To think they should test every smear for abnormal cells even if you are HPV negative?

[Notmoreraining]

Just had the results of my smear and it says that I have tested negative for HPV so therefore they won’t be testing for abnormal cervical cells even if I’ve had them before because the risk is low. I am appalled. I went through a smear test for them not to to even bother testing for abnormal cells, wtf? Even if the risk is low I want them tested. Just read 70% of abnormal cells/cervical cancer are in people testing positive for HPV so what if I’m in that 30%? Are the NHS now routinely only testing for abnormal cells where there is HPV and is there going to be a big rise in cervical cancer as a result - or is the 30% that will now be missed too small a number of new cancer cases to even register? Don’t think this change - if it is nationally across the country - has even been publicised widely. Does anyone know about it or when it was brought in? Thanks

I'm worried about this too, April 2018 I had lettz for cin3, I was hpv negative at the time. My 6m follow up in October showed I was hpv negative so they wouldn't be checking for abnormal cells! How can this be when the reason for this smear itself was to make sure I didn't have any Abnormal Cells still!? As a result I've gone back to usual 3 year recall, which I'm astounded at anyway given I had cin3. Not due next smear until October 2021, and I imagine there could be huge backlog due to covid, so who knows when I could be seen.
Hpv can lie dormant can't it? If it's dormant at the time of your smear then surely you test negative, if these rules had been in when I had my smear in 2018 then I wouldnt have been checked for the abromal cells, its infuriating.

[quote Sidge]@corrag absolutely. Normally the immune system clears HPV within a year or two.

We know persistent High Risk HPV (HR-HPV) infection is a risk factor for high grade cell changes - hence why women with HR-HPV but no cell changes are invited back for a repeat smear after 12 months.

It's not purely a cost cutting exercise - research has strongly shown better outcomes (and less unnecessary colposcopy treatments) with primary HPV testing. It's also a precursor for urine home HPV testing.

HPV can be spread by any skin to skin contact, not just by penetrative penile sex. Lesbians can get HR-HPV too, and using sex toys can transmit HR-HPV as can digital penetration.[/quote]
I'd like to know where I stand- I had my first smear in 2013 aged 25 and had CIN2 cell changes and tested positive for HPV. Had Lletz for this.

I was on yearly recall after that and each test appeared to be fine, no cell changes until my last in December last year where there were 'borderline' changes, along with HPV. Had the colposcopy and everything actually looked perfectly fine so nothing needed, but I was told I would probably go back to 3 yearly recall now.

Is this correct? Given I appear to still have HPV, should I not be on yearly recall still?

Sorry for derail btw I just wondered

From www.nhs.uk/conditions/cervical-cancer/symptoms/:

In most cases, abnormal vaginal bleeding is the first noticeable symptom of cervical cancer.

This includes bleeding:

during or after sex
between your periods
after you have been through the menopause
Visit your GP for advice if you experience any type of abnormal vaginal bleeding.

Other symptoms
Other symptoms of cervical cancer may include pain and discomfort during sex, unusual or unpleasant vaginal discharge, and pain in your lower back or pelvis.

Also, while most commonly spoken about with cervical cancer, HPV is connected to anal cancer, vulval cancer, vaginal cancer, penile cancer, and some types of neck and head cancers. This is why people fought and went private for boys to be included in getting vaccine protection.
www.nhs.uk/conditions/human-papilloma-virus-hpv/

Same here cin3 25 years ago now and underwent a colposcopy. Went on to have annual smears for 10 years then put on to normal standard testing. I had a smear test recently and I think my wait is now 5 years between smears and was shocked to discover they only test for Hpv. In the back of your mind you always worry if it will return.

HPV isn’t just sexually transmitted. It’s often transmitted by poor hygiene too - the kind you get in some parts of India and Africa. All of my virgin aunts (and they were virgins) had hpv and all died of either cervical / anal / or vulvar cancer.

@DimidDavilby

I am also HPV negative with previous abnormal cells requiring loop excision. OK 99.7 is high but its not that high! That's still 3 in every 1000 women. I have 1000 Facebook friends!

You don’t have 1000 Facebook friends with cervical cancer though.

@GrumpyHoonMain

HPV isn’t just sexually transmitted. It’s often transmitted by poor hygiene too - the kind you get in some parts of India and Africa. All of my virgin aunts (and they were virgins) had hpv and all died of either cervical / anal / or vulvar cancer.

Over there not being a virgin can often mean escaping hpv because you have access to better hygiene products (presumably because you are married and so have more money).

@theGoldenApplesOfTheSun and @Sidge thank you, both posts were really informative.

