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?

I'm not sure why you're arguing black is white when the government/NHS guidance is published online.

If the sample is negative for HPV, the sample is not tested.

Either policy was different when your friend had her experience, or you're misremebering the details. Either way, it's frustrating to derail a thread with misinfo of women sharing their personal stories of this and why it's so upsetting.

@TiptoeThroughTheToadstools

Screening tests

HPV test

Cervical screening samples are tested for types of HPV that can cause cervical cancer. Testing for HPV first, rather than looking at the cells down a microscope (cytology), is proven to be a more sensitive test. It will help to find more women with cervical cell abnormalities that may need treatment.
HPV testing will help to prevent more cases of cervical cancer.

Results

If HPV is not found, the individual will be offered a screening test again in 3 to 5 years (depending on age).
Individuals who do have HPV will have cytology triage carried out on the same sample. This is to see if HPV has caused abnormal cell changes.

www.gov.uk/guidance/cervical-screening-programme-overview

As a Smear taker in my previous job, I would advocate that you go for your smear when you have recalled whether it be a normal routine recall of 3 years for 24.5 yrs to 50 yrs, to 5 years 50+ to 64 years. The laboratories check for HPV in the smear sample before they go on to do further checks that were previously routine. If the sample is HPV negative, the sample will not then go on for further testing. If your sample comes back as HPV+ depending on the result, will mean the difference between going to the hospital for further treatment or being recalled for a repeat smear in 12 months' time. As a smear taker, apart from taking cervical cells from the cervix, you look at the cervix and what it looks like, you look at the os, the vaginal walls, and the labia. You ask about the woman's periods, pain during sex, and bleeding in between periods/during sex. These are all important questions when you perform a smear. You can gather a lot of information by looking at the cervix's appearance. TBH, the documentation takes longer than the actual procedure. We don't care if you've not waxed down there, shaved your legs, whether your toenail polish is pristine, or if you have matching socks! SO for all of you that are overdue, call your GP practice tomorrow and book your smear test!

So if I've only ever had any form of sexual contact with my DH and vice versa I'm safe?

No, you can catch it in other ways in other ways too. healthclinics.superdrug.com/what-is-hpv/#:~:text=You%20can%20be%20infected%20with,cause%20transmission%20of%20the%20virus.

I'm not arguing, nor am I derailing the thread. Feel free to stop responding at anytime.

Where Women genuinely do find it hard to have a cervical smear, they can be referred to colposcopy/gynae for what is classed as a 'difficult smear'. This does not mean the woman is being difficult, it just means that the woman finds having a smear intolerable for whatever reason. There are also various lubricants that can be prescribed depending on age, and some practices will give the women a speculum to try at home. It is whatever works for the woman. You can get HPV even without having intercourse, and if you are more susceptible to HPV, have/have not had the HPV vaccine, or have a history of cervical cancer. Please go for your smear appt, and even if the Nurse does not get to do your smear that time, they can rearrange it and put plans in place to ensure your experience is a positive one x

HPV can lay dormant for decades. That is like saying you have only had 1 partner so can't be at risk after years together. Either of you could carry it without knowing for years, once it's active it can be passed on. Then it can attack your cervix. They don't call it the silent killer for nothing. Have your smear. They save lives. I wouldn't be typing this if it was not for mine as by now cervical cancer would have killed me.

Excellent post and sympathies to the OP but thanks for highlighting this.

Im in NI so different PHA to England advice etc

I have copied this direct from our NIDirect site and could do with a bit of helping understanding it

"If the result shows minor changes in the cells, the sample will also be tested for high risk types of HPV. If there is no HPV, the risk of significant cervical disease is very low and no further investigations will be needed at this time.

If HPV is found, or the changes in the cells need further investigation, you will be referred to a colposcopy clinic for examination. A result showing changes in the cells is common, but doesn’t mean you have cervical cancer.”

with regards to the first sentence, do you think this means our samples are only being tested for abnormal cells and then HPV will only be checked if abnormal cells found ? Ie different to England where only HPV status is being tested? The complete opposite?! Would honestly not be surprised at this stage though!

i will be checking tomorrow when my smear is due and whether it is a PAP abnormal cell test and / or HPV and can report back if anyone is interested.

www.nidirect.gov.uk/articles/cervical-screening

I suppose it's quite possible. TB tests are no longer 'routine' (at least here) and they no longer vax for smallpox. But even if HPV were to be 'eradicated', without Pap smears there's still that 5-11% of women whose cancer would go undetected until it was probably in the more serious stages.

There are currently over 100 strains of HPV of which 13 are directly linked to cervical cancer, others to other types of cancer. Viruses mutate, some quickly some slowly. So who knows if it will ever truly be eradicated.

I'm another whose cervical polyp was spotted and referred because of a smear. They do take a look as well as doing the HPV test, and you'll miss that if you do a home test. OTOH, a home test is better than nothing.

My daughter was told not to go for smears anymore. She finds them excruciating, the hcp can never complete it. She's never slept with a man, she's been with her partner for over 30 years. Between them (daughter and hcp) they decided there was no point in carrying on trying.

is that close to your position, opening poster?

