Do I really need a smear?

[humblesims]

Its that time again. The letter has come to make an appointment. I have always been responsible and had the smear test even though I hate it like everyone does.
But I'm fifty two. I dont want to go anymore. I'm menopausal. I have piles. My fanjo is not as neat as it was (I know that counts for nothing).
When does the risk of cervical cancer reduce? Will I still have to have smears when I'm in my dotage?

I know I'll go but...I'm tempted not to.

Kat, interesting, I don't have smears and I think I will opt out of breast screening when the time comes

my mum went once and said never again

aren't certain types of cancer actually caused by radiation? I really wanted a final x ray after a spinal injury but was told no because I felt okay and they didn't want to expose me to the radiation. So the breast screening thing just makes no sense.

My boss recently had weeks of stress over something they spotted in the breast cancer screening and it turned out to be nothing.

a lot depends on how you'd respond - I'd rather find out later than sooner myself, so only worth doing if you are a person who would have all the treatments etc.

My mum went twice for breast screening (just to make sure she didn't like it ) and after the second said never again.

Then she died early of something else, so she was probably right.

Terrylene and thinthistime I so agree. What winds me up is women are trained to fear cervical cancer and the NHS moan about falling uptake but won't bring out the self test kit the Dutch and Finnish women can access! No we're told to grow up and suck it up and are bombarded with letters and phone calls about it! I refuses mammograms precisely because I don't get the logic of crushing delicate tissue and bombard it with cancer causing radiation especially as their own leaflet says for every woman helped by treatment 3 others might end up having treatment they don't need. This treatment isn't a few antibiotics and painkillers either is it??
A friend of mine accepted her "invitation" to flexi Sig last year. Nothing bad detected but somehow the tube damaged her bowel. She was left in considerable pain with explosive diarrhea and had to wear a pad for months because she leaked. The hospital then decided to do a Colonoscopy and she was terrified... Complications can include severe bleeding and even death! she's a bubbly outgoing woman but she turned down a chance at an old schools reunion she attends every year because of the state she was in. It took months to calm down. And quite why anyone with no symptoms would think it a good idea to be anally pumped full of gas and have a camera inserted is another thing I don't get the logic of....

But as I said before its for every person to look at screening and make the best decision for THEM!

I thought the smears were supposed to get better when they changed from the wooden spatula to the brush, but for me they aren't and I have bleeding every time now. With the smears, the 0.65% is only an average. They have much more idea of how it is caused yet stick to an average one size fits all (and that is not just the speculum) method of screening. My DdepartedMIL stayed faithfully married to her equally faithful DH her entire life and the nearest she or he ever got to a bit of premarital nookie was dancing a waltz with a person of the opposite sex at the church social, yet she would go to every smear. Her risk was somewhere below zilch. Therefore there must be plenty others of her generation whose risk was way above to make the 0.65% who never go.......... The new system will probably thin out the women who do not need extensive testing, but if they do not make the test less unpleasant, they will not get the ones who need it, but never made it in the first place.

Terrylene I read the statistic of 30 million women in the UK. Around 900 die every year of cervical cancer which I agree is tragic but cervical cancer isn't the big baddie we're led to believe it is in my opinion. More women die of heart disease and stroke and even breast cancer than cervical cancer. I officially opted out of smears 2 years ago after refusing for 15. I am still hassled about it at doctor visits even though I never presented with gynaecological issues. Nobody has ever mentioned the fact I opted out of breast screening though!

Is there any decent research on the risk of developing cervical cancer to women who have previous abnormalities and treatment?

When you look at the figures for cervical cancer, and the tiny change since screening, it is extraordinary that women are so pressured to have the test.

I get told to go for my breast screening, but I am on hrt (it is not the big risk people think - drinking the weekly 'allowance' of alcohol is bigger). It is not as if I have ever missed any and I am sure I have had more than anyone else

I had a friend die of cervical cancer. If people know how the thing works, they can make their own decisions. Some people are more at risk and they need to understand without being frightened into it. I think they have tucked the information about cervical cancer under the rug in an attempt to get the numbers of takers up. Some people are more at risk and they need to understand without being frightened into it. My friend was all too aware of cancer risks and was more than up to date on her screening, but sadly that was not enough. She did get an extra 5 years though.

The reality is that there are lots of other things to die of that we do not particularly prioritise - things I have come across are: other cancers, gallstones, liver failure from dieting, Sudden Adult Death Syndrome, appendicitis. Keeping generally healthy and getting help from a doctor when something is up is also useful. Crossing the road is not very good for you though

Slimthistime not really surprising we are pressured to take the test. Doctors get paid incentives to persuade80% of us to be smeared..big pharma makes serious money out of supplying the speculum and brushes...people get paid to read the smears. Indeed over on the PHE blog about cervical screening there are posts from worried screeners about how the move to HPV testing will affect their jobs! Heaven forbid that e move might help women! We can throw steel workers and BHS workers onto the scrap heap in this could try but worry about people who work in an industry that in my opinion seriously harms women!

Kat, thanks for explaining that, I was wondering how the money chain worked. I didn't realise speculum and brushes was part of that though I feel stupid for not having thought of it.

I know in the US they have a thing about annual colonoscopy for men over 45 I think? Ridiculous and unnecessary.

Slimthistime that's what makes me so angry.. Women are deliberately kept in the dark about this process! We're just expected to roll up to our smear and spread our legs! If we ask questions or don't feel comfortable with the test we are told to grow up! Yes I heard about the annual colonoscopy in the US and until recently an annual gynaecological visit was recommended for women including smear test bimanual exam(doc puts 2 fingers in you and presses your belly) sometimes a rectal exam and sometimes a breast exam!!

