To think the new cervical screening system will miss cancer cases

[PeasAndFlour]

I think the new system is a blunt tool without room for nuance. E.g. if someone has hpv, then in the next smear they don’t, the previous hpv could have caused cell changes before the infection cleared but these aren’t picked up on, because the cells aren’t looked at anymore.

Privatisation through the back door. This will push women to go private if they have had previous complications.

@sunlovingcriminal

I am in exactly this boat. Previously had pre-cancerous cells and hpv. Last smear, no hpv, so no annual check up on my abnormal cells. So I've had to independently contact the gp, to see if I can get a referral for a colposcopy. Bet they'll come back and say no (only asked last week)- so that'll mean me going for a private colonoscopy which I can't really afford.

Which do you think is worth paying for, colposcopy or smear? Or both? Or colposcopy if you know you have low grade abnormal cells from a previous smear, and maybe smear to start with if you previously just had hpv?

@PeasAndFlour my letter also said back to 3 year checks. So I agree that it if your sister is still being offered annual more in-depth checks, that is a postcode lottery!

@PeasAndFlour I'll pay for a colposcopy as I know I have low grade changes. Just hope that the gp manages to get a nhs referral for me. Seems ludicrous that just because my body has cleared the hpv virus, they already know that I have low grade changes- so should therefore keep an eye on me! Infuriating!

[quote sunlovingcriminal]**@PeasAndFlour* I'll pay for a colposcopy as I know I have low grade changes. Just hope that the gp manages to get a nhs referral for me. Seems ludicrous that just because my body has cleared the hpv virus, they already* know that I have low grade changes- so should therefore keep an eye on me! Infuriating! [/quote]
Good luck. How much is a private colposcopy where you’re looking? I think a private smear is about £300. It’s not something I can afford either but I’d just put it on my credit card.

I don't know- I thought it was about that amount- but I realise I probably have underestimated the cost. So, will probably resort to my plan b) and go back to doctor and say I have bleeding in between my periods so that I can get a faster track in?

Although just found a price on Kingston (London) private health arm of their nhs hospital. Colposcopy is £180. It increases if you need a biopsy to £330. I'll await the outcome of my enquiries with the GP.

Can anyone help explain this to me? I had CIN3 found at my last smear, a lletz procedure to remove the cells, followed by a clear margins result - which was great.
I was told to go for a smear at my GP surgery 6 months later, which I did last month. I just got the letter to say no HPV, which is good news - but suggests they didn't even check the cells? Despite my severe cell changes last time. Does anyone know if this is correct, or if I should push back on this...?
Sorry, this is probably the wrong place to ask but wondering if anyone on this thread has a similar experience?

@rattlehum

Can anyone help explain this to me? I had CIN3 found at my last smear, a lletz procedure to remove the cells, followed by a clear margins result - which was great. I was told to go for a smear at my GP surgery 6 months later, which I did last month. I just got the letter to say no HPV, which is good news - but suggests they didn't even check the cells? Despite my severe cell changes last time. Does anyone know if this is correct, or if I should push back on this...? Sorry, this is probably the wrong place to ask but wondering if anyone on this thread has a similar experience?

Your letter should say whether they tested or not. If it doesn’t say your cells were tested, then clarify with your GP. I don’t know what the rules are for your history, it sounds like they absolutely should check your cells though. If they don’t, this is an even bigger problem than I thought.

@MrsDeadpool I was definitely told I would never be called again. Could it be an age thing? I'm 63.

Agree, I wouldn’t want to do the new test. I’ve had bad cells before that needed removing with a LLETZ biopsy, and I’d always want to have a proper smear done with a nurse.

I also tested positive for HPV a few years ago, and had a colposcopy which found nothing. My last smear was normal with no evidence of HPV found. Does previous evidence of HPV mean I’m still likely to develop cervical cancer? It’s not clear to me.

I was in the last year of people not to be vaccinated against HPV and it feels like we are a bit of a lost generation. We were 17 when the vaccine was introduced, so a fair few would have been sexually active but not vaccinated.

I thought this was about those who had the vaccination. I would imagine those who haven't, which I am one, would still need regular smears? Apologies if I have got it wrong. I read an article about it on the bbc this morning

@Dovetail6

I also tested positive for HPV a few years ago, and had a colposcopy which found nothing. My last smear was normal with no evidence of HPV found. Does previous evidence of HPV mean I’m still likely to develop cervical cancer? It’s not clear to me.

I was in the last year of people not to be vaccinated against HPV and it feels like we are a bit of a lost generation. We were 17 when the vaccine was introduced, so a fair few would have been sexually active but not vaccinated.

Really? I was 17 when it was introduced and we had it at school.

I still got HPV though (I wasn’t sexually active before I was vaccinated so didn’t catch it before) and am in the same position as you where I don’t know if previous HPV infection increases my risk.

