To remind you to look after your cervix (cervices?!)

[FourForYouGlenCoco]

I know it's been done plenty of times, but one more won't hurt, right?
So long story short:
Went for (overdue) first smear last year, after DC2 was born. Borderline changes & HPV - sent for colposcopy, they went for 'watch and wait' and asked me to come back in 6 months.
Went back, severe dyskaryosis/CIN III. Back again a few weeks later for lletz under local.

The hospital is an hour+ away. The logistics of it all, organising someone to take DC1 to/from school, trekking baby DC2 back and forth with me - not fun. But I am so so relieved I didn't put it off, so relieved I didn't just assume everything would be alright. In the 6 months between colposcopies, cell changes happened really fast. If I'd left it...who knows?
The lletz was really not that bad either - I was very apprehensive beforehand but it was maybe 5 minutes and done. Minimal pain, minimal bleeding afterwards, and definitely a damn sight better than cervical cancer.

So please, please, PLEASE book your smear if it's due or overdue. Go to your appt, don't bury your head in the sand, don't put it off. I know it's not how you'd choose to spend an hour, but it's really not that bad. And it's so fucking important. So do it.

Red you are extrapolating loads from a study of four HCPs.

Someone else on this thread said all HCPs they know get smears so your points are invalidated.

Fightinganxiety, with all due respect, I don't think posting that picture was very appropriate. A poster above has already mentioned how upsetting that picture is, due to never missing a smear yet still having cervical cancer. If it's affected you, can you imagine how seeing it again might affect her or any other poster in similar situations?

Here is a list of current screening programmes: www.gov.uk/topic/population-screening-programmes

Out of 12, 2 are just for women.

Most are for newborns. Does that mean that someone in his patriarchal tower is targeting newborns?

Also for those who think the public are being misled, here is a publicly available document about the consent process with a section on how write and express informed dissent... www.gov.uk/government/uploads/system/uploads/attachment_data/file/436770/cs4.pdf

Hi edmund thanks for your message. You are right. I hadn't read the full thread and can't apologise enough to the poster you are referring to. This is a very emotive topic for lots of people and I apologise for not putting myself in others shoes before posting that. It was insensitive of me.

I reported the post myself and it's been taken down. Apologies again.

Fightinganxiety, sorry - I can absolutely see the point you were making in your post though. Emotional blackmail should never be a factor in these matters. I'm sorry you're suffering with anxiety, your friend was very unkind doing that to you.

Thanks edmund

I know she had the absolute best of intentions but it really had an awful impact on me.

Hopefully I'll get my results through today and with any luck, my worrying will be over for 3 years. (Well that's until I find something else to worry about). Thanks for your message :)

I don't see the problem with raising awareness and suggesting that going for a smear is a good thing. I never went (past sexual assaults) until my mum was diagnosed with stage 3 cervical cancer because she went for her smear. She died 2 weeks ago, less than 2 years after the original diagnosis. So I'll be going for smears now regularly.

Fightinganxiety best of luck for today! I'm sure she had good intentions, however it's never ok to push a view on a person when it can cause upset, or even interfere with their health. Nobody should be bullied and broken into a decision about their own bodies, even if the other person thinks they absolutely know better.

YANBU

Not sure why you had a bit of a bashing there.

Creating awareness is not the same as pushing people or ignoring women's choices.

Some people are busy and forget. Some people miss appointments and get lost in the system and forget to rebook.

A thread like this could give someone a nudge to book an appointment when they have been preoccupied.

Of course women have a right to choose. I would never force my opinion on an individual who chose not to do it. Though I personally would rather a slightly invasive and uncomfortable few minutes and find out what's what rather than risk having cervical cancer, not knowing, and possibly die.

Too many women, even young women, die from this every year because they forgot or opted out of screening then found out too late.

I have just booked my long overdue first smear as a result of this thread OP, so thank you for telling of your experience. YANBU. If anything it makes you think of the importance of keeping up to date with these things. A moments discomfort could make all the difference, especially with having a 5 month old DD to be here for.

Red you are extrapolating loads from a study of four HCPs.

Someone else on this thread said all HCPs they know get smears so your points are invalidated.

Actually I'm not.

What I'm saying is, in effect, if smears for all are the best, then why do people who are supposedly the best educated about their health and are supposed to be promoting smears to other people sometimes make different decisions and go against that advice?

This is an important question to address because it offers explanations about why women don't have smears which are different to usual narrative of 'too busy', 'not informed enough', 'too scared' or 'have other issues that need a mental health remedy'.

It also undermines the assumption that there is an optimum blanket level of smears which should be achieved. The reality might be that different women in different areas might well be very different levels or risk which are not reflected terribly well in national statistics. It also neglects to discuss why some women should not be aggressively targeted because they might be vulnerable in some other way, and such an approach can be counter productive because these women might be more at risk from other health concerns. An aggressive approach might undermine trust and reduce rather than increase engagement with HCPs.

The fact you think my point is so narrow, really shows that you are not thinking about the issue the broad way in which it deserves.

Also for those who think the public are being misled, here is a publicly available document about the consent process with a section on how write and express informed dissent...www.gov.uk/government/uploads/system/uploads/attachment_data/file/436770/cs4.pdf

Which also shows just how bloody difficult it is to do. Its a 28 page pdf. Which is completely inaccessible to a lot of women. Not to mention it relies on GPs to actually respect your decision. In my experience this has proved to be harder to do than you might think. You have to actively justify and defend your decision against a doctor. And its especially difficult since that doctor has a conflict of interest because they benefit financially from you having a smear.

