To ask why you’ve missed/delayed/declined cervical screening?

[chickentikkawhatswrong]

I see a lot of the campaigns on Facebook about women not going to smears or putting them off for too long.

However it’s generally stats and doesn’t seem to delve too far into the actual reasons?

If you are reluctant what holds you back from attending?

Jennifer why did they do a biopsy?

I had CIN3 in 2009 and underwent LLETZ treatment under GA with six monthly smears for 3 years afterwards. I have now decided that I will not continue with screening for my own personal reasons.

I find the way that women police each other over this subject nauseating. We are grown adults and intelligent enough to look at the statistics around cervical screening and make a decision - we don't need people telling us that when we develop cancer we'll be sorry. Women have a right to choose whether they wish to opt out of screening and do not need to be made to feel guilty or stupid for making that decision.

I’m a single mum to a two year old, and his dad only sees him on Saturdays.
I’m going to try and get one done soon, but I’ll have to ask the ex to watch my son, and he gets so shirty about “doing me favours”. 🙄

The skill of the tester makes a HUGE difference.
No one in their right mind would like smears, but they are a necessary bit of discomfort.

As for embarrassment?.. The nurses do these day in, day out.. nothing to worry about on that score.

I've seen a lot of comments saying how painful they are. I'm 30 and have had a smear test every year since turning 25 as I have HPV that won't shift and borderline abnormal cells for the last two years. Anyway, my first few smear test were excruciating, honestly i was convinced I'd be heavily bleeding after it hurt that bad. And then when I had my 3rd, I explained to the nurse I find them very very painful, and she had a look. She said I have an inverted cervix which causes smear tests to be alot more painful than for those who have the"average" cervix position. She told me to put my hands into a fist and put them under my bum, and she used the device in a slightly different position, and before I knew it she said she was finished! I barely felt a thing let alone pain. Since then I've told every nurse just before the examination about my inverted cervix, and I havnt had a painful smear test since.

This might not be the case for everyone of course, but had that nurse not told me and I then told others, I fully believe I'd be going through this agony still each time.

@StaplesCorner I’ve been to the local STI clinic for smears 3 times now. It’s totally anonymous, you don’t have to see the nurse that resides at the doctors knowing she’s looked up your bits a week before.

Also the STI clinic must put in so many speculums they are very fast and very skilled. It’s always been over in seconds.

It was a revelation when someone told me about it!

@StaplesCorner
That's not been the case for me. My letter comes back saying abnormal cell changes but no HPV so they must be checking for both.

They don't check for abnormal cells if you're HPV negative (as I am), is that correct? My cervix is tilted towards the back, so they can't see anything, meaning they'd miss a cyst. Meaning I could have a 'less common' cervical cancer and not know anything until I develop symptoms?

They're just testing me for HPV, but I think I've had the all clear after a cervical smear?

There is no point in going through it then, is there?

[quote crosstalk]@bitemyarsenic

I hope people read your post.

However: if you've been monogamous throughout your life, presumably HPV isn't a problem? or can you inherit genital warts etc?

What is the NHS using instead of steel?

How widespread and reliable is home testing?

Is the NHS addressing the issue of women's reluctance to submit themselves to testing?[/quote]
The high risk HPV type doesnt give you genital warts.
Its hidden, hence the swab.
It can pop up at anytime even if you only have one partner in your lifetime.
If they have it, they can pass it to you and it usually dealt with by the imnune system.
In some individuals it then reactivates, probably something to do with the immune system

Its a clear plastic speculum now, single use only.
I dont think home testing is available generally on the NHS, although there must be potential for research/ studies.
It is available privately via online services such as Superdrug.

[quote SpaghettiArmsMurderer]@MarchCrocus What exactly do you think my view is? I expressed surprise that people are weighing up today's certain pain vs tomorrow's less certain but greater pain and coming down in favour of avoiding today's pain (which I suggested may be down to optimism bias, a cognitive bias everyone has which makes us think bad things won't happen to us), and concern that the women who develop cancer despite being low risk may be missing out on smears that could help them. How is that misogynistic?

And men are guilt tripped about prostate cancer risk. There are regularly stalls with people accosting men about it in my local train station. If anything I've previously wondered why there are stalls for that and not cervical/breast cancer![/quote]
The outcomes are actually unnecessary pain, greater pain or no pain. There is also the risk of psychological trauma and damaging the patient/doctor relationship through poor or gaslighting treatment.

