To think smear test should be available to women at any age ( sensitive)

[HadABadDay2014]

www.liverpoolecho.co.uk/news/liverpool-news/aspiring-wirral-model-died-cervical-6839200

I know that under 25 it is rare, but if a women request a smear test due to showing some symptoms or just for peace of mind should a smear test be done.

I think I had my first when 20 after DH seen the letter and encourage me to go. Then at 27 after again DH encouraged me to go.

visualiseahorse the screening age in Scotland will be increasing to be the same as England.
Women don't need have a smear early to get them oba list, because they will be automatically invited at the age of 24.38 (to give time for them to be screened by 25). If you're registered for with a GP, you're in the call/recall database and will be regularly invited, or called back depending on the test results.

Piperrose there's some evidence that giving the HPV vaccine to women who've already had the virus is ineffective. This would give false reassurance to people to start vaccinating older women. What may happen in the future, is women could be offered a high risk HPV test, and then be offered vaccination if HR HPV negative. The existing HPV tests are very sensitive though, so may women test positive, so probably wouldn't be offered the vaccine.

TreeFuMom this is the tricky part of screening, finding a balance between picking out the women who definitely need investigation, and then an acceptable treatment being available. There has been a lot of concern about the risks of treating younger women.

If we gave every screening test that is available to everyone on the very very slim off chance that they might have something to be found, then the NHS would collapse within a week.

Limited resources have to be prioritised.

I think people should have to pay a standard fee if they want something done by the NHS without valid medical reason.

treefu I had no symptoms of CIN3 either, although I was 29. My cervix went the other way and was so scarred up it wouldn't let DS out and ended in an EMCS.

Smears from 25 seems so old when some girls start having sex at 14/15.

But why should women who either got some symptoms or some anxiety about cervical cancer not have a simple test to put there minds at ease or to rule out cervical cancer.

A very sad story. There is a charge for travel vax so why not have a charge for extra tests that patients want doing but which the doctor doesn't think are necessary.

Patients would be reassured and this sort of case would be less likely to happen. I know if one of my teenage DDs was not well but not getting tests I would be willing to pay to get the testing done.

It IS available.

A GP will not be paid for doing it.
It may be inconclusive.

But it is available.

I had my first in my teens.

A few years ago I was teaching a student who was quite happy (I think actually enjoyed) sharing her gynae tales. She was 17 and having 3 monthly smears.

OP I have outlined the reasons why in my posts above.

1. Symptoms = diagnostic tests not screening tests. Screening tests are for people without symptoms. It should not be used to 'rule out' cervical cancer because you can have false negative and false positive results. It may actually wrongly put someone's mind at ease when they have something else wrong with them.
2. Someone with anxiety about cervical cancer should have appropriate discussion and counselling with their GP or other medical professional.
3. There are private providers of screening tests for the worried well. As explained above screening programmes are set up to make the best use of finite resources to give to most effective detection rate.

A very small rate in certain age groups does not justify either screening that entire age group or allowing ad hoc testing.

Sashh -that scenario of 3 monthly smears would only happen now if the tests were inconclusive.

Most labs under government policy now operate a rejection policy. If a test is received by the lab that is not due (i.e. The patient must have been called for a test or overdue) then it will be rejected. The practices know this so shouldn't be taking the tests in the first place.

Anxiety over not having a smear test is not valid reason for the NHS to spend money it doesn't have.

You are looking at this too simplistically if you genuinely believe the only cost involved is the spectrum and the swab. It doesn't work like that.

If you want to have a test that isn't medically indicated, then pay for it out of your own pocket.

Just out of curiosity , at what age are the beancounters presuming most women become sexually active ? If they are designing the screening programme with the age of 18 in mind then i can understand the age 25 cut off , but as lots of women begin being sexually active in their early teens then 25 seems quite a long time to wait , well over ten years in some cases .

Frumpet if you read the link I've posted, then you'll see that the time for pre-cancerous changes and cervical cancer to develop is an integral part of working it out.
The references include the scientific papers published examining the numbers and ages of women developing cancer. So the age of becoming sexually active is taken into account. Cervical cancer usually takes between 10-15 years to develop. Some cancers are more rapidly developing - the screening programme is not set up to deal with them because you would have to screen ever year or even 6 months to pick those up. At that point it is not viable because you'd harm more women by over-detection of minor abnormalities and it would cost far more for every cancer detected.

