Can someone explain hpv testing an smears?

[CloverMoon]

I may have gaps in my knowledge, I’m asking for information rather than imparting information.

From what I understand the new smear test tests for hpv, if negative they test no further?

If I’d had it would my body have cleared it by now? I’ve had the same partner for 20 years. Or can it still be detected?

I guess I’m asking- does it make smear tests pointless for women in very long term relationships?

No it doesn’t work like that. HPV can remain dormant for decades with no symptoms or none you know about but still be there.

If you google the research on it the only women who are almost completely safe are virgins. Nuns never got HPV and it was that which made scientists cotton on.

Before any pedantry- Aibu to be a approaching 40 and not understand smear tests still...

So if I have it it’ll show in my test?

That’s a good thing. I was worried that it meant my samples would no longer be properly monitored if it was undectable- despite me still being at risk

Certain types of hpv cause cervical cancer with out it the risks are tiny. They look for the types that can cause it. When found they test the cells to see if any pre cancer cells found and what level they are cin1 is low 2 is moderate cin3 high risk. They won't treat cin1 as often goes on own in next 6 months so would re test. Above that they treat.

Ooh, good question! I had a smear very recently (had put it off for years and it was long overdue) and I was surprised when the nurse told me that if the sample was negative for hpv, then it would not be tested further. I would be thrilled to never have to get tested again as I have a weirdly positioned and hard to reach cervix - hence putting it off for so long.

@CloverMoon I’m in Ireland so it might be different here. I have my smear tests done privately due to the cervical check disaster.

After the age of 30 the HPV test is done along with the smear test here.

As pp said HPV can lie dormant and show no symptoms so you need regular smear tests.

Next question, would a negative test and no partner changes mean you’d always be negative. Or could it flair up again and be detected?

I’m not out to refuse tests btw, I’m trying to work out if my samples would be properly checked under new rules.

I had pre-cancerous cells treated by LLETZ about 10 years ago.
Now they test for HPV they said I don't have it so they don't do the full test.
Does that mean that I had HPV before and now I don't?
Or were my pre-cancerous cells not caused by HPV and therefore there is a risk that they're not now fully testing all samples?

I've been with dp for 11 years and had tested fine twice in that time. Then last year I test hpv and cin level 3. The colposcopy team told me that it could have been there years. I could also test clear for the next ten years but it does not mean I am hpv free it means its dormant and can return at any time so its vital to keep check ups up to date. After being cin3 and told how close a call to cancer it was I will not be delaying any further tests.

Thank you @TriciaH87 for sharing that, I’m sorry you’ve been through it

When I went recently the nurse was saying she wa dthrilled they have decided to give HPV vaccine to teenage boys now too and it was nonsense it was only given to girls. She said whole generations ahead of us won’t need smears as if men and women HPV free then there is only a teeny tiny chance women would get cervical cancer. Is that true? Does HPV vaccine lower chances that much???

@Fruitbatdancer yes, it is that effective. Of 43,000 ish new cancer patients in America (with cancer in an organ effected by HpV) diagnosed in a year around 33,000 are linked to the person having HpV.

Apparently anyway: www.cdc.gov/cancer/hpv/statistics/cases.htm

I was the first year to get the HPV vaccine - my best friend is a year older than me and she had Cin3 high risk cancerous cells on her first ever smear test this year. Caused by HPV.

I know someone who recently said she’d had one of these new tests, it tests for HPV rather than cell changes, if no HPV is detected they do not look for cell changes as they deem the chances of you having any would be very low in this instance. This confuses me because I was told that a clear HPV test does not mean you are not infected with HPV it just means that it is not currently active (it can lie dorment in your system) but you do technically still have it.

I had a smear, it came back borderline abnormal but no HPV. Next smear also came back borderline abnormal but no HPV. Next smear came back CIN 3 pre-cancerous but still no HPV. I was sent for a loop a few weeks later where I was tested again for HPV which again came back clear. This was only 2 years ago. Under these new rules they would not have checked for cell changes in me at any point based on my HPV results but they were there. Does this mean my loop was a pointless exercise as I would never actually have reached cancerous stage anyway or would I have to be suffering with symptoms and possibly late stage cancer before these changes would actually be checked for/found? And whilst HPV is the biggest cause of cervical cancer it is not the only cause, does this mean these women are now going to lose the chance of early detection? It seems more like a money saving exercise than a life saving exercise to me.

I can't quite get the hang of it either — I had the HPV vaccine as a catch-up, but still before I was sexually active.

