we underplay anxiety as though this is a minor downside but for some people it's not minor at all.

I think it's very complicated and the decision should always be a personal choice.

@Theluggage15

"Women who get angry with other women not choosing to have smear tests are idiots. Absolutely. Sorry you struggle with reading comprehension."

Don't be sorry, no struggles here. I don't think anyone's getting angry. I personally think that people who choose not to get a potentially life saving, quick fuss free test because they "don't want to make a show of themselves" (OP's words) is idiotic.

Recurrent UTI or ones not fully responding can be caused as a side effect of cervical cancer where pressure is out onto the kidneys

People desperately needing scans are waiting months if everyone went straight to scan bypassing quicker more likely tests the wait would be years and more would die.

Your gp has no right to blackmail you by refusing further tests/treatment. Firstly I would put in a formal complaint then I would ask to sign a form to be taken of the smear test reminder thing. I can't remember the name but iv signed one as I refuse smears probably for the same reasons as you and I refused to disclose the reason. You have the right to refuse any tests or treatment and they are not allowed to do anything without your consent

Put asleep ? The NHS is on the floor and you’re suggesting being anaesthetised . If you don’t want a test which could potentially save your life opt out but this is ridiculous!

@Irisheyesareshining I have to have a minor procedure (uterine polyp removed) but I chickened out when they came towards me with the probe, so I'm going to have to have it under general. Apparently I'm not the only one.

I'd assume it's due to ab*se or something that OP doesn't like the idea of smears.

If a doctor hadn't pushed for me to have a smear test when I was 21 - I'd had one sexual partner at that time - I'd be dead now. First ever smear test and I was diagnosed with cervical cancer. It reoccurred again when I was 34.

If you think a smear is nasty and unpleasant, wait until you have treatment for cervical cancer. A smear test is like a tiny pin prick compared to chemo and radiotherapy.

Your gp has no right to blackmail you by refusing further tests/treatment.

@Bpdqueen OP thought the doc meant that but it's probably unlikely they'd be as hardline as that, or it might deter people from seeing them.

Sorry youve had a difficult experience. If they didn't grow an organism we start looking for alternative causes for symptoms, UTI symptoms overlap with cervical cancer symptoms, and you've missed screening so will always be on their mind.

You have the right to totally opt out of screening, it's your choice, just ask them to remove you from the recall system and that you appreciate that comes with associated risk

We can do them under GA but to be honest I've only anaesthetised for them as part of another proceedure (except for 1 patient with severe learning disabilities). If you're due an anaesthetic for something else they'll be able to liase with the gynae team to pop in and do a smear whilst you're asleep (could always ask for a gynae referral to consider a GA just for that but I expect the wait will be significant

If it was me I'd rebook and explain your concerns, it's unfortunately a v common occurance and when I was still working in GP there's ways to help (anti-anxiety meds you could have in advance etc), longer appointment times, bringing a friend or partner etc x

You will need smears in the future no one likes it but you must go it could save your life. Jade goody springs to mind bless her. They won't put you out for it no it takes seconds and really not that bad atall.

i was pushed into having a smear in Dec 2020 by my GP when I was on the phone to her about something else. I was a year overdue for the smear because of lockdown. I didn't really want to have one but went along with it as i felt pressured too. I have always had regular smears and appreciate that they really aren't the most pleasant of things but, as many have said, they are over very quickly and for most women there is discomfort as opposed to anything resembling pain. That smear eventually (after further tests) diagnosed cancer and I had a radical hysterectomy within four months of the smear. That smear saved my life as I could be sitting here now with the cancer slowly growing and be oblivious. It was caught early (stage 1) and I had absolutely no symptoms.

Would you consider talking to your doctor about taking somthing to relax you while you have the smear. I take a diazapam to get on a plane and it just chills you out and takes the edge off: would this help? I know you felt she was pushy but she is doing her job as smear tests save many lives every year.

OP, do you have a close family member (sister) or friend who would let you accompany them for their smear? A bit unusual but it might reassure you to see how they manage.

You definitely shouldn't be pressured like that. I've not had mine for years and nobody has said anything about it. The most I've had to do is ignore the occasional letter.

Suggesting it is one thing but withholding treatment unless you agree to this is really bad.

Agreed. I've had a lifetime of repeat UTIs and never a positive culture, and have had all sorts of investigations, but never once has anyone wanted to look at my cervix.

My reading of this is that the GP just wants the OP to have an up to date smear, which is fine, but I'm not sure it's connected to the UTIs. Only one way to find out though and that's to ask.

Thanks, @Catspyjamas17 that's really helpful. I've been putting off a smear test for the last six months mostly because the appointments I've been offered don't fit in with my availability but also because every single time I've had one done, I've come away bruised and battered. It's all very well for someone to tell you to relax while they shove a cold metal funnel up you and then poke around as though they're bloody excavating, not dealing with a highly sensitive bit of your anatomy!

My understanding is that they also take the opportunity to see if everything looks healthy and if there is any erosion etc.

That is the most ignorant stupid thing I've ever read and completely irresponsible to tell someone that. Have you not read just now the woman saying they would be dead by now if they had y had their smear. Grow up

Also, no one can say because theirs wasn't that bad that it's the same for everyone.

@Bpdqueen

Crikey. Suggesting the OP puts in a complaint over her GP offering her a smear test?

Ludicrous. I do think the OP needs to grow up too.

OP it’s completely up to you to have the smear. If you don’t want it, don’t have it.

However, if you do decide to have one, there is absolutely nothing to be worried about.

I have suspected endometriosis, so I find sex very painful. My last smear was excruciating, I bled, I cried, I felt so embarrassed afterwards. But the nurse was so lovely, she really listening to my concerns and fears. She used the smallest speculum and did her best to put me at ease.

I got a letter a couple of weeks later saying I tested positive for HVP infection. I have a history of cancer in my family, so I am glad I went through 30 seconds of pain so I am now able to be monitored for the HPV infection with a yearly smear.

Have you considered a career as a therapist? I'm sure a lot of people with serious trauma could benefit from being told to just grow up....

How do I get the diazepam? Do I just ring up and request it when booking the appointment? It can be hard to get to speak to the GP’s on the phone.

I'm not saying complain for a gp offering a smear im saying complain for a gp refusing further tests and treatment because op doesn't want a smear

There is a really low take up of smear tests compared to other types of health tests and they do save lives - so GPs are keen to ensure people get them. There have been lots of campaigns to try and increase uptake.