I had my first smear at 18 (11 years ago), it was the normal age to start having them where I lived. I got a shock when I moved and found out people here didn't get them until they are 25. I still don't know why there was a difference, both places are in England.

"Cervical cytology IS available to women of all ages, when carried out as part of a clinical investigation. If a woman of any age presents with unusual symptoms she should be fully investigated which may include a smear test."

My DD has just been refused a smear test again, she is nearly 19, we are in Liverpool.

My Mum had CC, my Neice died at the age of 22 from CC, after multiple treatments to save her life.

My DD has PCOS and at 16 needed a coil fitting to protect her from Female Cancers, she doesn't ovulate and will probably need IVF tc.

She had to have the coil removed because of severe Migraines.

This has terrified us.

My (and our) experience if Femsle reproductive Health Care/Treatment hadn't been great and there are a lot of complacency.

My DD has Bloating and is on strong painkillers for the effects of PCOS, so could monitor pain, but even at her last appointment at the Liverpool Women's the Consultant laughed and asked "why would we need to give you a smear".

So for women who become sexually active from say 14 or 15 , which was very common in my own peer group , then they are at risk of developing cancer or needing treatment for precancerous changes by the time they reach just 25 ?
I do understand what you are saying though bela , the NHS isn't able to afford the sort of screening programme that would detect the women who develop the more aggressive forms of cervical cancer . I wonder if this type of cancer is related to sexual activity or HPV ?

Whilst I understand that cost could be considered a waste of resources, why for high risk groups, such as my DD and my now deceased Neice, are Smears still being refused?

There has been a big campaign for Doctors not to ignore Severe Headaches, because Brain Tumours, in Teens, are another type of death that the UK doesn't do well on, surely if a young Woman expresses concern, a Smear should be offered.

Birds I am so sorry to hear about your niece, you must be so worried about DD. Can you go to another GP at your practice to get authorisation or failing that can you get it done privately?

Your DD's 22YO cousin has died of cc yet she can't get a smear test in the NHS?

Because if you read the links to the papers I've given, the risk isn't assessed as high enough to start screening earlier or more frequently. All GPs should be following the same national guidelines so will also not take a smear. There also isn't considered to be a high familial link for cervical cancer so earlier screening also isn't indicated.

I think you should have one min 2 years after you become sexually active.

It did used to be 21 I'm sure? Which was perfect for me.

Some girls start at 15! That's making them wait ten years Anything could develop in ten years :(

I would say though, if I had a DD, and I was concerned, I would just find a way to go private if I had to.

I had a smear test that came back "minor changes, repeat in six months" luckily the nurse doing it didn't like the look of my cervix, and referred me for colposcopy ASAP. The day I arrived back from my holiday, a week later, I had three missed calls and a request to call dr ASAP. I was in the supermarket I remember crying, by the time I got home my dd said dr had phoned twice. I finally got him and everything looked very suspicious he said. He wanted me in for a cone biopsy the next day, I freaked. Anyway the cone biopsy didnt get it all- turned out I had a 4cm tumour. I was scanned to stage the cancer, I was 1b1, which meant hysterectomy, removal of lymph glands and 3 inches of my vagina at the top.

My only symptom? ONCE bleeding lightly after sex, which I mentioned to the nurse.

80% of the population are estimated to have the Hpv virus, and 25 is simply too late to start testing. It should be done at whatever age the girl is when she becomes sexually active. I'm on a support board and there are girls of 24 leaving children and partners, it's horrifying. And to think I was going to miss it because I was busy at work before my holiday..
Had a friend come and see me in hospital, she's not had one for 13 years. Luckily I went regularly. My dd is getting one done soon, we are paying. She's 20 and sexually active.

That was the irony, coming home with a catheter and urine bag, opening my NHS letter "please return in six months as some minor changes were noticed at your recent scan". I may actually frame it.

It's £100 for a private smear test, by the way.