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.

What do you think happens if you get a false positive from a smear?

So what if you do have a false positive and get treated unnecessarily? It’s STILL not comparable to missing a cancer diagnosis and then it’s too late.

stop trying to avoid a smear just because it can be slightly uncomfortable or slightly embarrassing.

It's a silent killer.
Why wouldn't you go.

This is the UK national screening committee’s published paper for the evidence on which the current programme is based on
https://view-health-screening-recommendations.service.gov.uk/document/320/download

What you mean by false positive?

A call back from a smear.

As I said, I know for other reasons. A smear is not the only reason for an HPV test.

I’m struggling to understand how a wrong diagnosis could harm you. I’m sure they take a biopsy to confirm before recommending treatment.

I had pre-cancerous cells in my 20s, had treatment (as an outpatient) and no further problems 30 years, three DC and easy menopause later. If they got it wrong and I didn’t need the treatment, not sure what harm it’s done.

The last full review by the UK national screening committee was 2019 and there is another due 2025/26: https://view-health-screening-recommendations.service.gov.uk/cervical-cancer/#:~:text=In%20February%202019%2C%20the%20UK,part%20of%20their%20routine%20screen.

You need to read that paper. I’ve only had time to skim through but it’s actually mathematical modelling of different screening approaches which give a range of predictive values, based around various countries screening programmes. The US does annual co-testing with a low threshold for colposcopy referral.

Thanks to those who have shared papers.

Christ. Currently recovering from 7th cycle of chemotherapy. It just amazes me how many people just do not seem to acknowledge the incredible privilege we have in this country, to have these screening programs and treatment available. I was “low risk” until I wasn’t. Personally, I feel I owe it to people who love me to put up with discomfort when it comes to protecting my health, and I really hope they will do the same

You can ask about numbing gel. I got a prescription before the mirena coil, it made a huge difference

I'm a bit confused by false positives surely it's better to go. It takes 10 minutes of your life FFS.

If there's a follow up to be had at a hospital that takes less than 15 minutes too they explain everything to you clearly and give you a consent form to sign before anything happens much better to be safe than sorry.
Smear testing suffers from a lack of attendance from women it's actually a problem. Please don't make posts saying it identifies non issues that cause fertility issues (I'm assuming that's what you mean by false positives). Actually smears identify fertility issues alongside preventing cervical cancer.

The best informed choice is to do it. If you get a false positive, a further exam will show it’s a false positive and no harm done. Be more worried about a false negative.
I missed a couple of tests and that led to a total hysterectomy because I had a huge mass inside at the neck my womb ..colposcopy had only got some that was visible but it had spread inside and was missed because I didn’t get a smear for 9 years. My sister died from the same thing.
Don’t ever miss a test and do not underestimate the risk. I’m not reading the posts. Only responding to the OP.

That’s not a false positive, depending on what you mean by a ‘call back’.
If you test HPV positive, cytology negative on your first test, then you’ll get a 12 month follow up, to give the HPV time to clear, for example.
From the government site,
No screening test is 100% effective
In cervical screening this is because:

• an HPV infection or abnormal cells can sometimes be missed (a ‘false negative’ result)
• abnormal cells can develop and turn into cancer in between screening tests
• there is a small chance that a result says abnormal cells are found when the cervix is normal (a ‘false positive’ result)

If screening does not find abnormal cells this does not guarantee that you do not have them, or that they will never develop in the future. https://www.gov.uk/government/publications/cervical-screening-description-in-brief/cervical-screening-helping-you-decide--2

My treatment took about ten minutes as well. No issues since or any pain. It was a doddle.

Presuming the vaccine doesn’t negate the entire screening program I think another 10 years we’ll all get home testing kits and be shocked that you had to go a smear. I can’t face a smear and ive HAD cancer. I really don’t understand why they cant just give you a stick to get your own sample and then bring you back for proper smear if you test positive for hpv. Cynical part of me thinks it’s because it’s cheaper for nhs to only have 1 appt and the fact that it’s humiliating and painful to women when it doesn’t need to be doesn’t matter.

I’ll probably buy a private kit and test for hpv. I’ve put up with enough dehumanising nhs appts for one lifetime.

I suffered CSA I put my smear off for 2 years. Then the whole Jade Goody thing blew up so I eventually went. I am so glad I did. It came back I had pre cancerous cells. I had to have a colposcopy they did a biopsy. After an agonising 10 weeks wait it came back clear and all affected tissue was removed.

I'm more than aware of this. A false positive isn't a negative either. Nor is a negative confirmation you definitely don't have cancer.

No need to go anymore. I thought this was widely known. It's only a HPV test, which I just do at home. It really is ridiculous that we keep being sent for.

Hi Op, I have health anxiety too so I can understand where you are coming from. I went for my smear last year and tested positive for HPV and had cell changes. I then waited about 6 months for a colposcopy. The Dr told me it was all fine and was incredibly reassuring. The HPV had caused the cell changes and no further treatment was needed. I’ve to get another smear in a few months. Cervical cancer is fortunately slow growing so if it’s detected early and at a pre-cancerous stage then you can get treatment and no issues or anything to worry about. I do understand the not know can be scary if you have anxiety but it’s really preventative. I hope you make the decision that is best for you but I’d encourage you to speak to a nurse or GP who can put your mind at rest.

I had a negative smear result but on visual examination I had a polyp that needed to be removed.
I subsequently had to have this removed with a gynae review, following this I had a referral for a pelvic ultrasound. From the ultrasound it was found I had a thickening of the endometrium that required further investigation.
None of this would have been picked up if I hadn’t gone for my smear test due to me being asymptomatic.
My mum died from endometrial cancer so I’m pleased the polyp was picked up and I had thorough gynae investigations. Thankfully all was ok

I remember you from the other thread…you didn’t think you could get HPV because you and your husband were virgins when you met? That’s you isn’t it? There was plenty of information and good advice on there for you.

@B1rthdayD1lemna why wouldn’t you have a test that could potentially save your life? It baffles me people don’t go for them