Smear results neg but endocervical cells absent...wwyd?

[paisleyII]

stressed out, got smear results which initially i was really relieved about as i have had two cervical ops since i was early twenties (i am now nearly 47) and have ever since had a smear a year. last op (of the two) was about 3 years ago. my initial relief that this years smear was neg was short lived when i looked further at the lab report that said endocervical cells absent. having gone on the internet (as you do) it seems to spout that you need to get it done again if you have history. i called this morning the private place where i had it done in london and the nurse who called me back said that the lab was REALLY thorough and that they were happy with what they saw and that it was fine but the net seems to think they hadn't seen the cells right inside because they must have been hard to find. come to think of it the dr as nice as she was who took the smear was probably the WORST smear i have ever had, she was fiddling for ages and it really hurt and the blood test she did too was pretty awful, blood falling down my arm, not exactly a nurse like gentle hand. i have called them again (they will think i am this neurotic) and a nurse (different one will call me back) - question - do you think i should accept the labs report which summarises with it saying my result is 'negative' and be satisfied with that and have a repeat smear next september.....thanks

Ok so I need to try and get the facts of this straight.

1. you've had previous treatment for a pre-cancerous changes, the second about 3 years
2. You're on yearly repeats.

Q1: what did the treatment 3 years ago show?
Q2: are you on annuals with the NHS - it sounds like this one was done privately?

The NHS screening guidelines say that NHS labs don't have to report the presence of endocervical cells. Many do as it can help the sample taker to get an idea of how their sampling technique is doing. You don't need to have these cells seen in your sample unless you had treatment for an endocervical cell abnormality. That the (?private) lab has said for an annual repeat suggests it wasn't for an endocervical abn and it should be ok.

HTH

hi bela thanks for response. from memory both loop/letz or lazer treatments i think i had CIN1/mild pre cancerous cells. i pay and go privately every year as nhs says i only need (i think) every 3 which i don't agree with (nor do drs i have spoken to. you sound as if you are a medical person? i'm not so have no real idea of what i am talking about, only guessing, but i have no idea if my two previous abnormalities had anything to do with the actual endocervical area (this is the deeper area is it not in the cervical canal?), i am guessing that my dodgy previous cells may have been on the surface which i am guessing was successfully checked in my latest smear? my understanding in that old bags such as myself (nearly 47) our bodies change and it can be harder to find these cells as they may be more inclined to move deeper into the cervical canal..... question - if my two previous abnormal treatments were both for CIN1 does that mean that it was not a endocervical thing? is that more CIN2/CIN3? is this what you mean? thanks alot, sorry to waffle, i have my AF and am somewhat pm'd :)

I post in a personal capacity, my knowledge is because I work as a scientist in a screening lab.

CIN1/mild often goes away by itself without treatment, so it needs less follow up pap tests than CIN2 or CIN3.
An endocervical abnormality is called CGIN which your GP/clinicians should be aware of it you'd had it.

The presence of endocervical cells hasn't been mandatory since 2000 (IIRC) unless you've had CGIN.
So, under NHS guidelines the test sounds like it would have also been reported as adequate. If you're concerned about what is the correct follow up for you (based on your recent treatment) then you need to find out what the histology (i.e what CIN) it was.

hi again, your responses have been much appreciated and helpful. looking at the letter from the gyni who performed the last opp in 2008 it just says CIN 1 with active chronic inflammation but no mention of CGIN. i will ask the nurse from the clinic when she calls me but i am hoping that i will just accept the result/not have a repeat smear and just have another smear in september next year which is what i always do, thank you

ps: just noticed that it also said (at the beginning) 'that it showed prominent HPV induced changes & CIN 1' (if that makes any difference to what i said above?)

Basically the same thing really.
Here's the quote from the relevant NHS publication:
"SUMMARY OF CHANGES TO
SECOND EDITION
? Endocervical cells are not essential for an adequate smear, except where the previous abnormality was seen in endocervical cells." from here page iii

bek - you're lovely, thanks so much for your help :)

i meant bel !