@PeasAndFlour I just checked my letter and it says "your result is HPV negative. This means your risk of cervical cancer is very low and there is no need to check for abnormal cell changes even if you have had these in the past".
So briefly my history is: HPV found on previous 3 smears so on one-year recalls. No cell changes at all on first 2 smears, and then suddenly CIN3 after pregnancy. Obviously the cells went from nothing to severe very quickly. And despite this they didn't check my cells and have put me back on a 3 year recall, even though the dr who did the lletz procedure told me I'd be on yearly recalls until I'd had 2 consecutive years of clear results.
So I'm gunna follow up with my GP now - but seems like yes this is worse than you thought

I had my last smear in Jan this year - previous smear was 5 years ago as I’m mid 50s and in my Menopause.
My letter from the smear stated that I had tested positive for HPV and that because of this my cells had been checked and showed no signs of changes.
I would then be recalled for another smear in 12 months, where hopefully I would no longer be showing HPV. If I was still showing HPV then I’d have another smear after another 12 months, followed by a colposcopy if I still had HPV.
I find it concerning that I’ve now tested positive for HPV and if future smears show no HPV then I am back to waiting 5 years between smears. Meanwhile my husband probably has HPV, so even if my immune system manages to eradicate I could easily get it again (condoms do not 100% prevent infection).
I shall definitely go for all my checks but waiting 5 years between smears when I have previously been HPV positive is very worrying and it’s also concerning that there is no screening at all after the age of 64.

The new system will miss some cases of a particular sort but pick up more of the other cases and in a more accurate manner.

The old system used to mostly miss these cases too - it occasionally picked them up late on, if the timing was right.

I thought the current system doesnt check enough - I'm from a country that offers annual smears, so every 3 years in the UK seems too little, so I pay for private smears in between. I've had hpv, abnormal cells, biopsy, loop excision of cells etc. I think the change to 5 years is outrageous.

My understanding is that HPV screening is automated so saves money. Looking at cells is manual and costs more. As mentioned there are cervical cancers that are not HPV related and there is a risk that these will be missed.

[quote rattlehum]@PeasAndFlour I just checked my letter and it says "your result is HPV negative. This means your risk of cervical cancer is very low and there is no need to check for abnormal cell changes even if you have had these in the past".
So briefly my history is: HPV found on previous 3 smears so on one-year recalls. No cell changes at all on first 2 smears, and then suddenly CIN3 after pregnancy. Obviously the cells went from nothing to severe very quickly. And despite this they didn't check my cells and have put me back on a 3 year recall, even though the dr who did the lletz procedure told me I'd be on yearly recalls until I'd had 2 consecutive years of clear results.
So I'm gunna follow up with my GP now - but seems like yes this is worse than you thought [/quote]
I’m curious about what the GP response will be. Specialists and consultants saying we need more tests than the system allows is a sign to me that it’s another NHS thing that’s fallen into shoddiness.

@IDidntKnowItWasAParty

I thought the current system doesnt check enough - I'm from a country that offers annual smears, so every 3 years in the UK seems too little, so I pay for private smears in between. I've had hpv, abnormal cells, biopsy, loop excision of cells etc. I think the change to 5 years is outrageous.

Can you recommend a private place to go for smears? Any particular companies? I’m semi flexible on location so it’s good to know what is out there.

@longtompot

I thought this was about those who had the vaccination. I would imagine those who haven't, which I am one, would still need regular smears? Apologies if I have got it wrong. I read an article about it on the bbc this morning

Yes I read on the BBC that those who have been vaccinated are likely to only require one smear test in their lifetime.

Rattlehum you said your severe cell changes were after having your baby? Pregnancy and birth can affect your cervix! It’s possible to have a wild result then normal!

@KattyR786

Rattlehum you said your severe cell changes were after having your baby? Pregnancy and birth can affect your cervix! It’s possible to have a wild result then normal!

Thanks, I hope this is what's happened! I just feel a bit weird knowing that they haven't even checked the cells are all normal... because the HPV came back negative. Feels a bit risky, I dunno - esp reverting to the 3 year recall?? This whole topic makes me uncomfortable for all women tbh

Hi

You might find this link useful regarding the screening process. There is a flowchart showing what happens with each result.

So if you were HPV positive on last smear but no cell changes, then get invited back for another smear in 12 months time. If HPV negative the you would go back to normal recall. If it was positive and no cell changes again, you would have another check in 12 months. At this point, if you were still HPV positive but still no cell changes, you would then get referred to colposcopy regardless.

If at any point before then you had cell changes, you would get referred to colposcopy at that point.

www.gov.uk/government/publications/cervical-screening-care-pathway/cervical-screening-care-pathway

[quote Lilyappleorchard]Hi

You might find this link useful regarding the screening process. There is a flowchart showing what happens with each result.

So if you were HPV positive on last smear but no cell changes, then get invited back for another smear in 12 months time. If HPV negative the you would go back to normal recall. If it was positive and no cell changes again, you would have another check in 12 months. At this point, if you were still HPV positive but still no cell changes, you would then get referred to colposcopy regardless.

If at any point before then you had cell changes, you would get referred to colposcopy at that point.

www.gov.uk/government/publications/cervical-screening-care-pathway/cervical-screening-care-pathway[/quote]
Thank you, this helps