Change to Cervical Screening

[Idontpostmuch]

AIBU to think it's a bad idea for cervical screening tests to only test those who are HPV pos?

Before anyone points out this has been done to death I'm well aware of this, but if I posted on an existing thread, some bright spark would peremptorily ask if there was any reason I was posting on an old thread. Basically, you can't win.

Anyway, a year ago I tested pos for HPV. Not enough cells to test for abnormal cells, so I had to wait for 3 months before I could be tested. Three months later still pos, but no abnormal cells, so another test in 12 months. Relieved, but my next test now 2 months away and getting anxious again. A lot of women could be saved a lot of worry if they simply went straight to testing for abnormal cells. Does anyone else feel the same way about this?

I'm not sure I understand what you're grumbling about. You've been tested for abnormal cells. The only reason they didn't test for it first time round was an inadequate sample wasn't it?

Four of you have voted. Two of you understand what I'm grumbling about. Two don't.

Your post isn’t that clear and it’s starts with a combative approach.

I don’t think there’s much point in cervical smears only testing for HPV on women who’ve had the HPV vaccine but from
the OP I don’t really understand what your problem with it all is.

I understand the general argument for testing all samples for abnormal cells but I don't understand why you in particular are calling for it. It wouldn't make any difference to your current situation. Your sample was checked for abnormal cells. Apologies if I'm misunderstanding you.

The HPV vaccine only covers some strains of HPV, so while it's contributing to a big reduction in cervical cancer, it's not foolproof.

If you compare the overall outcomes, HPV testing picks up more cervical cancer cases than cytology (looking for abnormal cells), largely because of the element of human error in cytology. We've had a serious issue with that in Northern Ireland in the last few years. Both systems mean that some cases will be missed, unfortunately no screening system is perfect.

The HPV test IS a cervical screening test. High risk types of HPV are the primary cause of cell changes leading to potential cervical cancer, hence why this is now the initial test rather than sending all samples straight for cytology (looking at the cells). Cytology takes longer and may introduce human error as unlike the HPV test, it can’t be automated. Self-sampling is going to be the next big change in the UK cervical screening programmes but is an at-home HPV test rather than a smear test, so if we didn’t have HPV testing, we’d have no option to support women who are uncomfortable with the idea of a smear test to ever be screened.

I went over the top with anxiety for 3 months until I could be tested. I was only anxious because I knew I had HPV, and I needn't have worried because all was well. It's been at the back of my mind for a year and I'm becoming more worried again.Under the old system I wouldn't have known I had it. Five yrs later any abnormal cells would have been treated and I wouldn't have had the stress caused by HPV.

So do you think they should only do the cytology? Not check HPV status at all?

Well, I can see the benefit of HPV testing but I just wondered if it was worth it, given the effect on mental health. Looking at the votes so far, some women have been in my position, with the majority thinking I'm being fairly pathetic.

I doubt anyone thinks you're being pathetic. Your anxiety is understandable. But remember that cytology testing also causes anxiety for some. Many women diagnosed with CIN 1 will worry unnecessarily since it often resolves without any treatment.

I don't think any testing protocol is perfect.

I don't think you're pathetic. That's very loaded. I assume that the current approach is evidence based. It's not a verdict on you at all. Disagreeing with someone doesn't mean you think anything about them. It's a neutral act.

Before the sensitive HPV test was developed, screenings threw up a lot of false positives and missed quite a few cases. Without looking this up, I think they just got rid of any tricky-looking cells just in case - so many women were, effectively, being treated for a cancer they didn't have. I know this caused huge anxiety, as it happened to two of my flatmates!

Any woman getting a negative for HPV is now (almost) guaranteed to be clear of cervical cancer for ten years. Since the smear test is a clunky tool by comparison, it never came with a 'guarantee' so this is way better for all these women.

It's horrible to know you're at risk of a disease. I sympathise. Your anxiety's very understandable ...and serves no purpose. You're being monitored, just as all of us with any elevated disease risk are. You're okay and you will be okay

I don't think testing for HPV has ever been restricted to those who have been vaccinated. I must be missing the point of this post.

Thank you for being so much more empathetic than others on this thread.

I hadn't realised some women turned down their smear tests because they were uncomfortable with the idea. I knew there wasn't 100% take up, but not everyone takes other screening tests. HPV testing will benefit these women, but leaves the minority (between 1 and 10%) of woman whose cancer is not caused by HPV without any screening and therefore without any detection of pre cancerous cells.

I had stage 1b cervical cancer so when I learned future screenings would only be based on being HPV positive, I was VERY anxious, worrying I would be the 0.00001% who didn't have HPV but would develop cancer again! I spoke to a health professional about my concerns and was suitably reassured approach is fine.

It's too expensive for how effective it is. Cell changes are also common, especially in younger women, and don't indicate a cancer risk, so it leads to unnecessary, expensive and stressful intervention.