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.

This is the breast screening change in NHS guidelines

www.scotsman.com/news/nhs-changes-advice-on-breast-cancer-amid-concerns-of-unnecessary-medical-treatment-1-2502019

I just got my smear results this afternoon. I used to live in Scotland and was invited for a smear at 20 but I now live in England and am nearly 29 so I'm 4 years late by englands standards.

Results all clear. So relieved.

The problem isn't just my practice.

Are you trying to deliberately miss the point? There are lots of people who have similar issues and the NHS policy is not transparent and not clear to women. It should be on all NHS literature relating to screening if it was. It should be a simple form that people can just fill in and hand in at the surgery. It should be user friendly.

This is my point. Its not. The whole system is weighted so 'yes' is the answer and its difficult to deviate from that. You can't just say oh look its in the NHS guidelines therefore its easy. Even GPs are on record stating this.

To say it is easy is just a total cope out and fallacy. Its a matter of how easy it is to do in practice rather than it simply being a policy. Its an accessibility issue for this reason: only the informed can say no because they know how to.

I'm sorry alpacasandwich you have repeatedly belittled and dismissed my point about this throughout the thread which is why stand by what I say about silencing. There is more than one way to silence people. Its not just about telling them to shut up. It can also include saying things are isolated problems and not more widespread. It can include saying that because the policy is there, job done there is no further problems and everyone can say no. It says you don't have a responsibility to do more to enable women to say 'no'. Its about denying there is a problem and being hostile to all criticism rather than asking 'how can this be improved'.

The whole dynamic rather undermines the very principle of informed decision making. If you can't say no easily and are not easily directed to how you can say no, being asked time after time, is to some harassing. To others it is indeed welcome and I don't deny this. This is the problem though. you need to properly acknowledge weaknesses in the system rather than saying 'oh its just your practice, no one else has problems'. Cos its bull shit as the many threads on the subject testify to.

To those whom it is harassing, at some point, some will 'consent' purely to shut up people, rather than out of real free choice. That is coercive and unethical in nature.

As I say, I don't think screening is a bad thing. I do think the manner in which the system is set up and is applied practically has some serious flaws which those who support the system are wilfully blind to because of their ambition to extend it. And that is what I have huge problems with.

Its the attitudes that support the culture of screening, and ignore the ethics of consent which are not completely black and white in terms of 'yes' and 'no'.

Op i have not read all the responses as too busy but i will accept this thread in the spirit in which it was intended.
I dont see anything wrong in sharing your experiences and using them to encourage others to be pro active in looking after their health, dont see why you are getting a kicking but there you are . Glad all is ok for you now x

It is a system that does not recognise 'no' as being a 'normal' response.

It has improved. The leaflets have this on them now (at the end)

It's your choice whether to have screening or not.
If you decide you don’t want any more invitations, you
can opt out. Visit www.gov.uk/phe/screening-opt-out
to find out how.

This takes you here: www.gov.uk/government/publications/opting-out-of-the-nhs-population-screening-programmes/opting-out-of-screening#cervical-screening

then to here:www.gov.uk/government/publications/cancer-screening-informed-consent

where you will find www.gov.uk/government/uploads/system/uploads/attachment_data/file/436770/cs4.pdf

In the index you will find the template letter that your GP should send you, then you should fill in and send the form to them/the screening programme......... You need to read Cervical Screening The Facts which is the out of date 2009 version of the first leaflet.

If you are unlucky the service provider of cervical smear recall system for your area will have made its own interpretation guidelines and your doctor is supposed to call you in for 'counselling' but PHE do not say this. (total waste of an appointment).

The charities involved want the above wording taken out of the leaflet altogether, otherwise women might realise they have a choice . They had questions raised in the House of Commons on the issue.

Public Health England have done extensive research on informed consent and in producing these leaflets so I hope they ignore that.

Yes, it won't really do to simply say oh well it's not NHS policy to be like this, it shouldn't happen. While it's very welcome to see acknowledgement of that, it's evidently something that is happening. To lots of women, at lots of practices. There are systemic issues.

It clearly isn't simple to opt out for everyone, and bear in mind that not all women have access to the same resources. If it can take a few phone calls, letters and some faffing for someone reasonably assertive who speaks English well, that's obviously going to be much more of a mountain to climb for women not ticking those boxes. Personally I don't give a fuck about a few letters and I've time to spend addressing these things, but one simply cannot assume this is true for everyone.

Baffled by some of these responses. I wonder how some of you get on in real life being so sensitive to a few letters reminding you about a service which is available to you. There are many women I'm the world who don't get the chance to choose whether they want a smear test!

I wouldn't bother to opt out. I just don't agree to go and no one has ever every forced me to . I have been to the GP twice in 15 years and once I have been asked between visits if I still exist and want to stay on the list (yes I responded). Presumably the GP still gets paid for having me on the list - I think it is £146 a year and I don't cost my GP anything like as much as that so I think all is well. If they waste 2 stamps on me every 5 years the £146 a year will cover that.

There are many women I'm the world who don't get the chance to choose whether they want a smear test!

Including a few in the UK, perhaps?

