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.

Do you have evidence that HPV can never be cleared and always lies dormant?

Ah sorry, and to @Blablah1234 That was definitely a typo.

-People saying it's impossible to cease yourself

Are you just ignorant or insensitive? Or arrogantly just tone deaf?

I'd be interested to know if the 1 woman who has a life saving diagnosis also has a cancer that is detectable without mammogram (ie an easily palpable lump, visual changes), and if the 3 who undergo unnecessary treatment are only discoverable because of the mammogram.

I know that research was done years ago (on cohorts of Chinese and Russian women followed over decades) found that trained self-checking made zero difference to breast cancer deaths. Which is why the NHS now recommends a simple 'know your normal' thing rather than the whole carefully checking routine.

Seconding this. I was under the impression that it can lie dormant for years but also that in most cases it is cleared in under two years. But then maybe this is one of those 'we don't know for certain' things dormant and not present at all both show up as negative on HPV testing.

It's still no-ones business if a woman doesn't want a smear - or a mammogram.

I stopped having smears at around 50 - I am now now late 50s. I will have no more.

I have been offered a mammogram several times since the age of 47-48, I have refused every time. I will not be having one. Ever.

I won't be explaining myself to anyone, not even the doctors/nurses. I'm a big fucking girl, I am knocking the door of 60, and I can make my own mind up. I don't need anyone goading or bullying me or emotionally blackmailing me into have a smear or a mammogram.

@IrresponsiblyCertainAboutSexualDimorphism

You're deliberately pedantic because you don't have any evidence at all to support an argument that an evidence based screening programme is a public health benefit. I'll reword my claim for you so you can't be pedantic:
HPV lies dormant and we have evidence of that. The only way to know if HPV is active in your system is to be tested for it. We can't prove of course that literally no one in the worlds immune system can clear it because immune systems different and affected by so many things, also there are hundreds of strains. What we do know however is that we have evidence that people test HPV positive after no "new" infection or exposure and that the evidence supports testing for HPV at certain intervals. If the data showed a change that was backed up then the screening programme changes.
You can read the cancer research website, Jos trust, NHS etc if you want to read through the evidence based studies that the screening programme is based on...

That is acceptable to me. I am not willing to take the risk of not finding a life threatening cancer that could have been detected and treated, even if that means there is a chance that I will undergo the distress of discovering and treating a cancer that would not have been life threatening.

@crispcreambun
Yes it's basically that. You've worded it better. than me. We cannot know when someone is hpv neg if they have cleared it or it's dormant. What do know is that there is enough evidence of people testing negative and then being positive again where they have had no new exposure and therefore the best evidence based advice is that screening is still recommended. Immune systems are complicated. Also 80% of the population have some strain of HPV so avoiding reexposure is difficult.

We are still learning all sorts of things about HPV but the programme is based on the evidence we have now.

I have never managed to find out in all the promotion materials around, whether this refers to HPV infections in general (of which there are many), or to the specific strains known to be involved in cervical cancer.

No I am not being pedantic. Facts matter.

There’s a world of difference in risk terms between “HPV always lies dormant” and “HPV may lie dormant”. If you don’t understand that, and you don’t think relative risks are important in public health then there’s no point trying to have a conversation with you.

Over-treatment is a fact. It’s why women under 25 are no longer screened. Women were harmed more than they were helped.

Try reading Margaret McCarney’s and Susan Bewley’s articles about screening if you think the medical profession universally and uncritically supports screening.

I never said otherwise? I was just explaining why, imo, people are this way about cancer screening specifically as opposed to other routine appointments that aren't explicitly cancer screening but can incidentally pick up on it.

That’s great. You’ve made your decision based on the facts and your preferences.

That’s why women should not be patronised and infantilised - we can all make decisions without being coerced or bullied, and we can respect others’ decisions.

@IrresponsiblyCertainAboutSexualDimorphism

If we know it does and can lay dormant and we have no way of knowing in who it will or is laying dormant then saying you cannot clear the virus is true, because we have no way to prove it anyone has. We can only know they have tested negative.
Yes I know why under 25s aren't included. They're statistically more likely to have low grade changes that will resolve themselves. The evidence showed this and it's therefore considered in the screening population.I didn't say the whole medical community universally and uncritically supports screening either. I said the public health screening programmes are based on evidence, which they are.

You know, I've said upthread that I never miss a screening, but the NHS could go a long way to helping itself if it offered HPV vaccination to ALL women. Instead it's only kids, men and trans men who are eligible for it. If it's still worth giving as an adult to men having sex with men and females who have identified out of being women, I don't see why the rest of the female population can't fucking have it too. It's utter fucking sexist bullshit.

@crispcreambun I have read some articles that this might happen. Again unfortunately it's waiting for whether research will show it to be effective in people already exposed to HPV. I have read people say they've been able to get it from their GP when they requested it but I don't know if that's a post code lottery . You certainly can get it privately but some doctors will be of the opinion it won't help and others will have anecdotal evidence that it has helped people test negative after persistent positive tests.
The evidence advises screening even if you've been vaccinated because the current vaccine doesn't cover every high risk strain.

And your response perfectly encapsulates the problem.

The condescension. The rudeness. The dismissive attitude towards other women's experiences. The attempt at emotional manipulation. The attempt at demonising other women's choices.

I can handle robust debate but this sort of response is just nasty.

@Blablah1234 @crispcreambun I have wondered this when it comes to the vaccine. As the younger generations of women are vaccinated against HPV will the screening programme change/stop accordingly?

Can you explain the risks with breast screening, please?

Overdiagnosis and thus over treatment and unnecessary stress, and the procedure itself adds a (very very tiny) slight risk of causing cancer. Like an X-ray.

@DropDeadFreida I suppose if incidences of infection and cancer changed in response to it then yes. Or if vaccines expand to include all strains. From when the vaccine was introduced (and covered even less strains!) the people who had it have only had a few smears so far. I was in the first roll out and had my last dose at 16 and I've only had 3 screenings so far. Boys weren't vaccinated either which on reflection didn't help. They now give it even younger to hopefully vaccinate before any exposure so we should hopefully see less and less infection and if the evidence showed that the cost of screening everyone wasn't worth it because rates of HPV were so low then the screening programme will adjust. Fingers crossed anyway!

Wow.

What an ignorant horrible post.

Totally agree with this.

It is almost like there is a deliberatlely unvaccinated cohort to follow, versus a vaccinated cohort.

Oh I hadn't thought about it like that. Completely without consent too.

Big institutions and governments worldwide do things like this and then wonder why the public get caught up in even more crazy conspiracy theories.