This is not an easy thing to do for some women - its down to where the balance of power lies. You have to be aware of your right to do this too - when women are given information on smears, the long term opt out clause is not included in this. The system is set up in a way which at easy step makes this a bureaucratic nightmare. The health care culture that has arisen around screening is in essence - Patient Stupid. Patient Should Comply - rather than treating patients as thinking individuals with lots of different and competing concerns which need to be balanced. The public culture that stems from that does not recognise other factors or reasons as somehow being 'legitimate'.

that doctor has a conflict of interest because they benefit financially from you having a smear.

They actually don't. Smears are not part of QOF. There is no financial benefit to the practice.

And it's hardly a "bureaucratic nightmare".

You write to your GP and ask to be taken off the list. The GP tells you to write to the organisation that sends out the invites. You write. You are taken off the list.

Do remember that some tests (breasts) have led to unnecessary surgery and the NHS has had to change its advice as it is by no means clear that for some of these tests your health is better protected if you have them!

Of course its a woman's right too decline a test BUT of course it's a woman's right to talk about her recent treatment and use her experience to recommend a smear. You don't have to click on a thread if you don't want to hear that message.

I am surprised on dyings stance. Whilst hers is an awful experience I would have thought that having that experience would have made her more pro testing. It was truly bad luck that hers was one of a small percentage that wasn't picked up, however given that many are, I would have thought she'd believe that anything that could possibly prevent others going through what she is having to endure, should be grasped by both hands.

My life was saved by a smear test. I know people hate that emotive language but it is the truth and I have the right to say that, just as people have the right to choose not to be screened.
Going through the diagnosis and treatment was horrendous and I would do anything to prevent others going through that experience. Had I listened to posts such as dyings then I wouldn't be alive today again that awful emotive language . Tests are not 100% reliable and that's awful and unlucky for people who are missed. The opposite side of that is the pure luck of people who it does benefit.

I knew a lady that assessed the evidence regarding total mastectomy when she was diagnosed with breast cancer, and choose not to have one as they are often done unnecessarily according to some research. It was a gamble that didn't pay off. Now we don't know whether that wouldn't have been the outcome if she had have had it, but it may well have saved her life. She exercised her choice as is how it should be, but I know she regretted that decision at the end.

I truly believe that no one should be forced to do anything that they aren't happy with. It is a woman's choice but I also don't see what is wrong with giving personal experiences to help that choice. Just because it would be easier to not hear those experiences doesn't mean they shouldn't be put out there. Hear what people have to say or don't click on a thread and then make your own mind up.

X post with Lucy's breast surgery post.

And for dying
You were so incredibly unlucky to have the strain that isn't picked up. I really feel for you.

I had a really traumatic smear and colposcopy on the NHS. I've never gone back. I wouldn't put myself through that experience again.

You write to your GP and ask to be taken off the list. The GP tells you to write to the organisation that sends out the invites. You write. You are taken off the list.

It assumes your own GP surgery knows the procedure. And the receptionist isn't a complete jobsworth about it. It assumes you don't have to explain your rights to them. Or explain to them that the explanation that the limitations of their system not allowing you to be removed is bullshit (and down to their inability to use the system). And that don't have to make an appointment with a GP to remove yourself either

Then later they come back to you (after about the 5th attempt of trying to resolve it) saying yes ok, but you need to provide them with a letter and the one you have previously given isn't sufficient. This letter needs to be in a particular format or they won't recognise it, because otherwise it doesn't cover their backside sufficiently.

Frankly anything that falls outside the boundaries of 'normal' and not consistent with targeted and rigid structures in the NHS tends to be met with a 'does not compute' type of response rather than being easy.

The GP also can't guarantee you won't get letters from the centralised database because they don't have control over that - they only have control over what they send from their own system. And no they don't have the details of how you might be able to remove yourself from the centralised system.

Not to mention that if you go to a hospital they might pester you about whether you are up to date, and how you really should have one, if you go there for something completely unrelated. The note on your file saying 'do not pester about smear screening' only applies to your GP because systems are not integrated with all NHS hospitals / other HCP. Cue, the lecture from someone about the merits of screening, rather than accepting just a simple 'no' in response to question over whether you have you had one recently.

But yeah. Its not a bureaucratic nightmare. So speaks someone who has not actually attempted to do it.

Overall it would be nice if reasons and experiences of women from both those who decide to have a smear and those who don't were acknowledged and respected. There are positive and negatives to both.

The whole debate is not being had and there is a wilful attempt to silence those don't want to have one. Or to try and discredit them.

I'm sorry you've had that experience, but it's obviously an issue with your practice and it's not NHS policy.

I have removed people from the screening list personally as I used to be in charge of cervical screening recall. Patients were put through to me and I told them what to do. Never had a complaint.

If you're finding it confusing you should speak to your practice manager.

And again, it's nothing to do with targets. There are no smear targets. Practices choose to audit screening for the sake of patients' health, not because they have some weird idea about women being children or wanting to exam women intimately unnecessarily.

Nobody is being silenced and you've had your say throughout the thread. Being so dramatic is unnecessary.