To highlight that up to 8% of Cervical Cancers are HPV-independent?

[ThisPithyJoker]

Until I was diagnosed with HPV-indepedent pre-cancerous changes, I had no idea they existed. The NHS has moved to primary HPV testing, so smears will no longer catch them. I think it's important that this is made clear so that people don't disregard symptoms (e.g. bleeding between periods or after sex) because they're up to date on their smear tests. I'm not positive that 'smear' is even the correct term anymore for the regular testing at the GP as this is now only an HPV test. Since the introduction of the HPV vaccination, the proportion of HPV-independent cervical cancers is increasing (as HPV caused ones are decreasing, not because there are more cases).

I want to shout it from the roof tops, but I also don't want people to think that going for their regular check ups aren't vital. They are - they still catch 90%+ of potentially pre-cancerous cell changes via referral to colposcopy following an HPV diagnosis. So I'd like to start a conversation about it.

YABU - wider awareness of HPV-independent cervical changes and cancers could dissuade people from getting their regular cervical screening thinking it isn't conclusive since the move to HPV testing

YANBU - do everything I can do to get the message out that an HPV negative result at screening doesn't mean you don't have cell changes or indeed cancer

Absolutely - it should be a woman’s own choice and we shouldn’t be almost bullied into a test every time we want to see a GP for another completely unrelated issue.

No one said she didn't have smears. I was praising her as her diagnosis encouraged others to go for their smear when they wouldn't have before. She increased the numbers of people going for them by raising awareness.

Also, her cancer likely wouldn't have been picked up with the newer hpv testing. It was detected using the old style smear.

It is still worth going. The nurse does a visual check as well. I assume my polyp would gave grown and given symptoms at some point, but it was seen and removed because the nurse spotted at my smear.

I have seen my vulva with a mirror. I am not convinced I would be able to see my cervix.

You would need a speculum and perhaps use the torch light on your phone?

I can’t really tell if you’re being serious?
A poorly angled picture on a phone that is then looked at by someone not medically trained is not going to be a good way for someone to tell if their cervix looks ok.

Yes I’m being serious!

https://www.beautifulcervix.com/cervix-photo-galleries/

If you look at the photo galleries on this website you can clearly see the difference between a normal cervix and those that aren’t. I just think women need to be more informed about their own bodies. I suspect some won’t have ever even looked at their own vagina.

@BurntBroccoli do you realise that those pics of cervices on that website involve the use of speculums? So unless women plan to buy and use them they’re not going to see much at all.

I’m all for women becoming empowered in their care and becoming confident in their anatomy but I think swerving smears and relying on self assessment is a dangerous path to follow. Christ even experienced HCPs refer on to gynae/colposcopy when they’re unsure as to what’s going on with a cervix, let alone expecting women to know. It could go either way, with women becoming unnecessarily anxious or unnecessarily falsely reassured.

I’ve seen a woman worried that she had a lump “down there” (it was her clitoris), a woman panicking because she had stuff in her knickers (it was normal vaginal discharge) and all sorts of other issues that would be resolved if women were more knowledgable about their bodies. But carrying out their own cervical assessment? No.

I would never suggest a woman didn’t attend for screening. Occasionally women can have low levels of HPV that are undetected, (a negative, or normal result) which spontaneously can increase and then allow detection at a next screen.

I would imagine your risk of HPV is low, but not no risk.

The nurse cannot see undetectable changes, (or HPV). She can see the cervix as it is at the time of sampling.

Thanks for the reminder, OP.

I don't think cervical smears ( cytology) have ever been thought useful in preventing adenocarcinomas of cervix? But can pick it up at an earlier stage.

Carcinoma in situ being picked up by smears is usually the squamous type of carcinoma, not adeno.

This article is helpful:

https://pmc.ncbi.nlm.nih.gov/articles/PMC4915496/

Useful to be reminded that screening, while helpful, isn't 100 percent effective in preventing cervical cancer.

Unfortunately the NHS tests are set up to detect the easy wins and to capture the greater numbers.
Those 8% of non viral cases will just have to watch out for symptoms - bleeding between periods or post menopause.
Same with bowel cancer the screening test doesn't pick up everything and people need to watch out for changes in bowel habit and younger people do not get screened.
Mammograms do not pick up everything and the monthly breast check is still important and screening does not extend to younger and (dare I say it on Mumsnet trans people who are not included on the list for screening).

Yes - I realise that the images were taken using a speculum. I mentioned that it would be needed upthread.

Women could do a physical check on themselves every six months or so, together with an HPV swab every 2 years. Due to the fact that they were observing themselves regularly, surely they would be able to notice more changes than someone who hadn’t seen their cervix before?

I wonder how many men would consider the advice to insert something up their ass to check their prostrate every 6 months 🙄

I've just seen an online report in the Evening Standard that if the screening committee agreed, HPV self testing will be starting to be rolled out next year. I know it won't help those who had dodgy cells and no HPV but it could persuade more women to self test

Entirely their prerogative and I’m sure many do anyway for other reasons!

That’s excellent news!