do i have this right about smear tests?

[tefley]

So, last time I had a smear test, I got a letter saying I was negative for HPV and therefore no further tests were done on the sample like looking at the cells.

I haven't had any sexual contact since my last test, therefore there's no way my HPV status can have changed. So am I correct in saying there's no point in me having a another smear test unless I did have sexual contact?

I'm confused because I tried to explain this to a nurse and the receptionist at my GP clinic, but they were both insistent I come in, and I've been getting multiple texts and letters about it.

My situation is a bit more complicated than most- I have vagnismus which makes these kinds of things genuinely excrutiating. I'm trying to work through it, and I'm worried an unpleasant experience will set me back. The appointment is tomorrow and have been prescribed valium to try to stop the muscle spasms, but it just seems like a lot to go through when (if I've got it right), the sample won't even be tested?

Definitely agree with this, I was referred when the nurse found a lump during my smear. Luckily all was clear for me but I'm grateful that it was found and checked

I’m pleased you’re going OP.
as others have said, sex or no sex, it lays dormant. It did for me- I had HPV rear its head whilst in a long term relationship, with a partner who was only with me.

I vividly remember my mother in law saying the complete nonsense that only women who were ‘sleeping around with multiple partners’ got HPV, like it was some sort of STI.
yep… you’ve guessed it. She put off a smear, found out she had HPV. Sadly she had gone from clear smear to HPV and cancerous cells within 4 years. She died from cervical cancer within 8 ish months.

it literally saves your life. To anyone putting it off, my MIL was 61.. so much life left to live.

misconceptions -
—both partners only having one sexual partner— doesn’t matter.
—it’s not an STI.
—you can carry the dormant HPV from being sexually active. There’s no rhyme or reason if or when it becomes active.

best of luck to you OP- sounds like it won’t be nice for you, but I hope it goes well!

Not to worry you but my smear test was clear and then I hadn’t had sex and then the next one came back positive so it can lie dormant.

I’ve also never had any STI’s like herpes, chlamydia etc as I’ve heard a false rumour that if you’re negative for them you’re also negative for hpv.

Hopefully there is a way to make the smear easier for you.

I had a clear smear test 3 years ago. 2 months ago I tested positive for HPV despite being in a monogamous relationship (I am now single but not sleeping with anyone) the nurse explained how it can lie dormant. I had severe dyskaryosis and CIN 3 cells. I had a lletz procedure 2 weeks ago and have a follow up smear in 6 months to check for HPV again, I would always advise people to go for their smear tests, without it I wouldn’t have even consider testing myself for HPV

I didn’t realise the smear test only looked at HPV status. Does that mean you only get cervical cancer if you’re HPV positive? Or is it only the test that tests for HPV status and doesn’t pick up cervical cancers that started unrelated to HPV?

It’s not a false negative, it’s just lying dormant.

Presumably that's still a false negative result though?

If you have HPV, but that test is not able to provide a positive result because it is dormant?

Over 99% of cervical cancers are caused by HPV

I was wondering the same so I’m glad you posted this as I know to keep going now

YABU, the weird cells can develop at any time. Get your smear.

I raised a similar question to my GP and was told that the smear test is a chance for a health professional to also see any obvious changes or causes for concern as some changes can happen without HPV being present. If you really struggle to have a smear test, even with medication, you can request to have it somewhere where gas and air are available.

There are some (rare) cases of cervical cancer that are not caused by hpv.
I was sent for a biopsy (scary two week cancer pathway) despite testing negative for hpv.
over and done with in one hospital appointment. The lump turned out to be a harmless bruise but it was worth checking.

www.england.nhs.uk/2021/02/nhs-gives-women-hpv-home-testing-kits-to-cut-cancer-deaths/ available in some parts of NHS for around a year. £25 from superdrug to avoid (for you) a potentially traumatic experience you have to take valium for. Much better alternative

Yes but the smear test only tests for HPV to start with. It’s only if someone tests positive that the cells are then screened for cancer. Those rare cases which aren’t caused by HPV will now be missed.

Much better to go for your smear. I've got an appointment next week to have polyps investigated that were picked up during a routine smear. Not looking forward to it but I'd rather that than not being checked.

No because it’s negative in the sense that it won’t cause any changes to your cervical cells. False negative would mean that it’s incorrect and is actually positive, and could thereby be causing changes to your cells.

>99% of cervical cancer is caused by HPV.

Thank you for posting this OP! I’m glad you’ve found it useful and I’m sure others have too. FWIW we have absolutely tiny speculums in our clinic if we need them. I used one on a lady the other day which was about the size of my index finger as she was post-menopausal and very dry and sore, still managed to fully visualise her cervix.

I just want to say bravo OP for being so receptive to the information as to why smears are so important & also for being able to steel her nerves and get it done. You got this OP and I hope it's not as bad as you think it will be. Maybe have a chat to the nurse beforehand as well so they can be extra gentle and as quick as possible?

Is the smear test still worth doing if the nurse practitioner always complains while manoeuvring the speculum like a periscope that your cervix ‘is pointing the wrong way’, makes it very unpleasant and painful and then afterwards you get a letter that the result is ‘inconclusive’, please return for another round.
After decades of this shenanigans and reading up that HPV can survive for about 15 years before it naturally disappears, I took a home test for the full range of HPV, and it came back negative. I’m not sexually active and haven’t been since the nineties and have never had a positive test.

Like you, I find smear tests horrendous. My reaction is so bad / extreme that I've been asked if I've previously been sexually assaulted

But it is quick. And stops hurting as soon as it's over. And PP are right that the HOV virus can lay dormant

So, I'm glad you have decided to go. Well done

Diazepam does help me. The other things that help are (1) tell them you're scared, don't try to be brave, (2) remember you can tell them to stop any time (3) get them to do a countdown 10 9 8 etc so you are prepared for them to start

I used to find smears really painful so put them off for a long time. The last one I had was actually surprisingly easy and was shocked that I tested positive for HPV! it must have been dormant for a reeeeeally long time. It's 100% worth doing and I will never miss another one again. Good luck x

Does anyone know if you can have cell changes whilst HPV is dormant? As in you have HPV, you test negative on the day of smear, so no further examination of cells, but you have it in your body? Could you have changes that are not investigated or is someone with cell changes always going to test positive?? I have not had HPV as far as I know, but I just wondered (another who has difficult smears due to tilted uterus).

OP the smear can also detect random things like a polyp on your cervix. The nurse would actually see it in that case.

My smears have been really painful due to disability. I was referred to my hospital to have them done with the proper gynea chair and dr. They have gas & air on standby but so far I've not needed it. Being in the correct position has helped immensely.