Is there any point - smear

[theskyispurple]

I'm almost 50, married for 10 years, never had abnormal smear results.
I know that the cells only get looked at if the hpv test is positive.
What are the chances of me having hpv now considering that it has never shown up before?
Trying to minimise unnecessary anything in my life - is this something I can cut?

What difference does it make if they spot erosion? I got told I have erosion but everything was normal.

But they test the sample for HPV first and only look for cell changes if you are HPV positive. So an NHS "smear" is an HPV test first and foremost.

That is a decision made to reduce the number of treatments given to otherwise healthy women whose cellular changes would have resolved on their own without a cancerous outcome. But it does mean, as far as I can see, that an home HPV test with a smear afterwards if positive has the same effect. It's not free on the NHS for now but I have no idea why it isn't - it would increase uptake rates and decrease the time needed by practices to complete them.

Haven't read every previous post but my thoughts are:

• this from the World Health Organisation says at least 95% cases of cervical cancer are caused by HPV. Not 100%.

www.who.int/news-room/fact-sheets/detail/cervical-cancer

• home HPV tests are way less effective at detecting HPV than clinically conducted HPV tests.

It's a small probability but what if it wasn't an HPV related cancer or the test was wrong?

Why fuck about?

I used to find smear tests excruciating but then a nurse told me my cervix tilts to the one side. Now I always tell them that and they use a smaller speculum and it's much better.

I'm really quite shocked about this! Thankfully our system works very differently. Firstly, we have pap smears every year, and tested for all the hpv strains every time. Mammogram every two years. I have abnormal cells so I go every 6 months for a pap. I've never tested positive for the 2 hpv they look out for so I really don't understand this new system. Having hpv and abnormal cells are two different things.

Luckily I go to a gynecologist and I don't experience any pain, but he checks everything else at the same time with an ultrasound. Uterus, bladder, colon etc. When do you get offered these checks?

I can understand why people aren't keen to have the test now, but I just do not understand the reasoning behind this new testing system.

For me personally, it isn’t a traumatic event, it is just a bit bothersome to book and find spare time to go. My feeling is that I would never regret going for the smear but I may regret not going, no matter how small the risk is.

Also, although the vast majority of cervical cancers are related to HPV, some aren’t, so I think someone being able to visualise the cervix every so often to look for any changes is a good idea especially since they only test the swabs for hpv now and don’t analyse the cells.

Obviously if there were reasons I would find the whole event traumatic that might change my outlook.

In Scotland if you get a negative result, it’s every 5 years, regardless of age. It’s not good!

If the home test isn't as good they should offer just the HPV swab, I'd have that. I'm 49 and have always had smears but I had one last year that was absolutely agony. Then separately I had another one with a gynae as I was having a weird period and that was also agony - bastard started with a medium speculum and only moved to a small when I was literally pushing him off me .

They should offer just HPV since that's what they test. Then I'd have to have a GA for a smear now . I couldn't do it any other way.

I've had a different cancer and I'm not taking this lightly, but I could not tolerate that pain again.

Yes it's true that HPV can exist in your body at a subclinical level for decades and then proliferate at random. Worth going..

But it's the only test the NHS actually do on your sample initially. It only gets looked at further if hpv positive. Do any other cause of cervical cancer will be missed.

I'm not suggesting not having anything at all - well maybe I was but I'm not now
I think I'd want to do the home hpv test, but don't want to pay £50 for the privilege!

I'd just go for it - what's the worst that could happen either way?

My GP surgery is still not doing smears "due to Covid". I'm 27 now and I've never had one. Doesn't stop them sending me pestering letters though. 🙄

The nurse found that during the smear test?

Where are you?
I know the reason ££££££££££££

I've decided I won't be having any more smears. If I have a non HPV cervical cancer it won't be detected anyway

It's been a while since I did smears but it makes no sense to me to not check both. Cervical cancer without hpv is rare but still feasible. My understanding is that the vaccine doesnt prevent all hpv strains either. Ask at your gp surgery ie your practice nurse if getting the gp is not accessible. But to be honest someone having a look down there for polyps or erosions or other abnormalities is good too. It's a good opportunity to get swabs done for discharges, discomfort, checking for prolapses, thrush, and the like too. Many women find it's a good time to ask intimate or embarrassing questions since they're there anyway eg if they're suffering some incontinence issues or sex related problems.

I don't mind being checked and having a swab it's the opening of the cervix that I can't tolerate . I had quite a lot of investigations last year and had scans etc so I know it's all ok until they start messing with my cervix!

I'm wondering this. But I'm also sure I've had it every three years. I'm 60 now and have been celibate since my husband died 12 years ago and my last smear was extremely painful. Never had an abnormal result.

We have no way of knowing if your partner is faithful to you OP.
It's up to you to decide whether you are at risk of catching HPV or not.
My mum is a nurse and also says it's a good idea for the nurse to "have a look up there" every few years. So smear rather than just HPV test is a good idea.

@theskyispurple I have been referred for colposcopy on the basis of something the nurse saw while doing my smear last week.

Hopefully it's nothing sinister but the hospital referral was done very quickly & I already have an appt fixed.

A home HPV test is not going to give the same information.

It's worrying that people know so little about their bodies and what is happening to them during a smear.

In my area they only check the cells if you're positive for hpv. When I asked the nurse well what about those cervical cancers not caused by hpv she looked at me and gave a shrug.

All health screening is optional, and a matter of personal choice. If you want the test - great. If you don't want the test - that's great too and don't let anybody manipulate or guilt you into anything. Same applies to mammograms - it's OK to opt out of those, and they'll just ask you to sign a form and then you can forget about it.

@Crinkle77 I understand cervical cancers not caused by HPV are extremely rare. The fact is that the NHS have to do a cost/benefit analysis in terms of pain/anxiety to the patient, cost of lab time and subsequent treatment - apparently smear tests done the "old" way used to result in a lot of unnecessary treatment for abnormal cells which would actually have resolved on their own. So only HPV positive PLUS abnormal cells result in treatment these days.

I will be opting out of these in the future due to my personal circumstances.

Yeah, I'll probably get my ass handed to me on here for being selfish because it's a free test, only takes a few minutes and I should be grateful it's being offered to me. But what's that saying? "My body, my choice"

@Crinkle77 I understand they use it to see your cervix my query is why do they do that when they're only testing for HPV which is just a swab. It's unnecessarily intrusive. No need to be so rude and patronising, read the thread properly .