To be upset with my friend - he is upset with me for not having a smear test

[pussinboots61]

This is a sensitive subject but here goes. I have never had a smear test. I do have reasons but I can't cope with the thoughts of it. I am now 62, been married twice, I haven't been sexually active for some time now.

I will go for other tests but refuse smears. I have a very close male friend who is more like family to me. I worked with him until he retired two weeks ago but we still keep in touch and meet up. I do rely on him a lot and he is very supportive.

The other night we were messaging each other and he just told me randomly about a doctor he had been listening to on the radio talking about smear tests. It was just a general chat and I just commented that I've never had one. He asked me why I am not concerned about my own body and why I won't go for a test and I just told him its something I have always feared.

Then he just went off on one about it, said I should look after myself but not only that, he said I had upset him very much. The conversation went very sparse after that and when I went to bed and messaged him goodnight he just said I had upset him in a big way.

The next day he continued to be off hand with me and when I asked him why he felt I had upset him he went on about how I don't care what happens to me and was on the verge of unfriending me the night before. I was stunned by this. I can understand him being concerned and maybe trying to persuade me to have a test but to want to fall out with me over it was baffling.

I ended up ringing him and then he told me that his Dad died from throat cancer, he had been a heavy smoker from a young age and at one time his GP had offered to give him tests to check if he was going develop cancer but he refused. He said it is now a sore point for him if anyone refuses to have tests. He said he will try and help me get over my fear of smear tests but wants me to have one because he doesn't want me to be in any danger.

I met my friend today for lunch and things were fine but I am still very hurt and upset by this. He wants me to tell him the reason why I am so scared but I don't want to talk about it. I have told him about other friends of mine who won't have certain tests, one of them won't have any test of any kind, she won't even do a urine sample for the doctor because she fears so much what they might find but he said that is them and I can't go on how other people are.

Is he right in being this way or am I overthinking it? I do suffer from depression and I was getting on a more even keel with some new medication I am on but this is setting me back again. I know he is concerned about me but this is just over the top.

Well quite. Not everyone finds it this easy. Because the procedure is designed to be as difficult as possible. You somehow slipped through. This has NOT been my experience.

@RedToothBrush and I would argue that having to look through reams of documents and click through five different links to complete the form, find the correct email address and send it off is not easy, it's ridiculous.

It is interesting to see the types of words/phrases that a lot of the posters have been using on this thread (regardless of whether they support screening/have had smears/will have smears etc.)

Harassed
Painful
Traumatic
The fear of cancer being "hammered" into us
Threatening
Bleeding
Abuse
Sexist
Infantilising and so on

Something is clearly going wrong here. I wonder if men feel the same about prostate cancer screening?

There is no prostate cancer screening program in the UK.

@MartyMcFlysPurpleUnderwear I didn't say there was a screening programme, my point is that I wonder if the same tactics used on women by healthcare providers, in advertising, in conversations etc. are employed when discussing the pros/cons of testing for prostate cancer in men.

Do men report feeling harassed, threatened, manipulated etc. in those same settings into agreeing to testing for potential prostate cancer as I hear women report when being spoken to about testing for potential cervical cancer?

Case in point. There are many, many examples of this.

I am just guessing here but I am going to say no.

I did wonder if it was a bit of a loophole - I tried to get it out to as many women as I could at the time. I don't have the links as they are on my old computer.

It seemed a far more civilised way of removing yourself from a programme you never signed up to in the first place.

Not so long ago, the policy seemed to be delegated out to the administrators of the recall software and there was a long list of hurdles, including mandatory counselling from a doctor, to be overcome. None of it complied with the documents being put out by the national screening committee etc.

Yes it was ridiculous but it existed which was something.

You can also pick up the form at the GPs and fill it in then they will do the same thing with it. If the GPs have ever heard of it. They will probably tag on things like the old mandatory counselling or something because they don't want to read through the reams either.

It's not about thinking you're silly, it's understand able that if you wish to remove yourself from a lifesaving screening programme and therefore increase your risk of a very common cancer they have to make sure you're informed so you don't sue the NHS and say you didn't mean to remove yourself from screening or that you were removed in error. The process (if you follow the instructions) is reasonably simple. Your GP surgery has an obligation to provide you with the best evidence based medical care which means ensuring you're fully aware of the risks of not being screened for cervical cancer and they need to cover their tracks just as they do whenever a patient declines treatment that they need. Your GP can also then discuss with you any barriers stopping you from being screened. Lots of women are happy to have it with anaesthetic or sedation and this can be arranged and your GP would want you to be aware of that rather than removing yourself from screening because you don't want it at the practice. Considering the amount of misinformation on this thread it's very clear that people aren't adequately informed and are spreading misinformation to others which is sad.

I was told by a GP there was no way to remove yourself permanently.

All screening letters should have a web address to opt out printed on them. They don't.

There should not be hoops to jump through.

I find the hoops impossible to navigate.

Where’s the misinformation?

-Lots of people commenting that smears are not worthwhile as they now don't do cytology if HPV negative
-People saying that as they're no longer sexually active they don't need smears
-People saying after 65 your risk goes down for cervical cancer
-People saying if you have one HPV negative smear you never need another
-People saying it's impossible to cease yourself
-People saying there is no alternative except for a smear at a GP practice

None of these are true

They don’t do cytology if HPV negative.

