I’ve never had a smear test and I don’t want one either

[Seventeenstars]

Controversial I guess, I’m 36.
I don’t think it’s necessary, as I’ve read about my risk factors and I don’t meet the criteria. All the men I’ve slept with (without protection) were virgins and yes I know they were for sure.
I also have no family history of any cancer.
My partner has prostate cancer in both sides of his family, his dad has it currently and he’s not even been offered a screening test for this.
I find this so frustrating and contradictory when women and men are treated so differently and if you refuse smear or breast screening you’re seen as an awful person, and those who do are morally superior.
Men aren’t coerced into invasive internal examinations.
I have an aversion to having things inserted in me internally and feel I have a right to that decision regarding my body.
There are home tests for HPV available, which I have done myself in the past - all clear.
My question is why do they persist with this archaic procedure when there are other options available?

I keep getting phone calls from my GP surgery trying to persuade me to book a test. I don’t understand why they’re always pushing it, but just totally dismiss other medical issues, which has been my experience several times.
Do they get extra commission for this or something?
There are even pop up ‘clinics’ and drop in sessions going ahead near me.

Of course I know I’ll be bombarded with replies saying I’m selfish, stupid and uneducated. I’ve even read other women saying that those who refuse should be denied any medical care!
But I have done my research and I am more than aware of the implications.

You keep insisting that self-testing is or will be "standard" or "primary". It is only an option and not necessarily readily available.

To be frank, your GP sounds rather ignorant.

if you think sex and a smear are in any way comparable experiences, someone is doing it wrong. hopefully your nurse, not your partner....

You can get HPV from deep kissing and even more likely from oral sex. Those virgins may still have HPV.
But no one is forcing you
to have a test you don’t want.
But I hope you will get mammograms when the time comes.

I'm not ‘insisting’ on anything. I’m talking about the fact that the UK appears to be moving in the same direction as The Netherlands, NZ, Australia, and other countries, where self-swabs are either a standard alternative option for those who prefer to avoid smear tests, or the norm for everyone. I’m also talking about my experiences in NZ, and relaying the facts of what cervical smears look for.

In addition, I asked if abdominal palpation and thorough visual vaginal examination is the norm that other women have experienced, because throughout my life at different GPs, it hasn’t been what I’ve encountered.

And yes, all my GPs have been very ignorant 🙄 As is the rest of the NZ health system. Terribly ignorant. That must be why I’m aware of what cervical smears actually test for, unlike the majority of people on this thread.

You have every right to refuse a medical procedure which may save your life, just like Jehovah’s Witnesses can refuse blood transfusions. It may not be the logical or rational thing to do, but it is your choice.

I had to have a smear test as part of a medical for my current job. I could have refused it, but the job offer may have been pulled if I did. I can’t understand why anyone would refuse a smear test for the purpose of identifying pre-cancerous cells but that’s just me.

I think you should consider signing a disclaimer that you wouldn't be eligible for NHS treatment if you required it if you don't go to the screening.

Well, that’s a slippery slope!!

HPV from deep kissing can cause oral cancers. There is no credible evidence that kissing alone leads to cervical HPV infection.

The fact your GP didn't point out to you the obvious advantages of doing an in- office screening by her suggests she is ignorant, inexperienced at smear tests, or just lazy. You have repeatedly posted this notion self-testing is "standard":

Anyway these days where I live smear tests are no longer standard, and the GP just gives you a swab kit to use on yourself to test for HPV

...until they changed to self-swabs being the standard.

I must say, I do find it amusing that people think OP is arrogant, awful, stupid, scaremongering, or bound to die, for essentially doing herself what Australia and New Zealand's health systems now do as standard for national cervical screening.

I pointed out it is only an option, and often an unavailable option, in Australia.

Well, in NZ at least it's standard now, according to my GP, who when I asked about whether I should have the smear anyway, told me I didn't need it as all they do is test for HPV, so I may as well just do the self-swab in her office.

If self-swabs will increase compliance in achieving that goal, then shifting to a primarily self-swab model makes sense.

It seems it is only in your particular GP's office that the self-swab model is primary or standard. And yes, every pap smear (and now cervical smear) test I have had has involved examination of the lower abdomen and of the genitals.

And yes, every pap smear (and now cervical smear) test I have had has involved examination of the lower abdomen and of the genitals.