If you have been sexually active in your life time you must attend all routine smear tests, you can develop cervical cancer at anytime.
Your HPV status can change with no sexual contact in between.

my friend (PT, non smoker, healthy weight)didn’t have sex or a smear for 6-7years, she has just been given the all clear from 2 horrific years fighting stage 3 cervical cancer & lymph nodes. Chemotherapy radiotherapy and brachial therapy! ITS NOT WORTH IT HAVE ALL TESTS OFFERED!

I agree 100%.

I understand your pain OP. I've been with DP for 10 years. Only 2 men before him. When I had my smear it was incredibly painful.

I don't want to go through that again and it seems unfair I would have to. Why won't they leave me alone???

But unless you're a virgin it seems we will be hurt and punished forever z

Plus I had the HPV vaccine. What was the point if I still have to be told to shut up and calm down when a nurse is forcing something into me.

I asked the question regarding the job vaccine and those women who have a family history of cervical cancer. I was advised at that time that the hpv vaccine in those circumstances would cover for the hpv strains in that vaccine. It would not protect the woman from cervical cancer, and that those women should be asking their GP for further tests Inc the cervical smear test. It would be nice to think that one day we wouldn't need a cervical smear, but there will be circumstances where a qualified professional would need to look at your cervix.

Nobody MUST go for a smear, it's not compulsory. Ideally women will have them but they are free to say no for any reason. If I hadn't seen the lovely consultant in August there was no way I was going to have another one because of previous experiences.

This thread is very interesting and informative, thank you! Sympathies to those who have difficulties being tested. I was fine up until my last baby, tests easy and results clear. Since then (10 years) my uterus has moved (is that a thing?) and I have to lie with my fists under my bum and even a gynae (seen for something unrelated to cervix) had trouble. Not pleasant, but needs must. I will be booking mine.

The discussion on here is good and in general, I would say we are lucky in this country to be offered free smear tests, they pick up problems which would otherwise go unnoticed, and they do save lives....so I am not advocating that women should avoid the tests in any way.

However, if you really don't want to have the tests, it is also your right not to. You cannot be forced to have them. In my younger years I wrote to my GP and said I wanted to be taken off the smear test program, not be called up for more tests, and I wanted my decision to be included in my medical file. They weren't happy but they complied, and I wasn't called again. A practice nurse told me the pressure on calling people up was actually about hitting targets (GP surgeries aim to have 100% take up) and costs....in those days they were paid by the NHS for every test they did, in order to encourage compliance. I have no idea whether it's the same now, this information may be out of date as that was some years ago.

GP practices do have targets yes, however, as a former smear taker in a GP practice. I was passionate about getting women in to have their smears. There is a whole range of different sized speculums Inc virgin which is approx 2 inches long and less than 1cm in length. Yes you can refuse to have a cervical smear, however I always talked about a lady when discussing cervical smears to women, and their reasons for no wanting one which is this.... when I went to do my colposcopy training. She was in her early 40"s with 2 young children and a history of cervical cancer. She'd been for one smear in her 20's and that was it. She went to her GP in her 40's with symptoms, was sent for a colposcopy and was diagnosed with stage 4 cervical cancer. It is such a shame that there are women who have decided for whatever reason, to not have a cervical smear. I would recommend going to speak to your GP/Practice Nurse about your reasons for not having one. They can then document according.

My mum also said when I told her I had HPV she said what you don't sleep around. I gave her short shrift and said you can get any time not even from sex !! I'm wondering if this impacting on testing some moral thing. There's a lot misconceptions out there about HPV..

Please do have it done, it’s such a lifesaver and having HPV predisposes you to cervical cancer. It may have been lying dormant before but maybe not now. I feel for you with the vaginismus, it must be so awful for you - but not as awful as what you’d need to go through with cervical cancer. Get it over with, good luck OP x

Where did you see that figure because it’s absolutely not correct. I updated my smear training last week and >99% of cervical cancers are caused by HPV.

The UK system changed in 2019 to primary HPV screening; if HPV is detected then cytology slides are prepared and carefully examined for cell changes. If no HPV is detected then the sample is discarded. Also if a woman’s cervix looks unusual or suspicious during examination we can refer them directly to colposcopy.

I understand that it’s frustrating for the sample to be discarded if HPV isn’t detected but I’d much rather see ‘negative’ in my results than have to be told I have CIN3 and have to undergo LLETZ or worse.

@Twinmummy74 the reason I was going to refuse an NHS smear was the attitude of the nurse. Last time I was crying in pain but she just kept going, there was no offer of having it done in the colposcopy chair in the hospital and I didn't even know it was a thing.

I have to go back next year but no way will I be having it done on the bed when there's another option. The only problem I have is I don't know how to have it done elsewhere if I don't pay. I can't get an appointment with a GP for love nor money and I'm not prepared to deal with the nurses again as I'm sure they'll be pushing me to have it done by them.

I heard that such a lot when doing smears. Please do speak to whomever is doing your smear next time about your previous experience, they will ensue that this does not happen with your next smear. It should never have happened in the first place, and you should be er have been made to feel the way you did. Please speak to them xx