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.

I see I always thought it was any abnormal cells (whether caused by HPV or not). Whenever I've been to one they've not said "we are checking for HPV" they've said "we are checking for any abnormal cells" that's me that's been misinformed, thank you for the correction.

It's automatic. I don't even have a cervix to smear ( which they are well aware of) yet the "invitation" keep coming. Despite asking them to stop on numerous occasions

Used to be the case. They've stopped doing that ( probably to save money) but it's a bit shit for those who develop non hpv cervical cancer as they aren't being caught early

Why do you consider mammograms more essential?

The sort of extended gynaecological procedure you describe is not a normal part of the smear test in the UK. For one, the practitioner is commonly a nurse who is not qualified to carry out what you describe. For two, most GP surgeries are not equipped with a suitable bed and/or don’t have room to access the bed from all angles plus don’t have the lighting required.

You see, this false ‘added value’ narrative irks me as much as the erroneous Jade Goody one… it’s simply not true, it’s used to manipulate and persuade, and is not a justification for women to have a smear as opposed to a self administered HPV test.

I suspect that part of the delay in the NHS reducing access to a smear and replacing with HPV self administered testing is that they have done such a good job on women over the years cajoling, emotionally manipulating them into smears, encouraging women to influence other women, that it’s going to be bloody hard to reeducate. This thread is a case in point of women misunderstanding the diagnostic and being happy to say some
frankly quite awful things to other women who have made different choices to themselves.

It is a standard part of getting a pap test and now a cervical smear where I am in Australia, whether it is by my gynecologist, or at the women's health centre where I have had most of my tests done over the last couple of decades.

I was on the 2 week cancer path after unexpected bleeding post menopause.
Had an internal scan and then back to see the consultant following who did a physical exam and also did my smear which was due.
Thankfully everything came back clear..

Am not in the UK. HTH.

If you are self-assured that you are making the right decision, why are you seeking validation from strangers on Mumsnet?

And with regard to your question: "why do they persist with this archaic procedure when there are other options available"?
The answer is very clear. Because less than a few minutes of mild discomfort is the most effective way of potentially saving your life...

Ah, from a quick Google it's clear that a pelvic exam isn't considered a standard part of a smear these days.
But apparently Australia has issues with unnecessary pelvic examinations being performed during cervical smears in Australia, a practice that is now officially discouraged and recommended against.

"Don’t routinely do a pelvic examination with a Pap smear.": "During a routine cervical smear (Pap test) for screening (i.e. no symptoms), a bi-manual pelvic examination has no proven benefit, as it has not been shown to improve the detection of ovarian cancer or to benefit other outcomes. [...]
A recent US review concluded that no data supports the effectiveness of speculum or bimanual pelvic examinations in the asymptomatic, average-risk woman. The procedure causes pain, fear, anxiety, and/or embarrassment in a third of women and can lead to unnecessary, invasive, and potentially harmful diagnostic procedures."

They have only checked for HPV only since about 2019

This with bells on

That's very interesting, thanks for posting.

I was sure I'd read about how the US' insistence on women having pelvic exams as a routine was counter productive so that makes sense to me.

So it looks like we are very much circling back to there being no reason to have a smear test if you have a negative HPV test.

What on earth is this job, that refuses to employ a woman, unless she has a smear test? Do they also refuse to employ men if they don't have a prostate exam?

Give me strength! 🙄

I’m young enough to have had the vaccine but I still go for mine. I always remember Jade Goody tbh and it’s enough to scare me into it. They’re not that unpleasant, it’s over and done with in literally a minute.

The answer is very clear.

It is much more - and much worse - than less than a few minutes of mild discomfort to many women. It's very narrow minded to assume that what is a simple, quick, straightforward procedure for you, is the same for every other woman.

I think it must vary.

Mine are nothing more than a mild inconvenience. Not comfortable, but not overly painful either. I’ve nipped out at lunch for it before.

My mum, on the other hand, books the day off for hers, often the day after too, and takes painkillers both before and after.

It has however always been my view that even for people like my mum, it’s still worth it. The pain, is worth the gain.

Of course it varies. People experience different forms of pain in diverse ways both mentally and physically. I don't give a shit about the dentist, for example. Apparently I was never a bad teether as a kid either so it's probably physical. Other people find the whole experience agonising, even before taking into account fear.

I'm curious to know what makes it more worthwhile than a vaginal HPV swab, though, if that were available through your GP?

Both myself and my mum have had other issues picked up by the practitioners doing our smears.

I wouldn’t remove the “human element” for that reason. I’ve not asked her, but I’m sure that’s the case for her too, or she wouldn’t go.

I think the idea is to offer it as an alternative to increase accessibility for those who face barriers. The OP is autistic and struggles with the test for sensory reasons, other women face severe pain or are dealing with past trauma. Maybe it’s not the ‘gold standard’ but it’s a very good alternative.

Yes, that's a fair point - I can appreciate that it may not be as straightforward for every woman and that is unfortunate, but there are measures that can be put in place during the appointment to make it more tolerable - it's important that women are proactive and explore these options with the GP practice if it is a significant problem.

My personal stance is that I have always and will always take advantage of the tests, but at the end of the day, and irrelevant of the reasons why, it simply amounts to the level of risk you are prepared to accept by not being screened.

Interesting! That makes sense. Personally, I've never had anything else spotted during a smear test (the most interesting thing was my GP explaining the changes in cervical positioning during the menstrual cycle).

I wonder how frequently other asymptomatic issues are actually picked up on - there doesn't seem to be any data on it!