to remind you all to go and get your smear tests done if they are due or overdue!

[RedCrimson]

8 years ago I had severe dyskaryosis (pre cancerous cells) and was bloody lucky I got it all taken away when I did.

I went for my yearly smear today and the nurse was new to cytology and I was the first smear she's ever done (supervised by my usual nurse).

So I just want to remind you to get yours done if it's due. I very much doubt I'd be here now if I hadn't have gotten the treatment when I did.

Last time I went had a bollocking from the nurse about being 4lbs over ideal on the BMI index, I'm now 10lbs over, and suffering from depression so can't face her wrath again. As an aside, she looked way over her ideal BMI!
I have a tilted cervix that is difficult to find, and it can (sometimes) be uncomfortable, but in my last practice I never had an uncomfortable one, so must be to do with the person performing.
Recalled a year ago, but real life does actually get in the way for some people!
I had an abnormal smear test in the 80's (definitely called in for one, as wouldn't have booked one myself, so a previous poster was wrong) , when I was 20, a colposcopy and cryotherapy afterwards.
My father has died from prostate cancer, my mother has had a mastectomy. I was (wrongly) told I had cancer 6 years ago.
Call me stupid, but I'd rather live my life in the moment than know any more - because that's my own personal choice!

I think most people have advocated free choice and I doubt anybody agrees with the hounding if you choose not to

however

The argument that doctors only do it for the financial incentives can only be true on an individual surgery basis. Yes they do get funding so encourage, or in some bad cases try to force, you to have it done
BUT
The NHS is strapped for cash. They aren't going to incentivise surgeries to increase their take up numbers unless there is a real benefit to patients on a national level. If it doesn't save lives then they wouldn't be wasting money on paying surgeries to chase up patients would they?

A lady I knew had breast cancer. Doctors wanted to give her a mastectomy. She did her research and concluded that UK doctors do this far too much as a matter of course when a lot of time it was over treating just as some are arguing on this thread On the basis of this research she chose not to have the mastectomy, opting just for chemo and a lumpectomy. Sadly she died. Maybe many other women would have got away with it, but she weighed up the risks, took that risk, and the gamble didn't pay off for her.

Doctors shouldn't pressurise. It should be free choice but equally those who have personal experience of CC including me shouldn't feel that we are not allowed to tell our stories because some people are saying

I bloody hate these threads, so patronising.

The NHS is strapped for cash. They aren't going to incentivise surgeries to increase their take up numbers unless there is a real benefit to patients on a national level. If it doesn't save lives then they wouldn't be wasting money on paying surgeries to chase up patients would they?

I'm not in the UK, so NHS finances don't apply (though I don't think my insurance has that much money to spend) but I was told to let her do it even though I had never engaged in vaginal intercourse with a man, and had told her this.
Unless previous information is wrong, the risk should therefore have been almost non-existent.
BUT she could probably just omit the fact that I wasn't "sexually active" as it is called, and get the money nevertheless.

Ranting and raving on a public forum DOES change things. In fact a similar "rant" years ago led me to do my own research about this screening programme . I'm very grateful to her , whoever she was.

I feel similarly to Red about this issue. There IS a an issue regarding informed consent , people are not given the facts. I personally have been lied to repeatedly ,intimidated and bullied into having this screening test several times. In fact I was first subjected to this intrusive invasive screening at 15. Fucking 15 ! I hadn't even had sex. I was a child. There was no reason at all for it to be done. None at all. And I'm not the only one.

Just because a system is in place doesn't make it right , neither does it mean it works.. There's many things that people previously thought were wrong or right . We now know better. Being a female is not a disease. We don't need constant checking and poking in case something is wrong with us. We don't need to whip our knickers off and leave our dignity at the door ffs.

That shitty little leaflet you get that blatantly lies about the risk of cervical cancer , it's full of shit. It's criminal that they can print these lies. Slightly uncomfortable ? How many people on this thread alone have described it as painful ? How many women were scoffed at for complaining about the pain ? How many women describe this test as deeply traumatic ?

Who was actually informed of the facts as Red outlined

Screening tests are different. Because they aim to find disease you don't know about, the trade-off between benefits and harms tends to be more nuanced compared with tests done to investigate symptoms. Cervical screening does prevent deaths from cervical cancer. But to get that reduction, you have to follow up and/or treat all the women who have cell changes on their screening test. However, most cervical-cell changes found at screening will not lead to cervical cancer. The problem is we can't predict which will, so all need further monitoring or treatment. A study from Bristol in 2003 found that 1,000 women have to be screened for 35 years to prevent one death from cervical cancer; and to prevent that death, 80 women have to have further investigation, with 50 women having treatment to their cervices. Four out of five women found at screening to have "high-grade" changes in their cervix did not go on to develop invasive cancer.

I'd love to hear from someone who's gp told them that they were financially motivated for you to have this test. I'd love to hear from someone who's gp told them that this test is painful for some people and for some , deeply traumatic. More than anything I'd love to hear from someone who's gp told them that having this test can put you at approximately 70% risk of having painful treatment you don't need.

@Matrix, was that in the UK that you got cervical screening at 15yo?

The financial incentive for English GPs is tiny. About £2 per patient each time. But effectively there are performance measures, too, that surgeries are judged by, so GPs need to show they have tried to encourage patients to be screened (with reminders & discussions, etc).

Ranting and raving on a public forum DOES change things.

