To think in this situation a smear test is a waste of time?

[coffeeforone]

My nurse mentioned recently that smear tests only test for HPV, if you don't test positive for HPV then they won't look closely for pre-cancerous cell changes. Given this info I started wondering. DH and I were both virgins when we met. Assuming we both remain faithful, is it true that we can never contract HPV and so there is no point in the test?

Of course I will never stop being tested regularly (as I can never be 100% sure DH will always be faithful) but it did get me thinking, is this the only risk here?

@Pannalash @Username321

This is exactly my concern. In my situation, I feel I'd be more at risk of non HPV cancer, so I wish they hadn't changed the way they are testing.

Thismummyruns she said it looked red and slightly inflamed. No it wasnt picked up in the smear itself but after they had a proper closer look. It was the a slightly rarer form of cancer so it is slightly harder to detect. It was a real shitty diagnosis but finding out has extended my life no end through treatment.

I am concerned by this. I had my first smear 10 years ago, at 18, after bleeding during sex. No one has ever denied me a smear based on age and I've always been thankful for and really impressed by the services in my area. Of the 3 smears I've had in my life, 2 have been because I was referred or recommended to get one after bleeding . I was very lucky and I take my smear test seriously. Fortunately I had friable tissue that could be treated with silver nitrate and have had no further problems, but it was frightening. Rightly or wrongly (will investigate further, obviously) my initial position is to be concerned by changing to a testing system that doesn't appear to see past the end of its own nose.

I used to know someone who'd never had sex, or even any 'heavy petting' as we used to call it. TBH I think the mere thought of penetration terrified her so she absolutely hated smears - would always tense up so much that it was both painful and difficult.
I asked her why on earth she was putting herself through it, then, since there was no chance of her getting cervical cancer or anything else sex-related. (There had been no childhood abuse, in case anybody's wondering.)
So after a little talk with the GP, it was agreed that smears were just not necessary for her.
Presumably quite a rare case nowadays, though.

Women who are having symptoms like bleeding should NOT be asking/being referred for a smear test. They are a screening tool. Any woman with these symptoms, regardless of age, should be seeking and insisting on a referral to a gynaecologist or colposcopy clinic. Cannot stress this enough. This is not what smear tests are for.

Surely a hpv test is a blood test?

No it's a swab/brush or a urine test.

I agree username and it will be national by next year.
It is already national in Wales, some areas in England but all of England by 2020 I believe.

The practice nurse told me that 99% of cervical cancer cases in under 50’s are HPV related. I don’t know where she got that figure or if it’s accurate. But doesn’t help the 1%.

@adaline However isn't it better to have a thousand women treated for changes to cells if it means one of those gets an early diagnosis that saves their life?

Recurrent miscarriage is a risk of treating abnormal cervical cells, through damaging the cervix. In young women, almost all these changes will reverse to normal if left alone, which is why the screening age for asymptomatic women is 25, to avoid unnecessarily damaging the cervixes of many women under 25 and causing them later problems in pregnancy. There are risks and benefits to any screening test.

In my area smear samples are tested for HPV and, if HPV negative, no further testing is done. This will pick up more cases of cervical cancer in total, as most are caused by HPV, but the lab won't detect the minority of cervical cancers that are unrelated to hpv.

However a smear test also involves a visual examination of the cervix when the nurse/ doctor takes the sample, and they could see a suspicious lesion on the cervix that way.

@Wenttoseainasieve- if your comment was for me, I had smears alongside full std screening and thorough examinations. Both times I was told to also get a smear but got a straight forward diagnosis. If silver nitrate hadn't worked I would have gone straight back and demanded a gynae referral. Realised my earlier comment was a bit drip feedy, sorry.

My gut-instinct worry is really that HPV makes for a lazy approach and blinds people to rarer, unusual cases. Will read up on the topic though as this is initial thoughts from my own PoV and experience of getting smears.

This is interesting. My last smear results were borderline abnormalities but HPV Negative. As HPV was neg no need for further screening despite the borderline changes and I will be recalled in 3 years as normal. But if the new rules are in place then and I'm still HPV neg they won't check to see if the borderline changes have progressed? That's a bit scary!

If you've got a cervix, a smear test isn't a waste of time.

Quite frankly, MN is full of people whose partners/husbands have turned out to be knobbing somebody else, sometimes for years. You can never be 100% certain about a partner's history unless they have been kept in a cage from the age of about 9 (and even then, there is the chance of sexual abuse/assault having passed the virus on).

And there are other cancers that can be picked up that haven't been caused by HPV - I was a Gynae Secretary for a few years, and there were even elderly Nuns who were v.i. but had consented to an examination, only to find other cancers present.

The very fact of having somebody professionally trained looking up there and talking to the cervix owner reduces the risk of cancers becoming fatal.

So no, it is never a waste of time to have a smear.

HPV lays dormant so even if you're HPV negative you need to have a smear.

No one needs a smear. Everyone is entitled to choose, based on their own personal risk.

HomeMadeMadness

No a smear test is NOT a HPV test.

See the NHS website here

Smear tests look for changes to cells of the cervix, while HPV testing looks for the presence of the virus.”

This is true but after years (I’m 55, never missed a test, my mum had cervical cancer) of receiving letters informing me that my smear test showed no evidence of abnormal cells, I received a letter last time simply telling me that’s as there was no HPV present in the sample, abnormalities were very unlikely so no further tests would be carried out. It made me feel rather uneasy, that tests aren’t as thorough now as they used to be.

@Langrish the nhs website is out of date. Smear 2 days ago (south east) and was told smear now tests for hpv and only if positive do they go on to test for changes in the cells

It's also bad that the NHS website is out of date as some areas it's just basically an HPV test.

They've had to start the new test early in some areas, ahead of national roll out because of the staff shortages. The backlogs of tests waiting to being screened was massive.
Unfortunately or fortunately (depending on how you look at it), the first national screening campaign was launched during the time when it's already busy, so the labs can't cope again, because everyone's coming for tests.

The poster that asked about picking up ovarian cancer. As cytologists we are trained to identify not just cervical cells but any other cells that might make their way down to the cervix and be present at the same you have your smear.
So we can (and I have) picked up ovarian cancer, endometrial cancer, fallopian tube cancer, bladder cancer and one I'm particularly proud of - a breast cancer (that was quite tricky).
In future, if your test is HPV positive, a slide is made from the same sample, so if the extra-cervical abnormal cells are present then we do have a chance of picking them up.

I have had the HPV vaccine. So assuming that they only check whether HPV is present then me having a smear test would be pointless, no?

I think the HPV vaccine doesn't protect against all strains of HPV.

@QueenOfTheTofuTree I'm assuming the test will hopefully pick up any strain even the ones you haven't been vaccinated for so yes I think for you there is a point in the test.

I've decided not to go to my smear because they're doing primary testing for hpv in my area and I have a practically zero chance of having HPV, it's therefore a waste of time for me. If I had symptoms of cervical cancer I'd obviously get checked out but that's not screening that's diagnostics.

The chances of contracting cervical cancer in a virgin is extremely unlikely. Also the more sexual partners you have had unprotected sex with increases your chances of HPV. Speak to your GP about the risks and come to a decision.

Sorry, read it that you were a virgin. Yes you should be tested. HPV is very common and most people who are sexually active get it at some point. You may have a lower chance than other people statistically but I don't think you can be 100%.

Dareiadmit your thinking is very short sighted. As a stage 4 cancer patient myself I had no symptoms what so ever. Few the few minutes it takes its worth it

I think they should run both tests in tandem before changing - as previous posters have said there are people who test negative for HPV but have cervical cancer.