[quote BiBabbles]From www.nhs.uk/conditions/cervical-cancer/symptoms/:

In most cases, abnormal vaginal bleeding is the first noticeable symptom of cervical cancer.

This includes bleeding:

during or after sex
between your periods
after you have been through the menopause
Visit your GP for advice if you experience any type of abnormal vaginal bleeding.

Other symptoms
Other symptoms of cervical cancer may include pain and discomfort during sex, unusual or unpleasant vaginal discharge, and pain in your lower back or pelvis.

Also, while most commonly spoken about with cervical cancer, HPV is connected to anal cancer, vulval cancer, vaginal cancer, penile cancer, and some types of neck and head cancers. This is why people fought and went private for boys to be included in getting vaccine protection.
www.nhs.uk/conditions/human-papilloma-virus-hpv/[/quote]
So you have a smear - not examined, HPV Negative. Then you bleed after sex. And your GP says "Well, your last smear was fine" - then what?
Or your GP says your last smear was fine but let's do another one anyway to be safe, and again they only look at HPV and you're told it's all fine? How does this process work now??

Dimid, I think it's 99.7% of cancer arising form/linked to HPV, not 99.7% of women so unless all your 1000 Facebook friends are women with cervical cancer, there won't be 3 who's disease progresses.

Then you bleed after sex. And your GP says "Well, your last smear was fine" - then what?

Your GP does not say that. Your gp takes a full medical history, examines you, sends off tests and if necessary refers you to gynaecology.

The screening programme is for people without symptoms.

And is it possible to have any smear examined fully if it is HPV negative??

This is a far better method and will actually mean they are better able to focus on those at risk. If you have cervical cancer symptoms you shouldn’t have a smear. It’s a screening test not a diagnostic test.

What service do you propose getting rid of in order to test all of these extra smear tests for abnormal cells? If we had limitless resources then yes test them all why not but since we don't adding an extra load in one area involves getting rid of one somewhere else. If you have a large scale statistical survey proving that providing the extra testing in this area would save more lives than the service you'd get rid of to provide it then yes I'm all for it.

Can anyone advise me?

Had first smear a couple of years ago and got the recall for 6 months time as changes in cells.
Finally got that smear recently (over a year late, my fault) and the results say I tested negative for HPV. No mention of cells?

I’m a bit worried now that I’ve read this thread because I’d been fully expecting a ‘your cells are fine this time’ type letter.

@Theluggage15

This is a far better method and will actually mean they are better able to focus on those at risk. If you have cervical cancer symptoms you shouldn’t have a smear. It’s a screening test not a diagnostic test.

Thank you - that's definitely the key to this - not diagnostic I will remember that

I've just found my last smear letter from 2019 and it just says no abnormal cells were found - no mention of HPV

@HandfulofDust

What service do you propose getting rid of in order to test all of these extra smear tests for abnormal cells? If we had limitless resources then yes test them all why not but since we don't adding an extra load in one area involves getting rid of one somewhere else. If you have a large scale statistical survey proving that providing the extra testing in this area would save more lives than the service you'd get rid of to provide it then yes I'm all for it.

This is bollocks because cervical screening used to work exactly this way - every sample examined fully

This is bollocks because cervical screening used to work exactly this way - every sample examined fully

Yes but they’ve since realised through research that hpv testing is better than cytology. They didn’t used to test every sample for both hpv and abnormal cells.

The thing that is a real worry is that this wasn’t explained properly at the time of the smear. To give meaningful consent to the test you should be clear about what they are testing for. My cervical screening reminder came with a leaflet that explained it and the nurse also explained at the time she did the smear

Maybe the NHS should call it HPV Screening (which is what it now is) and drop the cervical bit altogether?

As @Theluggage15 says don't confuse screening with investigations - any symptomatic woman regardless of age, last smear interval or result or history would be referred under a two week wait if there was a suspicion of cervical cancer.

This means examination and colposcopy with a gynaecologist, not a smear.

I'm confused by the change too, I have only ever had one sexual partner and he has only ever been with me. So I'm HPV clear. I still have had smears tests. I am currently symptomatic (a whole other thread) and had a smear but only tested me for HPV. I realise the risk is less than 1% but surely if patients are symptomatic they should test?

@Someonesayroadtrip if a woman has symptoms such as bleeding between periods, bleeding after sex, pain discharge etc she needs referral to gynae for colposcopy examination, NOT a smear at her GP surgery.

Smears (or primary HPV screening as it is now called) are a screening tool, not an assessment or diagnostic tool.