But the fact that some people don't get access to certain care isn't a reason why it's appropriate for everyone. The list of screening and medical treatments that women in the developing world don't have access to is lengthy, but one assumes you don't use that as a reason why we should all have all of them? In which case, why is it relevant here?

Wank, I'm not saying it's a reason why we should all have them, but puts it into perspective when people seem to be offended about being reminded of them.

I can't remember when I last had a smear test, but it must be well over 10 years ago. I hate the things! I've convinced myself that I am very low risk and don't need the tests.

Well done OP! Glad you're ok

Baffled by some of these responses. I wonder how some of you get on in real life being so sensitive to a few letters reminding you about a service which is available to you. There are many women I'm the world who don't get the chance to choose whether they want a smear test!

Living in a modern day civilised society doesn't just mean you should be grateful for the care you have because others don't have it. You should aspire for the best for everyone and providing a good example to others who don't have the system.

There are country where in order to access other health care women HAVE to have smears. That is equally wrong.

Its not a race to bottom where you should be grateful for having care. You should get the right access to right care. You should promote the principle of consent in healthcare as well as healthcare.

I must say I am please to here that there has been improvement in the system since I opted out (this is only a couple of years ago) and the top link is dated Sept 2016 but that's STILL just a link to the a 28 page document. That's not really very user friendly.

The improvement has been a line on a leaflet which points to a website that then links to a 28 page document which is quite daunting and intimidating by that very nature.

Right hapalax. You're not really putting anything into perspective though, because it has nothing to do with the subject at hand. I'm also left wondering whether you've ever actually spoken to many women in the developing world on the matter, about what screening tests they might want, or whether you just decided to throw their plight in there to make a point without knowing anything much about it.

Hapax, sorry.

I don't accept that disagreeing and calmly replying to your arguments with a dissenting view is "silencing".

I don't agree that correcting incorrectly quoted statistics is dismissive.

I accept that you have your view but I don't share your perspective and that's that.

Then we completely agree to disagree then.

Of course going for a smear will be difficult for some people. In the same way that going for a colonoscopy would be difficult for someone else. Invasive medical procedures are rarely enjoyable and often quite distressing. But they might just save your life so perfectly reasonable for the OP to try and encourage others to have their routine smears.

There's plenty of reasons women choose not to have smears. You have a 0.65% lifetime risk of developing the disease. Smears aren't particularly accurate and miss many types of cancer. So you could still die if you attended every smear you were "invited" to. Medics can't always predict which changes will turn cancerous so everyone is offered treatment. Many women are over treated. A study was done in Bristol to save one life from cervical cancer you would need to screen 1000 women for 35 years and quite a few women would be sent for colposcopy ect needlessly as over 200,000 smears come back abnormal each year. Obviously there isn't that many cases of the disease! There are around 30 million women in the UK and cervical cancer kills around 800 which I agree is tragic but then around 875 women die in falls each year! Heart disease and stroke kill more women than cervical cancer. .are we told this? Plus of course most women hate the speculum exam and find it agonisingly painful. And are quite often told by medics and other women to grow up and suck it up! I decided 17 years ago not to put myself through any more smears but I don't pretend to tell anyone else to screen or not...it's entirely the decision of the woman involved. Finally doctors get incentive payments for persuading 80% of the women on the books to smear. ..conflict of interest?

not an evil stepmother. There are around 30,000,000women in the UK. Around 900 die a year of cervical cancer which I agree is very sad. Many of those will have attended every smear they were "invited" to but still contracted the disease because actually smears aren't terribly accurate and tend to miss adenocarcinoma completely. Its for every woman to weigh up the pros and sons and make the right choice for her and her family. Speaking personally I don't screen. Should I develop cervical cancer or indeed any other serious illness ( I don't smoke or drink and am active re exercise) then I would expect the NHS to help. Its free. And by the way I work full time and pay tax and NI. So I do co tribute to the system

I keep getting the reminder letters but TBH I can't bring myself to get it done.
Wish there was a less invasive way to do these tests.

User1490465531 but there is a less invasive way! We just aren't told or offered it. Since last year our Dutch counterparts have been able to self test for HPV. Here you can order a HPV self test kit online . You have to pay but I think Superdrug do one for around 50. Remember that cervical cancer isn't the rampant threat to women we're led to believe.

Agree Kat876. The smear test is not diagnostic anyway. It detects abnormalities caused by the HPV virus. If you have not got HPV, you will not get the type of cancer that would show abnormal cells on a smear. They should test for HPV instead and monitor those that have it. Also, whenever you hear of a young person dying of cervical cancer, there's always a bit about how they should have been offered a smear when they started having symptoms. That would not have helped. Once you start having symptoms, you don't need a smear, you need cancer treatment.

Jade Goody had numerous smear tests and had abnormal cells burned off every time. Her cancer was still missed until it was terminal. It made no difference.

I actually got my reminder letter today. Hate the bastarding things but needs must! Off on annual leave in a few weeks so will book one for then. Please try and have one of you haven't as it's all over quickly, is uncomfortable but I just look at ceiling and think of something else. I then come out and eat my chocolate bar that I buy specifically as my reward.