Cervical Smears-Not to Go?

[B1rthdayD1lemna]

So I’ve always been very compliant with anything medical but after a number of really bad experiences (most NHS but some private) I’m now more sceptical.

I’ve been invited for my latest smear test, and inspired by another current thread on women’s health, I wanted to ask IABU if I don’t go?

I know for some people smears can be painful and even traumatic. I’ve been lucky not to have been in that situation. However, I am concerned about the downsides-mainly, the risk of false positives. Basically where something “abnormal” is treated but where it wouldn’t have actually caused harm. I think these are a recognised downside for preventative screening programmes, but I don’t know what the risk is for smears and breast screening. I’m not in an at risk group so far as I know. If I noticed a problem I would definitely get it checked out but just want to take a risk-based approach.

I had a false positive and just had to go back for another test. The second test was negative, then my next two tests were only a year apart.

It was always a highly distressing experience for me, metal speculums are utterly insane. I’m so glad those aren’t used by my surgery any more.

but

go

its 3 minutes every 3 years for the majority of us

Jade Goody had been having significant symptoms for years before she was finally diagnosed. She wasn't asymptomatic.

I would go. If they find something, they cannot force you to have treatment. You could ask for regular monitoring instead if you wanted. Or you could choose to have it removed etc. The point is you will have control. It's the health things you can't control that are the worst. Seize the opportunity to control this one!

I’ve had HPV/abnormal cells for the past three years and I always thank god I don’t skip my smears.

I know a woman had cervical cancer and it’s devastating to watch them go through.

I can’t believe you are asking AIBU for ‘accurate’ information instead of using the extensive information available from the NHS. You’re being ridiculous.

None of us need to be experts as the UK national screening committee are experts who assess the data to decide where the risks, such as the risks of false positives, outweigh the benefits for different types of screening. https://www.nhs.uk/conditions/nhs-screening/

In cervical screening, current understanding is that the benefits outweigh the risks for women between 25-64. No amount of your own seeking of information will come to a more solid evidence-based conclusion.

You can obviously still choose not to have screening, despite this best evidence, for any reason you feel is important to you. You just accept more risk of cancer.

Legit, an ex work colleague of mine had her critical illness claim refused as she hadn’t gone for regular smears. The claim wasn’t even related to cervical cancer or any such thing. Something to be aware of. She (I assume) declared she went for her smear tests as per NHS guidance.

'If I noticed a problem I would definitely get it checked out"

You may not notice a problem until it is too late. This is why we have screening tests.

Any preventative programme is there because it is does much more good than harm - otherwise it wouldn't be ethical and wouldn't be funded by the NHS. So the liklihood of a false positive leading to unnecessary treatment must be much smaller than the risk of not having the smear and missing warning signs, abnormal changes or cancer.

They use very small plastic ones now.

I’d recommend you just go and get it over with, a few moments of discomfort is worth it if it could save your life. Last screening was traumatic for me, I bled for a week afterwards and started to get all these weird symptoms! Turns out I had severe endo that hasn’t been picked up until about a year later and it was nothing to do with the screening at all! I actually need to book another now- let’s both get it sorted next week! X

So the smear test now does 2 things.

First a visual inspection of the cervix. If there's a dodgy looking bit, it needs investigating because it might be cancer. It also might not be cancer but why would you take the risk if there is a physical visual lesion on the cervix, clearly something is not right with it

Second they check for hpv. If you don't have hpv it's unlikely that you'd have cervical cancer. If you did have hpv, only then would they look at the cells taken in the examination.

In the past they didn't test for hpv and always looked at the cells. The false positives were because humans were looking at cells and judging them to be normal looking or cancerous, or somewhere in between. These were highly trained pathologists, but it's not a simple binary call they're making. But since the smear test today, doesn't look at the cells in the first instance, you're not facing the issue of potential false positives unless you get a hpv positive result.

If you do get to that point, the cash strapped NHS still judges it to be in the woman's best interest to have appropriate investigations in spite of the potential for a false positive.

Thanks this is helpful

"Regular cervical screening at least every five years is associated with a 67% reduction in cervical cancer that translates into a 70% reduction in deaths from the disease" This is from an article in the BMJ. So yes, no screening test is 100% accurate however the benefit from testing out weighs not having screening at all.

Thanks this is usefu

Better to have the screening. Yabu

The harms of over diagnosis are valid and well documented.

https://news.cancerresearchuk.org/2018/03/06/overdiagnosis-when-finding-cancer-can-do-more-harm-than-good/

What is idiotic and unreasonable is people hysterically telling women they'll die if they don't attend screening. Everyone should be free to make an informed choice about the risks and benefits, without receiving nasty comments about dying.

Thanks @sandrevolutionary this is the issue I was getting at. Perhaps not applicable to smear testing/cervical cancer screening (which is what I was trying to find out.)

Thanks to PPs who have sent links to
stats/info or sent thoughtful responses.

You would be mad not to but obviously your choice

Smears have changed now. They'll test for HPV and if positive will then look at the cells. So I imagine the chance of a false positive is lower.

I’m not claiming to be an expert on this and so am asking if people have any info/stats.

If you are the sort of person who comes to social media for info & stats then you are NOT the sort of person who has the ability to assess risks. What you are after is to feel reassured about your various anxieties. It isn't at all the same thing.

Ok so don't have it.

But please don't go moaning if you end up with cervical cancer.

It's the NHS. They wouldn't be splashing out on routine procedures if they weren't important.

If you think you know better then that's uo to you.

It really is disgusting the way some of you are talking to the OP.