To insist on a repeat smear test?
Worried1800 · 07/05/2021 11:30
Name changed for this.
I recently had a smear test. Previously they used to test for cervical cancer. Now they test for HPV and if you don’t have it they don’t test for cervical cancer. My letter says as I don’t have HPV they won’t be testing for cancer.
I’m not happy with this at all - I want the cancer test. I’ve had surgery to remove abnormal cells in the past and I want a negative cancer test to put my mind at ease. I’m not satisfied to just assume I don’t have cancer because I don’t have HPV.
Secondly, I caught HPV from being attacked over 20 years ago. I passed it on to a partner 5 years ago so I clearly still had it. I find it very odd that it’s apparently disappeared now and I’m worried the test result is wrong.
What would you do? Am I entitled to insist on having the actual cancer screening and not just the HPV test?
Blablah1234 · 07/05/2021 12:12
You can insist but they will refuse/ if they give in and do it the lab will just reject it and them reprimand your go for taking a smear test outside of protocol so you are wasting your time. They screen for HPV because it causes abnormal cells which can lead to cancer. If you are negative for HPV you are very very very unlikely to have abnormal cells ( which is what is screened for even previously, not cancer. A smear isn't advanced enough to confirm cancer)
MarshmallowAra · 07/05/2021 12:32
I'd try to use your previous abnormal cell detection and removal as a way to ask for a psp smear.
I think there are a small number of cervical cancers caused not by HPV and you could say you're concerned about that.
If you get a sympathetic gp you might get a pap.
Not sure what you mean by having HPV five years ago since I'm not sure the test was available then - do you mean you had warts or (?) The wart causing strain is not the high risk strain.
However it dies seem likely you had a high risk strain previously as you had abnormal cells.
I understand strains can be cleared by body over time - and I'm not sure but may go dormant etc.
ForgotAboutThis · 07/05/2021 12:37
It's vanishingly rare to have abnormal cells without having HPV. Hence the way the test works. I would ask to speak to the practice nurse because it is clear they have not explained things well to you. As I understand it HPV doesn't go away but can be inactive, and when inactive wont show up on a smear and you won't have abnormal cells at that time.
KFleming · 07/05/2021 12:41
I think HPV can go away. Both me and my best friend had a positive HPV result following a smear, both tested negative at the next smear test. At the bottom of this page it says that most HPV infections go within two years.
alittlequinnie · 07/05/2021 12:47
I too had abnormal smears a few years ago.
I had my latest smear test about 18 months ago and I got the letter to say "you tested negative for HPV so we discarded your test".
It seems SUCH a strange way to go about it? I too tested positive for HPV and didn't realise that it can "go away". I thought it was with me for life.
Funny enough I went the to GP a week or so ago and she INSISTED I was due for my smear - I told her it was less than 18 months but she said she would do one anyway.
Got a call yesterday to say the lab rejected my test as it was not due.
So there's a GP insisting on doing one and the lab say "no thanks"!
I understand your worry OP - I think if you've had abnormal in the past you just worry so much that they will mutate again and nobody will know!
Surely there's an easier way to test for HPV than doing a smear too -the one the GP insisted on doing was pretty painful and it made me bleed - frustrating for it to then be rejected!
FelicityBennett · 07/05/2021 12:48
Your GP won’t be able to order cytology as this is a screening test and this has now switched to primary HPV testing
A repeat smear will be rejected.
The reason for the change is that research has shown that primary HPV testing is more a more sensitive test for detecting changes which may lead to CIN than normal cytology which has a lower detection rate and higher false negative rate hence the switch.
The evidence suggests that in the absence of HPV it is unlikely that any cervical changes progress to cancer
I understand your concerns and suggest you have a word with either the nurse or GP but they will not be able to order cytology
This would only be available privately.
Jo’s trust has a really good page on this and is worth looking at.
All cervical smears are only screening test and hence if you have any symptoms eg bleeding after sex, pain, irregular bleeding, persistent discharge need to be investigated and not just a smear
Blablah1234 · 07/05/2021 14:12
@0gfhty because the virus may have been dormant and can "flare up" again depending on your immune system. A smear test is also never 100% accurate so even if you're previous test was negative it doesn't mean there wasn't actually viral or low grade changes that were perhaps not picked up
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