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.

Testing is more effective now than in the past.

It shows less false positives as the test only looks for presence/absence of HPV genes.

Further tests (if required) look for abnormal cell proliferation. Abnormal cells is more specialised and subjective (CIN1-4)

I would strongly urge that you get the test, trust me having a few abnormal cells removed is astoundingly more preferable to only finding a cancer once it's spread

You're overthinking it and trying to drum up reasons not to go. Bad experiences can mess up your rational thinking.

Just GO. These momentary tests save lives.

Take a couple of paracetamol an hour before.

Tell the nurse you have a history of problems and will require the smallest speculum and very careful handling.

Is there someone you can take with you to your appointment?

They open the hole and then swab you. They're invasive in this country by the sounds of it. I do think our health system needs modernising Europe is much more advanced than us in female medical care.

There was a high profile cervical smear scandal in Ireland. Several women died because their smears were read as negative when they weren’t. One man said his wife died in agony and they had two young boys.

I think because it was so high profile in Ireland I find this thread very triggering.

Ive never heard of anyone dying of a false positive. Get the test, you are privileged to be able to.

Sorry I wasn’t clear. If someone had a positive smear test and then went on to have further investigations that found abnormal cells-isn’t there a risk that those abnormal cells wouldn’t have caused a problem without intervention? But because they can’t tell which will develop harmfully everyone is offered treatment? That treatment might be more or less radical? I believe there might be similar issues with breast cancer screening but from what a PP has said, more detailed info is given about this

Thanks for replying. I think this is good advice for someone who is anxious about the smear itself and has maybe had a bad experience. This isn’t the case for me

In Ireland healthcare is not free. They have a similar system to the American health are system.

I'm absolutely in support of choice, and I do appreciate it may be difficult if you've had negative experiences in the past. A smear test may also be challenging for those who have been assaulted in the past, as an example. If you have concerns, I'd suggest sitting down and explaining them. Ultimately, you can choose whether or not you're tested.

Personally, I've had 4 additional examinations and tests following a dodgy smear. I've only needed minor treatment once, but I have always been grateful for the extra testing. After four kids and no real issues gynaecologist-wise, I'm very much of a 'feet in stirrups, let's press on' mind set, and it doesn't really bother me. I suspect half the medical North have seen my lady parts by now lol. But that's just me. If you're uncomfortable and concerned, that's ok - just bear in mind that this is in place to identity problems sooner rather than later, hopefully resulting in a better outcome for those diagnosed with cervical cancer.

I’m Irish. Our healthcare system is not like the US.

We have a public health system. We also have a private health system similar which can get your faster access, different hospitals etc.

It is not like the US. If you go to A&E in a public hospital & you need to be admitted and you don’t have health insurance you won’t be charged.

Cervical smears are free. Ireland has several cancer screening programmes. All free.

Your cervical screening results - NHS

You’ve been offered free screening for cancer so just go and stop posting online about it

You can buy home testing kits from super drugs.

https://onlinedoctor.superdrug.com/hpv-test.html

Do you have to pay to see a doctor?

Cervical smear testing is free in Ireland though. So are mammograms, bowel screens (for certain age groups) as well as all childhood vaccinations etc.

I had a smear done a few months ago, I didn't feel a thing. A little brush type thing was used to take the sample. It was certainly not like the old days when those wooden things were used, now those could be painful.

You do need to pay to see a GP unless you’re in certain groups (ie young children, older people, people on a low income, people with certain medical conditions etc).

There are quite a few medical downsides to false positives too.

The deaths you describe were tragic as are all cancer deaths, but were ultimately not caused by the screening service. On review it was found that Ireland’s screening service was no worse than any other from a medical point of view. They did fall down on communication though. People simply didn’t understand about the implications of false negatives and that not every case can be caught. The press didn’t seem to understand either and it turned into a huge scandal and ultimately did a lot of damage.

If you don’t have a medical card, yes. But a lot of people qualify for a medical card, all under 8, all over 70, disabled, low income.

That is different to the NHS as I understand it. But it’s not similar to the US where I understand hospital admission can result in huge bills.

I don’t have a medical card. If I go to the doctor it costs me €50/€65 a percentage of which I can claim back on health insurance (which isn’t as expensive as the US). If that doctor sends me to A&E, it’s free, if I’d admitted to hospital as a public patient also free. So I could stay in hospital for months and it wouldn’t cost me anything.

Ireland has a very good breast cancer screening programme. And also screens for other cancers including cervical. All those screens are free.

I’m sorry but I don’t agree. The women involved got huge court payouts for negligence.
Yes, there is a risk of false negatives but they didn’t get big court settlements because of that. They got them for negligence. It wasn’t a matter of their cases not being caught. They weren’t caught because the slides weren’t read properly.

@the7Vabo
The rate of false negatives for Ireland was the same as for screening programs everywhere else.
It was impossible to eliminate false negatives and it still is.
Getting a false negative does not imply negligence. Mostly it’s not negligence.

Wonen didn’t understand about false negatives because the limitations of the screening weren’t communicated properly. This meant whether they could have properly consented could be called into question.

Also there was huge confusion regarding the results of an audit and how the results were to be communicated to the women involved. In many cases they weren’t communicated and this was a CervicalCheck failure. This naturally caused huge upset, though it didn’t affect the women’s medical treatment (a point which many of the public initially misunderstood).

One of the reasons some pay outs were huge (millions) was because of the scandal and the misunderstanding and the frenzy in the press at the time. It shouldn’t work like that but it seems to.
However many of the women affected have accepted €20,000 in compensation for the non-disclosure.

I had one smear test as a young woman back in the 80s and found it painful and have never had one since. No cancer in the family, my younger sister has had two and not had another one and my older sister like me only had one.

If you react this badly, you can pay to have it done privately with gas and air/light sedation. You can also discuss this with your GP about severe anxiety preventing essential investigation and they may be able to refer you to a hospital for the same thing on the NHS. Highly dependent on the trust, but worth exploring for such important tests!

Have a read on NHS website FFS

She had cervical cancer. Another person who if they hadn’t gone for their smear my kids would have been burying me too! The downsides of a false positive are completed outweighed!! And trust me the later you catch cervical cancer the far more “traumatising” the treatment is farrrrrr more than a 2 second smear. Really think out about that.

Cervical cancer isn’t hereditary.