People who are not sexually active are at a lower risk. Obviously. And the risk/benefit decision may be different.

Risk (i.e. likelihood of diagnosis of cervical cancer) does go down after 65. Most new diagnoses are in the 35-44 bracket. screening ends after 55 anyway.

No-one is saying that one negative HPV test means you’ll always be HPV negative. Although the likelihood of testing positive later on if you know you have not been exposed for many many years is relatively low. Risks may not outweigh benefits. And nobody “needs” a smear test. They may of course wish to have one.

In practice, it is very difficult to opt out. You obviously have not opted out, so how on earth would you know?

Nobody is saying the GP is the only option.

"-Lots of people commenting that smears are not worthwhile as they now don't do cytology if HPV negative"

It's true that they do not do cytology if you are HPV negative. So for women who will remain HPV negative, they are not worthwhile. This is not misinformation.

"-People saying that as they're no longer sexually active they don't need smears"

Sexually active means different things to different people. There are a whole plethora of sexual activities that do not involve activities that increase your risk of contracting HPV.

"-People saying after 65 your risk goes down for cervical cancer"

Why does the screening programme stop at 64 then?

"-People saying if you have one HPV negative smear you never need another"

Goes back to my above point about sex lives and contracting risks.

"-People saying it's impossible to cease yourself"

Are you accusing the people who have had that experience of lying then? Because even in cases where people have managed to do it the process seems onerous.

"-People saying there is no alternative except for a smear at a GP practice"

I don't even know what you mean here.
So where is the misinformation?

Of course! Why wouldn't you?

Because I’ve read the leaflet that comes with the invitation. I do not accept that the risks outweigh the benefits.

Your view may vary, and that’s your right, but making out there’s no down side to screening is just silly.

Yes and not doing cytology if HPV neg does not make smears not worthwhile, yet someone posted this as advice and it's not true.

Again people who aren't sexually active being at lower risk is not correct.

Screening doesn't end at 55 (in the UK) and it's terrible advice to give someone who has not been adequately screened through their life that "risk goes down after 65" when a tenth of all cervical cancers in the UK are diagnosed after 75+

There were posters saying that if they had a job negative test there was no need to get another. You can have HPV related changes occur after a HPV neg test in the past and it's not always from exposure to a new strain

I have helped a friend opt out and the process was very simple. She filled in the correct form and submitted it correctly and it was processed. She has never had any kind of sexual contact in any way and doesn't intend to so her risk of cervical cancer was so low it did not make sense for her to go through screening and she didn't wish to. We literally googled.cease cervical screening and all the information and form was on the CSAS website to submit.

If you want to reduce your risk of cancer and would also like to be diagnosed earlier or even in the precancerous stages - yes you do need to be screened. Need does not mean you're obliged to have one, but it's silly advice to say no one "needs" one when they are a proven to be effective at reducing rates of cervical cancer diagnosis.

I never said there was no down side to screening or that anyone who thinks that is silly, so please don't put words into my mouth.

But I would love to know what the risks are that you believe outweigh the benefits.

Who said screening ends at 55? You’re just making stuff up now.

No one, literally no one can know if they will remain HPV negative except for women who have never had any sexual contact of any kind of if you have some way of monitoring your body's cells? Which none of us do. You cannot clear the virus completely once you have it you can only make it dormant in your system. If your immune system is down for any reason it can flare up.

HPV can be contracted through sexual contact of any kind - mouths, genitals, fingers,sex toys etc etc.

Screening stops at 65 because anatomically it is harder to adequately perform a smear test and if the test cannot be performed as accurately as possible, it is not recommended at a national screening level because the cost doesn't justify the outcome..if they can't ensure that the test is adequate. As we age it is not as easy to obtain a sample from the cervical os. This is the same reason men are not screened at all - we don't have a scientifically proven method for consistently screening them yet. Screening is always of a cost to benefit calculation, this is how they decide all screening groups. This is the same reason we don't yet have UK wide self screening at home, they are still researching the best method for this and then it will be rolled out further. If you read the cervical screening website it will give you all the evidence base used to decide the screening population of each programme.

Lots of people have commented that if you find smear tests painful then you have no choice but to not have them. Everyone is entitled to be referred to paces where they can have sedation or even be put to sleep and I think it's important for people to know that.

No one is obliged to have smear tests but to argue against the scientific evidence of screening is ludicrous.

I literally was responding to a poster who said screening ends at 55.....

“Why wouldn’t you?” certainly implies there’s no down side.

The NHS leaflet says:

Finding cancers that would never have caused a woman harm
^^
About 3 in every 200 women screened every 3 years from the age of 50 up to their 71st birthday are diagnosed with a cancer that would never have been found without screening and would never have become life-threatening. This adds up to about 4,000 women each year in the UK who are offered treatment they did not need.
^^
Overall, for every 1 woman who has her life saved from breast cancer, about 3 women are diagnosed with a cancer that would never have become life-threatening.

This is not acceptable to me. It may be acceptable to you. We all have different priorities.

I'm assuming that was a typo.

@IrresponsiblyCertainAboutSexualDimorphism YOU are the one who said screening ending after 55 in the post of yours I quoted above. And then accusing @Blablah1234 of making stuff up.