I meant that it won't do anything to change the system or prevent abuse of the system which is what the poster seemed to think she was doing (she said that she was going to “continue to piss people off until it changes. Perhaps you would like to do something to support the removal of conflicting interests and targets for GPs”)

I totally agree that not everyone needs cervical screening (e.g. a muslim friend of mine who had zero contact with men refused- she was also a gynaecologist so certainly was making an informed decision) but for most women are at some risk and for them the benefits of screening outweigh the risk. Regardless, I agree women should make their own choice.

Mary your friend sounds like a really interesting lady! :) did she talk to you about her rationale for refusing - was it that she thought she couldn't have HPV and therefore low-risk for CC, or did she just object to all intimate examinations?

I think, overall the problem is that as dowhatnow quite rightly points out, at a population level the screening programme is a good thing. It has demonstrably saved lives since it began.

But humans are notoriously bad at assessing risk and so we all have difficulty calculating where we as individuals sit in relation to population-wide risk, iyswim.

I personally totally support the screening programme BUT I think the information around it should be much more nuanced, along the lines of

'you can always ask for a smear and we encourage you to have one every 3 years, especially if you have x y or z risk factors. You should be aware however that this may result in unnecessary treatment and ask your GP for advice'.

Mary your friend sounds like a really interesting lady! smile did she talk to you about her rationale for refusing - was it that she thought she couldn't have HPV and therefore low-risk for CC, or did she just object to all intimate examinations?

Her reasoning was that she couldn't have HPV and was therefore very low risk.

you can always ask for a smear and we encourage you to have one every 3 years, especially if you have x y or z risk factors. You should be aware however that this may result in unnecessary treatment and ask your GP for advice'

I think they need to give much more detailed information than that. They actually do give a lot of information on the pros and cons of breast cancer screening when offering it via a leaflet. I don't think that GPs have the time to discuss the pros and cons of all cancer screening with all their patients.

Actually they do provide quite a detailed leaflet nowdays.

www.gov.uk/government/uploads/system/uploads/attachment_data/file/523344/Cervical_screening_booklet.pdf

It makes it very clear that it is your choice and the title of the leaflet is "helping you decide".

Well, I'm sorry, but I'm one of those annoying ones who the second the letter announcing that your latest smear is due plops onto the mat, I automatically ring up and book it so I don't forget to.
I think it's so important to get one done, and figure they've seen it all before so there's nothing to be embarrassed about.
Sure, it's a few minutes of being uncomfortable, but I'd far rather that than the alternative.

Don't apologise Twirls, we all have to make our own decisions. and these will all be different.

Thing is, whilst it's a free choice, it's not always treated as such:

I went to see nurse for repeat prescription of pill, about 4-5 years ago. She asked if my smear was up to date, I said no. She seemed surprised, and therefore I briefly said that I've looked in to it and believe that a) 25 is too young, and b) I don't believe the positives necessarily outweigh the negatives. She then responded (and I quote): "I don't want to lecture you, but..." and proceeded to lecture me. I was a bit . It may be optional but it sure as fuck didn't feel like it. She talked to me like I was a silly little girl.

My request to be removed from the mailing list was conveniently lost twice, so I highly doubt that was coincidental.

About 2 years ago I decided to get the copper coil. Mid sesh the nurse asks the usual smear question, I say no, she says she'll do it whilst I'm up there. I say no, I don't want one, and don't worry, it's an informed decision. She just made sure that I was sure and dropped the subject (she is a fab nurse!).

I since had unexplained bleeding, and that for me was the moment to have it done (I was 30 by then). Not because of a quota, not because I'm being forced/convinced to have one, just because my body told me something was a bit out of sync. It came back clear

I will probably leave it now until my body tells me something isn't quite right.

Those of you who choose to have it done regularly: Good. As long as it's your decision and you are happy with it. If you don't have it done, make sure it's because of medical facts and not fear/embarrassment. Look up medical facts re smears and follow up procedures, and base your decision on those.

Then we can all avoid the bunfight.

acat A sensible post, however i would just like to point out that

I will probably leave it now until my body tells me something isn't quite right

You don't get symptoms of CC until it is quite well advanced. I had no symptoms whatsoever. The smear test picked it up. It was hard to believe that I was so seriously ill and yet I felt so well.

But well done to that nurse who dropped the subject when she needed to. I agree that they should ask but not pressurise too much.

Mine is really overdue because my first letter got accidentally thrown out before I read it, and I wanted to sort out getting my coil replaced before having mine done. But once I've had my coil checked, I'll book one. My family planning/sexual health clinic don't do them any more, so I'll have to go to my GP which is a shame because I find the nurse there hurts far more than at the clinic.

cottonweary - you do not have to submit to a urine, BP or weight check when you have your smear. These tests are optional and not compulsory - just like the smear test itself. Don't let the nurse or GP bully you into having tests or procedures that you don't want.

I would but I've prolapsed again and really sore I simply can't bear the thought.

You don't get symptoms of CC until it is quite well advanced. I had no symptoms whatsoever. The smear test picked it up. It was hard to believe that I was so seriously ill and yet I felt so well.

It does happen that you don't get symptoms until it's well advanced, and I'm sorry you did (and glad it was found and removed ), but that isn't always the case. The NHS website states:

The symptoms of cervical cancer aren't always obvious, and it may not cause any symptoms at all until it's reached an advanced stage.

There is no hard and fast rule with anything health related. Do what you are happy with, and what you believe is the right thing to do in light of all the evidence.