I'm not sure about UK figures but in Australia where until recently women were smeared every 2 years from about 20 to 70a staggering 77% had had at least one colposcopy and other treatment when no way were they all ever going to get cancer and in this country 200,000 smears come back abnormal and obviously they don't all have cancer either

Kat "Women are deliberately kept in the dark about this process"

in fairness, the speculum thing was just me being dense but I agree that the NHS generally is incredibly pushy about it and also seems to be denial about any risks. I virtually had a row with a GP about it once and it really shocked me how angry she was.

I think part of it might be childbirth linked - I am childfree but I get the impression some medics think woman = womb = will go through tons of unpleasantness anyway, which of course is not true for the childfree.

Slimthistime exactly! Cervical. Screening is a choice. The new invitation letters state that clearly but we are still expected to submit. It doesn't surprise me your doctor got mad. Though its appalling she treated you that way. The internet is full of posts from women who have had similar experiences. Some have been denied asthma meds or even told they won't be seen for anything until they submit to a smear. At one time there was nowhere women could go to get info until the internet took off and for the first time this appalling practice got more attention. I think the powers that be are getting very worried that word is getting out and more and more women are leaving the program. If you want to test for HPV you can order an on line kit and test at home. Word is slowly getting out that self test kits exist and more women are going to be demanding them

The view of my consultant gynae who is brilliant is that screening is useful for the individual even if it doesn't translate into a huge difference in numbers of cases found over the population.

I don't find smears a big deal. I've always had them every couple of years , paid for them, as because of my age the NHS does them only 5 years. I've seen friends with CN3 after a couple of years and if it not been found they may have been in trouble.

The point of screening is you can decide what to do if anything is found. It's not an automatic conveyer belt of treatment. I have private treatment and know that at any time i can stop and think about what I'd want next.

I also had the HPV test at my last smear test. These are not expensive and tbh I'd rather pay for it and forgo a pair of shoes inf that was the choice.

When you look at the figures for cervical cancer, and the tiny change since screening, it is extraordinary that women are so pressured to have the test.

I'm not sure what the point of this statement is.

There will always be a percentage of women who never have screening. So the actual numbers of deaths may never change, but what may change is the number of women with an early diagnosis which prevents deaths or massive life changing surgery.

slim the amount of radiation used for breast screening is minute. They also take digital photographs now.

I suggest you reconsider. I know of several women who had tiny tumours found on mammograms. If anything is found, that is the time to decide what you want.

I have opted out of NHS screening because I have private care. I am totally in control of when I choose to be screened and go with what my gynae suggests- he has no vested interest for percentages.

Kat do you understand why?
Leaflet says for every woman helped by treatment 3 others might end up having treatment they don't need.

This is DCIS. There is a 50-50 chance it will become cancerous. Most women opt for treatment just in case, but it's not mandatory.

The 'other treatment' may be no more than a needle biopsy.

I do think that if you refuse treatment you need to explore these things in more depth. The radiation and squashing does not cause cancer.

Polly "So the actual numbers of deaths may never change, but what may change is the number of women with an early diagnosis which prevents deaths or massive life changing surgery."

no, that was the number I meant. I'm trying to find it, sorry.

it is difficult because how would we know how many deaths were prevented, especially when the figures include those who were treated for abnormalities that might resolve themselves?

I've nothing against women having smear tests. I think there's a strange culture around it though - being tested regularly for something so obscure. I have to be tested for weight and blood pressure and so on because of being on the Pill but there are many women who won't need to see a GP at all for anything, and, like my sister, the only thing that she gets letters about is screening. They don't see to have any concerns about the rampant heart disease problem in our family.

I'm not suggesting they send out letters for those too - it's just interesting that they are not focusing on other things.

Polly "I do think that if you refuse treatment you need to explore these things in more depth."

I think a lot of us have considered these things in more depth, thank you.

I have a relative in another country - no NHS - who is currently battling her family's wishes as she has been diagnosed with cancer and refused treatment. She is having an easier time than you would get here because she'll have to pay a fortune for treatment, but really some of us can say hand on heart, no treatment. Painkillers and palliative care - sure. Nothing else for some of us.

well, you only said you wouldn't have a mammo because your mum had one and said never again. I assume it was a mammo and not a smear.
And it's recognised that the amount of radiation in a mammo is not harmful- you are likely getting more from looking at your pc screen or TV!

I couldn't agree more about the lack of preventative measures for other diseases, but on the whole, heart disease is a lifestyle disease unless there are hereditary physiological issues.

You are not really being 'tested' for weight and BP on the Pill; that's monitoring just to check all is okay. Screening and monitoring are very different.

Polly, sorry I didnt mean to suggest that was my reason, I was just saying.

my main reason is I'd rather find out later than sooner or ideally not at all. I realise that the last is a long shot but it's happened to a couple of people I've known and their deaths have ranged between the same evening and about two weeks later - which is far preferable to treatment and suffering but that's just me.

Surprised that no-one has mentioned the elephant in the room, that you need to have HPV to get cervical cancer, so if you don't have this virus you can't get this cancer.

Why do you think the rest of the world is switching to testing for HPV as the first option?

You can test yourself at home by ordering a kit online, and if your result is negative, you could safely decline the smear, as you're just not going to get this cancer.

It's not right that GP's are putting so much pressure on women to continue testing, but if you're going to get a £2700 cash bonus for getting 80% to put up with this nonsense, why wouldn't you?

PollyPerky I absolutely respect your point about DCIS. As I said it's absolutely up to everyone what decisions they make about their health. I prefer to live my life un medicalised as far as possible. I would prefer not to have my cervix scraped my boob crushed and cameras inserted in my behind. I respect your decision if you do