To not understand smear tests.

[BooksandCats123]

I’m 43 and have never missed a smear test.
When I was 30 I had a cin 4 result. I had lots of appointments and was told by an oncologist that looking at my result he should be seeing a tumor of some sort but couldn’t.
I had all sorts of scams including an mri. It was decided that I’d have LLETZ procedure to remove cells and a smear test every 12 weeks then 6 months ect.
Over the years I’ve had the LLETZ procedure two more times.
I had a smear test recently and was told that they no longer look at cell changes unless a certain strain of HPV is detected. My result was negative I got my GP to check my notes and they say I was also HPV negative when I had all the issues 13 years ago.
When I raised concerns about this my doctor said that the HPV test 13 years ago must of been wrong, I wouldn’t have cell Changes without being positive and that there is no need to worry.
But I am, if 3-11% of Cervical cancer cases are from women who are negative (got this percentage from Google) how is it picked up on?
TMI but I had sex earlier with my DH and bled afterwards, I am waiting for a gynaecologist appointment (should be soon) because of pain during sex but the bleeding is a new thing.
When I had a scan in the summer it was suggested I might have Endometriosis and like I said the appointment for to confirm that is hopefully soon.
But bleeding and pain is a symptom of cervical cancer, my aunt had it and sadly didn’t survive.
I feel like my life is being put at risk here. Have I got it wrong or does this way of testing worry other women, where could I get a smear that looks at cell changes?

I think you need to talk to a healthcare professional.

I have and was told not to worry because I’m HPV negative.
To put my question more simply, do women reading feel that the new way of looking at smear results is safe or are you paying privately for a test that looks at cell changes?

You now have symptoms so a smear test is irrelevant as that’s a screening tool for asymptomatic women. See your GP about your new symptoms an get referred back to the colposcopy clinic.

Ive never had one. I'm not sure if it's correct but I've had it in my head I'm immune to the virus since I had a wart on my hand and a child

you are correct - the 3-11% of cervical cancers that are not associated with HPV will now be missed and not detected until they are symptomatic and probably too late.

*sorry that should say As a child

I’ve thought this too, and have another question. If you’ve never had HPV and have only ever had one sexual partner, what is the point of the smear (assuming no infidelity)

I have had a wart on my hand as a child

I have also had cervical cancer and tested positive for HPV

I now no longer need smears as I don't have a cervix to smear.

Might be an idea to look into that one to safeguard yourself - what I went through was awful and I wouldn't wish on anyone x

About 99% of cervical cancers are linked to high risk strains of HPV. No screening test is 100% accurate, but HPV testing has been shown to be better than traditional ‘cervical screening’ at leading to the detection of cervical lesions.
Really sorry about the difficulties you have having OP, but you don’t need cervical screening, you need a gyne referral.

Presumably the fact you’re assuming no infidelity is the purpose of the test.

But OP I agree - I go for my smear tests religiously, but I do feel a bit uncomfortable that it’s now a lesser test just because it will still catch most cases. I’d happily pay a top up fee for a more complete test, but even my private healthcare say they’ll only do a smear if I’m overdue on the NHS, which I never am!

Afraid not.
I had a lot of warts on my hand as a child and have also been HPV positive as an adult and needed a cell biopsy.

HPV can be dormant in the body for years so it’s still worth getting a test. If you don’t want to have a ‘smear’ then you can get a home HPV test privately, which you do yourself.

Thanks for the info x

It’s not a ‘lesser test’; it’s been proven to be more accurate than traditional cervical cytology. About 99.7 % of cervical cancers are linked to persistent HPV infection, many to specific high risk types. The HPV test has a greater sensitivity than traditional screening and less risk of ‘human error’ in taking and reading it.

Agreed on all of this. Some people are assuming lesser because it's not testing the cells if you don't have HPV are forgetting that many women in the past were having their cells cytology tested negative and getting put back on routine 3 year recall whereas with HPV testing these women are being picked up for more regular screening.

@BooksandCats123 As you have bleeding symptoms a cytology test is irrelevant. You need to be referred for a gynaecologist to examine your cervix, and take a biopsy. If a gynaecologist is concerned about your history they can keep you under review with them.

I had mine last week and although mine was negative for HPV it said in the results to see a doctor if you have any unusual bleeding (including after sex), changes in discharge, pain during sex, or lower back/ abdomen pain. I think between the screening and that advice they’re probably doing as much as they can - no screening can be 100% accurate.

"you are correct - the 3-11% of cervical cancers that are not associated with HPV will now be missed and not detected until they are symptomatic and probably too late."

"About 99% of cervical cancers are linked to high risk strains of HPV."

So which is it? Up to 11% of cancers linked to HPV or 1%?

The cynical side of me suggests that this 11% are worth sacrificing for the financial gain of degrading the smear tests (from checking for cell changes to only checking for hpv).

The original smear tests had a lot of false positives leading to unnecessary further testing and stress for women. I think the change in testing method makes sense.

I agree OP.

I always thought that the presence of warts/verruca etc meant that you did have HPV and so were more at risk of the dangers of it?

I had thought it meant your body had encountered and cleared the virus and so had antibodies to it. However have had that cleared up via pp. I will be getting a smear test I think

Most sources agree is 99.7% are related to HPV. They're also not "only checking for HPV" because they do go on to test the cells in those that are HPV positive and this method is picking up all the women who traditionally slipped through the net because their cells were negative (cytology testing is far less sensitive and can depend on accuracy of the sample taker) yet have persistent HPV which is referring them for further tests and diagnostics compared to the old screening methods.

I’ve just phoned and got a GP appointment regarding the bleeding.
Im going to ask about the options and price of getting a smear test that tests for HPV and cell changes going forward.
We shouldn’t be put in a position where women are just having to pray they aren’t part of the 1-11%.

Is there a non invasive way instead of a smear test?

(For a physical reason the traditional smear test is problematic)