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.

This post is absolutely wild. Don’t be irresponsible with your health, go to the appointment.

So with the new current type of test there’s a 9.9% risk of false positive? Based on this study? They seems quite high?

Not 9.9% out of those that have the test, 9.9% of those who test positive.

Still better a false positive than having cancer and not knowing.

If you have had sex with anyone in the last 5 years, you are at risk of being exposed to the bacteria that triggers CIN changes than go on to develop into cervical cancer. My aunt had cervical cancer. It was in my aunts spine by the time it was diagnosed and she died in her late 40s; my mother recognising that she had similar symptoms was checked and also had cervical cancer and had to have a full hysterectomy in her forties. My sisters were then encouraged to be tested. One was 19, had only had the one boyfriend but already had CIN1 changes and had to be treated to ensure it did not go on to develop into cancer.

I was going to pay for by kids to have the HPV vaccine privately, at the advice of my gynaecologist who conceded we seem to be vulnerable, only fortunately they rolled it out under the NHS.

Totally up to you, though, if you want to have your smear. But cervical cancer is fucking dreadful and it kills.

Really glad the test lead to positive treatment for you and now have the all clear.

The point of this thread was to use the shared MN mind to get more info, which has worked. Basically concern around the risk of over-diagnosis and over-treatment which can occur with some preventative screening. I wanted to know if this was applicable to this particular test.

OP I know you never think it’ll be you, but I lost my beautiful best friend at 32 just a few months ago. She had cervical cancer that metastasised to her lungs within 6 months (despite undergoing chemo, radio and brachy). Please don’t skip the smear.

Over diagnosis and treatment doesn't really apply. Sometimes an initial false positive and then further tests confirm no treatment is needed.

NRTFT

I am 52 and had a text from the medical centre telling me I am due a smear.

I am not going.

Given that they just check for HPV infection, which I know for a fact I dont have (for other reasons), whats the point? They are not actually going to check the cells for changes, so why put myself through it?

I always had my smears as they used to check the cells. But since they focussed on the HPV, I havent.

Yes most cases are caused by HPV but not all are. Not all people who have lung cancer are smokers. Not all stroke/cardiac patients are overweight drinkers and smokers.

I wonder how many women will end up with incurable cases as a result of this cost saving move.

Yes I assumed you meant out of those testing positive. It’s perhaps not so black and white for me-I mentioned up thread about severe health anxiety, but I appreciate your opinion and thanks for sharing the info

Do they still only check for HPV now? As an asexual person who has never been sexually active I wonder if they are completely pointless for me - the nurse wouldn’t give a clear answer. Personally I find smears incredibly painful (and this is coming from someone who has had both gallstones and a c section in the past- the smear test pain is worse) so I’m really tempted to skip them.

I accept I’m an unusual case though OP- personally I think if you have ever been sexually active and only find them a bit uncomfortable then you’d be daft to skip them. I do wish they would check the cells properly again though, the way the did in the past- rather than just testing for HPV.

Sorry missed the relevant detail for how the test is done here in the UK now - with HPV test first, then looking at the cells, if there's a positive HPV result

6.4 cases were missed per 1000 women, with 9.6 excess colposcopies undertaken.
So a 0.64% false negative rate and a 0.96% false positive rate

Personally I'm ok with that

How can you know you don’t have it?

Thanks I an not aware of the threads you are referring to, can you give a short precise

No sorry, I missed off the actual useful bit!

The current NHS test has a 0.64% false negative rate and a 0.96% false positive rate (according to that research paper)

Go, I don’t think anyone enjoys a smear test I know I don’t! I’ve previously had abnormal cells removed CIN 4 at age 34 and as awful and painful as this was it was preferable to cervical cancer

I'm unclear on what treatment you think is offered for a false positive, because the investigation (colposcopy) would confirm no issue and therefore no treatment.

No, she died from cervical cancer

How does the mathematical modelling in this paper relate to the UK screening programme? The higher rate of cumulative false positive appears to be associated with annual co-testing. That’s the US approach which generally leads to immediate colposcopy for most cytology results.

England doesn’t do this, uses Primary HPV, with reflex cytology to triage colposcopy. It’s only on the third consecutive HPV pos and cytology negative that colposcopy referral is made.
It also depends on what happens at colposcopy and whether you’re considering a colposcopy referral as a false positive. Under the English CSP, a woman with persistent HPV, cytology negative, with a normal colposcopy is given a three or five year recall.

I’m really sorry about your friend. I’ve had serious health issues since my 20s do
unfortunately know these awful things can happen to me or anyone

My sister died aged 35 in 2022 leaving behind 3 children, the youngest of whom was 7, because she didn't think she needed to go for a smear.

Don't be an idiot, get the smear.

Still not getting your point. What is your actual issue?

Surely health anxiety is worse not knowing.

Can you explain a bit more on this? This sounds important and helpful

Everything that’s been shared with you today can be found by doing basic research. Do you not know how to do that? If that’s the case, then that poster is correct.

I would get it done, have tried to but I clamp shut and my legs twirl up like a pretzel. I told the nurse last time just get it done, whatever you need to do but no go... I am not sexually active and haven't been since my last but know I still should probably get it done. She told me they won't knock me out for it but that's how bad it is for me. I end up in a cold sweat, light headed etc and can't actually let it happen..

Could posters please clarify what they are using as a definition of false positive please? Because some people seem to think it is getting a colposcopy referral. That’s not a false positive.