Risk profiles for women are fairly well studied - I suspect they are in a similar place to breast cancer - which I said upthread is about to be streamlined to reflect this nuance and to try to reduce unnecessary harms.

We already know that rates of cervical cancer in women who have had the HPV vaccine are significantly lower - to the point that arguably negates the benefit of screening.

As for the guilt tripping over prostate cancer. I am not sure I've ever seen blokes posting on social media or telling their mates, 'oi have you had your prostate? Otherwise you could leave your children without a father' amongst themselves... If the most they get is a few stalls at the station (when most people round here drive) then I think we are talking a completely different level of harassment promotion.

@RedToothBrush

What is clear from this thread that one of the top reasons for not attending is not embarassment, but poor previous care and appalling attitudes from NHS staff that patients don't want to repeat.

Not exactly the narrative that the NHS PR people and government want to hear and promote. Easier to lay it on women and tell them they are being petty and pathetic.

We should all be asking them to 'do better'.

Completely agree with this. Inconsistent/poor quality care is a huge problem in the NHS. In loads of areas, including gynaecology, but also for example DP is having some mental health struggles and was having absolutely rubbish care from our GP, changed practices and the new GP is fortunately much better. But that shouldn't happen. I have PCOS and have had excellent care but I know from talking to others that that is hugely variable too - not just in quality but even what you are offered and who you are referred to.

Any nurses on the thread - do you get much training on giving smears? It seems that quite a few people are put off by bad workmanship as it were. I wonder if that is where the NHS could put more of its energy.

@CrocodilesCry thanks, will take a look

For those that do want the screening I absolutely endorse finding a sexual health clinic. They’re much more skilled in my experience than a GP or nurse at the GP’s.

Mine's overdue. They weren't doing them due to COVID when my letter came and I haven't got round to booking it.

I believe I am low risk these days, never had an abnormal one and single for years, now in my 50s. I will book it though.

Mine was cancelled first lock down and I totally forgot and never had a reminder off gp. I remembered last November but cldnt either get through to make it or when I did was no appts and told ring back which I did but date offered conflicted with a big work thing. Actually got one next week now. Do feel silly forgetting.

Vaginal atrophy.

@Dominoeffect101

I've seen a lot of comments saying how painful they are. I'm 30 and have had a smear test every year since turning 25 as I have HPV that won't shift and borderline abnormal cells for the last two years. Anyway, my first few smear test were excruciating, honestly i was convinced I'd be heavily bleeding after it hurt that bad. And then when I had my 3rd, I explained to the nurse I find them very very painful, and she had a look. She said I have an inverted cervix which causes smear tests to be alot more painful than for those who have the"average" cervix position. She told me to put my hands into a fist and put them under my bum, and she used the device in a slightly different position, and before I knew it she said she was finished! I barely felt a thing let alone pain. Since then I've told every nurse just before the examination about my inverted cervix, and I havnt had a painful smear test since.

This might not be the case for everyone of course, but had that nurse not told me and I then told others, I fully believe I'd be going through this agony still each time.

Ohj my goodness....same thing happened to me! I actually fainted after one smear test it was so ''urgh'' But the experienced nurse was so good and kindly.. Balled fists under bumcheeks made it so much more comfortable.

Blessed are the good practitioners.

@RedToothBrush do you know if the is NHS reducing it for vaccinated women? Or all women?
I am the age where we had the HPV jab at school, one of my friends unfortunately still managed to catch it and needed some treatment which was picked up on at her first smear. However that means I am also the age where no one posts on social media any more so I can't comment on that I went to a breast cancer charity do at uni and remember pink ribbons being on everything circa 10-15 years ago, but can't say cervical cancer has had much publicity in my age group apart from receiving the invitation to screening.

It's incredibly insulting to insinuate that it isn't painful. Nobody has any way of knowing what someone else's perception of pain is like.

For me it IS physically painful and emotionally triggering due to past abuse. I can manage to get it done by taking a diazepam beforehand.

