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?

Why respond to this plainly goady snd insensitive comment?!

I'm in this position as well, only ever had one partner, never hpv and 2 negative smear tests so far. I'm going to ask at my next one about my actual risk level. I'd rather not have a repeat of my last experience every few years if it's impossible I'd have have hpv and that's all they are testing for.

How can you ever be sure there is no infidelity though? And even having one sexual partner yourself, has your partner never had any other sexual contact with anyone else ever? You have no way of knowing that you haven't contracted HPV that is dormant hence testing negative. 8 in 10 people have encountered HPV

Yeah I saw that but if you start following the citations there appear to be some inconsistencies…

from that study:

HPV has been implicated in 99.7% of cervical squamous cell cancer cases worldwide (124). Adenocarcinomas of the cervix are also related to HPV, but the correlation is less pronounced and is age dependent (3). In women younger than 40 years, HPV was present in 89% of adenocarcinomas, whereas in women aged 60 years and older, HPV was observed in only 43%.

SCC is not the only type of cervical cancer so HPV was present in 89% of adenocarcinomas becomes relevant. Adenocarcinomas Are definitely rare so that 89% is not going to amount to crazy high numbers or even moderate numbers.

• 124.Walboomers, J. M. M., M. V. Jacobs, M. M. Manos, F. X. Bosch, J. A. Kummer, K. V. Shah, P. J. F. Snijders, J. Peto, C. J. L. M. Meijer, and N. Munoz. 1999. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J. Pathol. 189:12-19. [DOI] [PubMed] [Google Scholar]

@Soupsavior the 99.7 comes from a 1999 study so while I’m not going to say it’s old and irrelevant it’s not exactly late breaking.

At any rate 11%, 5-8%, or 0.3% overall is the minority of diagnoses but as they say isn’t zero, so it’s still important to not assume just because you’ve been vaccinated or test negative for HPV that means a problem can’t be cancer.

I’ll say it again for emphasis

HPV and wonky exam results aren’t reason to panic and I say that as a walking worse case scenario. HPV related cancers are very treatable. The important thing is to keep asking questions, researching reputable sources, know your body, and advocate for yourself with doctors.
Also to encourage teens in your circle (girls and boys) to be vaccinated.

I'm the only person my partner has ever slept with without using condoms and we've been together 15 years.
I'm not a doctor and I know that so have attended my smears, just something I've wondered about.

All that said, there is a reason almost all economically developed countries have switched over to HPV tests. Tha vast majority (most say 97-99%) of cervical cancers being HPV positive cancers is the major reason, from what they say. Less false results and unnecessary procedures is another. It is a pity that we are losing/have lost the skillset of the cytological examiners of the old pap smears in the process.

lol At this point I’m not sure you are agreeing w/me, disagreeing w/me, or something else 😁

For sure though you have a point about the skill loss. What is even a bit more worrying is the at home version for this (HPV) and colorectal cancer screening. Obviously there are some pluses to at home screenings but also some minuses.

I’m not sure what you mean by this.

Those of us who perform cervical screening (and I have been doing it for 26 years) carry out primary HPV screening in the same way we used to take the traditional smear - it’s just now we use a cervex brush and liquid cytology, rather than a wooden spatula and glass slide with fixative.

We still identify and sample the transformation zone of the cervix, which is where cellular changes take place. We still remove cells, which may or may not contain HR-HPV. This has the benefit of visualisation of the cervix, sampling of the correct area and the ability for the lab to review the cervical cytology if the woman’s sample contains HR-HPV.

It’s still a skilled procedure which admittedly will be lacking some benefits when we move over to home HPV testing. Hopefully an increase in self testing and better uptake will negate any downsides.

I'm talking about at the pathology labs. My friend who is a pathologist mentioned this.

Condoms reduce the risk of HPV but they don't cover the entire genital skin. My understanding is with how common HPV you can only really assume a low risk of encountering it if you or your partner have never had any sort of sexual contact or touching etc with anyone but eachother, ever.

@velvetgeranium ohhhh that makes more sense. Apologies.