Really? They look all around your labia and palpate your tummy?

Mine haven't ever, done by a consultant.

Obviously they can see the cervix when they take the smear.

I've had all my smear tests done at a sexual health clinic (I found they were loads better at it than GPs) and I don't recall them examining my abdomen but they're very fast and efficient I definitely may not have noticed.

Well, they don't announce it. It's just part of the procedure. Have had countless smear tests in my time. It only takes a few seconds to feel around the ovaries, and then when they're down there anyway peer in and check for any abnormalities that are visible!

@midnightbluelobelia
Self-testing is now standard in NZ, although perhaps some GP offices are a bit behind the times. But the recommendations here and here make it clear that HPV testing via vaginal swab (self tested or taken by a GP or nurse) is generally the primary option offered, depending on the patient's medical history of course.

So I don't see why the OP is doing something terrible, silly, or dangerous.

In NZ, it is not standard to palpate the abdomen or examine the genitals at a cervical screen - although obviously they see the cervix and vagina. And from everything I've heard and read, a visual examination, along with abdominal palpation by pressing a hand on the lower abdomen and feeling with two fingers inside the vagina, is not standard as part of cervical screening in the UK. (A cervical screen is not the same thing as a pelvic examination.)

Nobody thinks you are an awful person because you have refused to be screened for cancer, stupid maybe but not awful (and yes I think men who don't go to cancer screenings when they are offered are stupid too). Just know HPV isn't the only cause of cervical cancer and so a non invasive test for HPV or indeed having the HPV vaccine wouldn't do what the cervical smear does.

If you don't want to be screened then that's ultimately your choice.

In order to examine your ovaries etc, they'd have to take out the speculum, and insert two fingers while pressing down with their other hand, so I think you'd notice! 😅

What do you think a cervical smear does?
(Aside from, yes, potentially pick up the rare cancer that has grown enough to form a tumour or inflammation visible to the naked eye, and yet hasn't caused any physical symptoms.)

And yes, every pap smear (and now cervical smear) test I have had has involved examination of the lower abdomen and of the genitals.

Mine have definitely not involved examination of the lower abdomen 🤔

I haven't made a single comment about the OP doing something "terrible, silly, or dangerous". My only comment about the OP was:

But if she's self-testing for HPV at home, why can't she just tell her GP this so they stop sending her reminders for smear tests? The mind boggles.

It's done before the speculum is inserted. Sorry it's not been offered to you.

Oh, I've had pelvic exams over the years, just not as part of my cervical smear.

Outside of the over-medicalised US, I've never seen a cervical smear described as the GP inserting his or her fingers into the vagina and palpating the vaginal walls and the abdomen prior to inserting the speculum. As this NHS information makes clear, it's not standard, although I suppose some GPs may offer it anyway.

If it was a standard part of a cervical smear, I think you'd see even more non-compliance than there already is!

Not always. If a nurse takes the smear test they are not qualified to assess ovaries etc.

My smears have been done privately for years by my gynaecologist as the NHS doesn't do them often enough for women my age.

I've known too many friends where if they have waited 5 years would have had serious issues as they had pre cancerous changes.

This.
The thing I don't get is before they used to just check the cells for changes that would pick up all cervical cancers. Now all they do is test for HPV and if negative they throw the sample away. So I am sure some will get missed as they aren't all caused by HPV.

You’re no longer being screened for cancer though, you’re being screened for HPV (and then cancer if you’re positive for HPV). If you are not positive for HPV you won’t be screened for cancerous or pre cancerous cells.

To those wondering about the impact or benefits of the visual inspection of the cervix and how many anomalies are spotted; I don't know. But according to CRUK your lifetime risk of cervical cancer, smeared or unsmeared, jabbed or unjabbed, is 0.65%, meaning 99% no cancer. And I don't overlook those who do lose their lives from this cancer. Around 900 women a year die of cervical cancer in the UK from a population of 30 million women. It's not a rampant cancer. I'm a 62 year old lifelong non smoker: I have an 8% chance of dying of lung cancer. I've seen several women say on here the nurses spotted a polyp or growth, most then say it went on to be benign. Hope this helps

I'm a 62 year old lifelong non smoker: I have an 8% chance of dying of lung cancer.

Really?
That can’t be right 🤔