Oh - and as for childbirth - I couldn't give birth naturally either due to the same trauma and had a c-section I'd rather have my stomach sliced open than have medical professionals (probably men) rooting around down there

[quote SpaghettiArmsMurderer]@MarchCrocus What exactly do you think my view is? I expressed surprise that people are weighing up today's certain pain vs tomorrow's less certain but greater pain and coming down in favour of avoiding today's pain (which I suggested may be down to optimism bias, a cognitive bias everyone has which makes us think bad things won't happen to us), and concern that the women who develop cancer despite being low risk may be missing out on smears that could help them. How is that misogynistic?

And men are guilt tripped about prostate cancer risk. There are regularly stalls with people accosting men about it in my local train station. If anything I've previously wondered why there are stalls for that and not cervical/breast cancer![/quote]
I think your views are the things you have stated in this thread. They are unhelpful, as was your insistence on repeating them several times. To clarify, I don't think you yourself are necessarily a misogynist, the misogyny I referred to was about the way in which women are treated by parts of the medical profession.

And there is just no way that men are subjected to the same treatment as women when it comes to intimate procedures. It wouldn't be possible anyway, because the female experience in healthcare stems from societal misogyny, from women's bodies being seen as the problem rather than the default, and women as being lesser. But there is no male equivalent of, for example, the weaponisation of children to try and guilt trip women as in this article and the attached poster.

www.thetimes.co.uk/article/mothers-accuse-the-bbc-of-taking-them-on-guilt-trip-bh8lrhvhv

Btw I don't seem to be able to attach the photo without it looking like it's a quote from you, not sure why. Just to be clear I know it isn't, it's one I am citing as evidence for my point.

Oh it hasn't gone in the quote bit, nvm, it did in the preview.

[quote SpaghettiArmsMurderer]@RedToothBrush do you know if the is NHS reducing it for vaccinated women? Or all women?
I am the age where we had the HPV jab at school, one of my friends unfortunately still managed to catch it and needed some treatment which was picked up on at her first smear. However that means I am also the age where no one posts on social media any more so I can't comment on that I went to a breast cancer charity do at uni and remember pink ribbons being on everything circa 10-15 years ago, but can't say cervical cancer has had much publicity in my age group apart from receiving the invitation to screening.[/quote]
I don't there are currently any plans for the cervical screening programme to be formally reduced.

I do know there is talk that screening will become a thing of the past, but I don't think anything has been actioned and I'm not aware of guidance reflecting this yet. But I do think that they are starting to say that the research is building up.

@Dominoeffect101

I've seen a lot of comments saying how painful they are. I'm 30 and have had a smear test every year since turning 25 as I have HPV that won't shift and borderline abnormal cells for the last two years. Anyway, my first few smear test were excruciating, honestly i was convinced I'd be heavily bleeding after it hurt that bad. And then when I had my 3rd, I explained to the nurse I find them very very painful, and she had a look. She said I have an inverted cervix which causes smear tests to be alot more painful than for those who have the"average" cervix position. She told me to put my hands into a fist and put them under my bum, and she used the device in a slightly different position, and before I knew it she said she was finished! I barely felt a thing let alone pain. Since then I've told every nurse just before the examination about my inverted cervix, and I havnt had a painful smear test since.

This might not be the case for everyone of course, but had that nurse not told me and I then told others, I fully believe I'd be going through this agony still each time.

Smears were a breeze for me when I was younger, I have an inverted cervix. See how you feel when you're in your 60's, hopefully all will be fine.

@sairiegamp

Vaginal atrophy.

Precisely. Vaginal atrophy is a significant problem for many as we get older. It feels a bit patronising to see younger women saying that smears aren't a big deal if you deal with them the right way. They have no idea.

Because my cycles can vary from as short as 18 days to over 45, it takes literally days to get through to the GP surgery and they want you to go at a certain point in your cycle - I’m sick of ‘debating’ with receptionists about it. I can’t book a short notice appointment because of the difficulties getting through and how hard it is to get an appt with a nurse when I do get through.

I’d go if they made it easy to.

The comments relating to HPV vaccine are valid.
Pretty sure that the screening will change but remember thats the 26/27 year olds and under.
Women over that age wont have been vaccinated.

You are invited every 3 years from age 25 and then every 5 years from age 50.
Screening ceases at age 64 unless you have symptoms.
3 reminders are sent .
Can you imagine if one reminder was sent and was missed, the NHS would be sued left, right and centre.
Just opt out if you dont want to have screening.