So I'm the 'textbook' person for the vaccine, and will (fingers crossed) never be infected with those HPV strains. So presumably my smear test samples will never go beyond that first check.

I suppose the nurse will have a look at whether it looks healthy, but I presume by the time you were to see anything optically any problems would be quite far on?

Just to add to my above post and queries that have been raised: No samples are not being properly checked. They now base thourough checks on the HPV result, if you are ‘HPV clear’ they do not check for cell changes, however a ‘clear’ result does not mean you do not have HPV or changes to your cells it just means that at the time of testing any HPV infection is lying dorment, that does not mean it was not active on the run up to your smear or will not activate/reactivate right after the smear is done meaning you are still at risk of cervical cancer whilst being falsely led to believe you are not because your result that a week ago would have shown as positive says you are clear leading you to misguidedly think you don’t have it when in-fact that may not be true.

To answer some of the above, abnormal cells do not indicate cancer, they indicate abnormal cells...some of which become cancer. Most resolve themselves. Therefore, looking at stats only, yes, there will be a rather larger percentage of treatments taking place that are not necessary.

Presumably, HPV testing will eventually mean smears are mostly not needed. Which is fortunate, since they are ridiculously unreliable and some of the top experts in the field have already stated on record that if the NHS tried to introduce smear testing as new now then it would never pass the tests. Far too many false positives to be reliable.

As far as I understand it, cervical cancer without HPV is extremely rare, but not impossible. It can occur. So yes, these women will be missed with the new tests.

The new testing means women who may go on to develop CC can be monitored earlier (say if you've got HPV but no abnormalities you will be more regularly checked), and less women will gave unnecessary procedures. However the flip side is, a small number of women who go on to develop CC will be missed because they don't have HPV.

The vaccine protects against the most common strains of HPV that cause cancer, but not ALL of the strains that cause cancer. So just because you have the vaccine doesnt mean you are completely protected and you can go without smears.

Also vaccines don't always work.

I'm not an anti cancer btw - I wish I'd been young enough to have this. Just saying it's not a compete protection and people shouldn't assume they don't need smears.

RE, HPV is like the coldsore virus. Once you have it, you always have it, but it can go dormant not causing any bother. But can pop back and cause trouble sometimes. The reasons aren't clear, but being stressed/ run down is sometimes thought to trigger it.

Anti vaxxer, not anti cancer 🙄

Name changed.

I had the cervical cancer vaccine in the catch up program in my early 20’s (it was three injections). I was then diagnosed with Stage 3B, grade 3 (the worst) cervical cancer about 11 years later. My smears had always been fine except for some abnormal cells when I was 18, which had cleared up at a smear 6 months later. I have only been with my husband since I was 21, so having clear smears, the same partner and the vaccine does NOT preclude you from getting cervical cancer, it just means you reduce the possibility.

After two rubbish years of surgeries, chemo, radiation and brachytherapy (radioactive rods inserted into you can guess), I am in remission.

Even smears are not 100%. If they are swabbing the left each time, but it’s developing on the right, then you can still have cervical cancer, but a clear test. I am proof of this, as cervical cancer is so slow growing but based on the size of my tumours and where the cancer had spread to, I’d had cancerous cells for at least 5 - 10 years before it was picked up.

You’ll most likely not get cancer, so I wouldn’t actually be too worried about the new test, however I’m sure you could pay for private smears every two years to put your mind at rest.

Smears do not reduce the likelihood of getting cancer - they’re a detection method not a treatment.

I had cin3 but tested hpv negative so I am worried about the new testing tbh

All my smears have been tested for HPV and all have been clear. I have however had to have multiple treatment for cin-3 cell changes. This may not have progressed into cervical cancer but the cells were removed. It worries me that my future sample will be clear of HPV but not tested further. Now planning to go private for my smears so I can pay for the full testing. Although only a small percentage of cervical cancer is not caused by HPV, there are women who are going to be missed due to this new method of screening

If you're diagnosed with a high risk strain of HPV should you then be checked annually?

I had a positive HPV test around 15 years ago and abnormal cells. A few colcoscopies, cells returned to normal, back on 3 year smears.

Moved areas, another HPV positive result. Annual colcoscopies, but moved home again.

New GP seemed baffled when I mentioned HPV. I'd had another abnormal smear, referred to hospital. Colcoscopy smear was clear but gynaecologicist didn't have my old notes, refused to believe me that I'd had hpv. Refused to check for it, insisted a clear smear meant all was ok. Old area, colcoscopy nurse told me to stay on annual checks until HPV cleared.

I'm going private to get checked but I worry about women who can't afford to.