Should I insist on another smear test in 12 months or would I be wasting NHS resources

[Worriedaboutsmear]

I had a smear test in January which came back with me having borderline changes and testing positive for HPV.

I had the colposcopy a month later. The gynaecologist examined me and said "all's fine, back to 3 yearly smears". I received a follow up letter a few days later (addressed to my GP) which said "....examination was essentially normal, I have reassured her and discharged her back to your care and her next smear will be in 3 years time".

However I'm a bit confused; prior to my colposcopy I did a lot of a reading, and everything I read suggested that if the colposcopy goes ok but you have HPV, you are asked to have another smear test 6 or 12 months later to check that the abnormal cells have gone away by themselves.

I'm really angry at myself that I didn't ask the gynaecologist while I was there what he meant by everything "being ok" but I didn't enjoy the experience at all and felt very keen to get out of there.

I rang up the GP surgery to ask and the receptionist said that if the gynaecologist says 3yearly smears then I can't have another one until then, but surely they shouldn't leave it 3 years to check if the abnormal cells have gone away themselves especially if there is HPV present? I thought that was a huge red flag

Should I push to have another one or am I overthinking this? Should I consider going private if the surgery refuses ?

I think you are overthinking this. The expert has told you that all is ok. Now that doesnt mean that it is 100% completely and utterly ok, but it does mean that in the experience of the people doing the investigating, it is fine and you are no more at risk than anyone else.

Having said that, if you need reassurance, there must be someone within healthcare that you can speak to.
hugs.

Push for it! Just explain your concerns.

I booked myself in for a smear for this morning somewhat over-eagerly (couldn't remember when my last one had been... Apparently only 18 months ago!)

The nurse said unless I had a specific concern (I didn't) I'd have to wait another 18 months.

Your concern - although I'm sure you'll be fine! - is specific and understandable and it'll put your anxiety at rest if you are given another smear. Go for it! I can't imagine they are an expensive procedure for the NHS.

Hi, I understand your concern but you should follow what your gynaecologist has recommended. HPV infection is very common. The test is designed to pick up people who have abnormal epithelium so that can be treated to stop progression. If you had a normal colposcopy there isn't anything to treat.

Previously if there was evidence of hpv infection you would have multiple repeat early smears and only be sent to colposcopy if there was evidence of persistence in 3 smears. The current system of immediate colposcopy review and discharge if everything is ok is much better.

Don't try and circumvent the system by getting early smears. Just be glad and reassured that it is all ok. They will be rejected by the testing lab anyway if they aren't due.

I think most people have HPV don't they?

I had the same after my first smear - colposcopy but everything was fine. I've only actually had two smears in the 8 years since due to pregnancy.

You can push all you like but you won't get one. It's a screening programme, unless you're invited (as you were recently) then the lab won't process any sample taken (and the nurse won't take it if you're not due) and it would end up in the bin.

The recall process was changed a few years ago with the introduction of HPV testing, and if you have just borderline changes then after colposcopy you'd go back to a normal (3 or 5 year) recall if no further treatment needed.

I understand your concern but unless you go private you won't get a smear done sooner on the NHS.

As they have likely explained to you, most people with HPV and borderline changes , it clears up by itself

However it does seen unusual to leave it three years to check, IMO. I would have assumed they would have you back in a year to be sure

I think it may be worth you persuing this with your GP, alternatively if they refuse maybe go private in a year or so, just as a peace of mind thing? I mean you are more likely to be OK than not, but there is no price on peace of mind - after a quick scan on the tinternet, you can get a smear and hpv test for under £140 approx.

something like 80-90% of those who have ever had sex are HPV positive.

They won't process one out of programme so you can push all you like but it won't get done.

The smear is to pick up changes that may over time turn into cancer.

If there was nothing there at colposcopy, in a year your cervix won't have had time to make any changes. So no need for another smear for 3 years.

There are several types of HPV - some low risk, some high. You are only monitored more closely if it is a high risk type. Don't worry :)

www.gp-update.co.uk/SM4/Mutable/Uploads/pdf_file/HPV-testing-and-cervical-cancer-screening.pdf

I agree with you - you need a smear to know that you've cleared the virus - in 12 months there's a 50:50 chance you will have - if not you remain at higher risk.

You can get a private smear and it isn't too expensive, around £100 I think. Pp are right it won't be processed by the NHS labs as they are very strict with timings.

I had to have a blood test to determine the strain of HPV I have, did they give you one of these? You can also get one privately.

I agree with you OP. Twice in the last 10 years I've had a colposcopy due to borderline cell changes and on both occasions I was invited for yearly smears afterwards.

If they wont do it on the NHS then you could go private. Where I live we have them every year as standard, but we do pay for the tests.

If there was nothing there at colposcopy, in a year your cervix won't have had time to make any changes. So no need for another smear for 3 years

OP do not listen to this, this is absolute rubbish advise . Anything can happen in six months, nevermind 3 years

I have been going through cell changes for the last 7 years, some mild and some moderate and I have never been left more than 12 months

Like I said before, if your gp refuses, there is nothing to stop you going private

Ok thanks. I have an appt with my gp about something else in a few weeks so will raise it then. I'm sure it's fine but feel like I need to understand why it's fine. I should've asked at the time. If after speaking to the gp I am still concerned then I will enquire and/or go private

My gp wouldn't do a smear test more regularly than 3 yearly even given I've previously had abnormal cin3 and leep treatment when I started having abnormal bleeding. (It's ok now - was polyp / pill). They tested pretty much everything else but she said the labs just refuse to process it earlier than the 3 year gap. So pushing is unlikely to get you anywhere. I've paid privately before for peace of mind.