Implications of the new smear test that checks for HPV

[softmachine]

Has anyone had a smear test recently? I went for one a few weeks ago and they've changed the way they test. The actual test is still the same, but in the lab they check your sample for HPV first. If negative they don't run any more checks and just send you a letter saying HPV negative.

Apparently I'm HPV negative which is good, but I'm just wondering about the implications of this test.

For instance if I never sleep with another person do I never need to go for another smear test (because no chance of catching HPV)?

Or if i only sleep with DH, but at the next smear I'm HPV positive does this mean he has cheated on me since my last smear?

This is all hypothetical of course, I'm just curious of the implications of this way of testing...

Where I am I think they check the sample, and only if there is something abnormal do they go onto the HPV test. If that's negative and the changes were only very minor they put you back into the 3/5 year cycle, if it's positive, or the changes were more major, they call you back for more tests.

I understand that the approach is different in England to that in Scotland.

Some cervical cancer occurs where there is no HPV infection. It’s just that HPV causes, by far, most incidences of cervical ca. I’m not sure about your other question. As with most tests there is probably a false pos/false neg incidence but l don’t know enough to be clear.

It's the other way round where I am disahster ' they only check the sample if you're HPV positive. So if you are HPV negative and continue to stay HPV neg they will NEVER check your sample. Which means it's pointless to go for another smear if you remain sexually inactive.

This explains it here

The changes in the screening are a disaster waiting to happen. The screening programme in the UK has been VERY successful in reducing the number of cervical cancer cases and deaths from cervical cancer. At the moment smear test samples are checked under a microscope for abnormal cells and if abnormal cells are found the patient is either invited back for another smear test in 6-12 months or referred to colposcopy for further investigation and potential treatment.

Several areas have been piloting a HPV test, so that for any women who is found to have abnormal cells in her smear sample, her smear sample is further tested for high risk HPV infection. If no high risk HPV infection is found, it is assumed she is very low risk for cervical cancer and returned back to the routine programme to be called again in 3-5 years for her next smear test. If the sample is positive for high risk HPV infection, she is referred to colposcopy for further investigation and treatment.

The way they do smears in England is changing from 2019/20. The HPV test will become the primary screening tool and cytology (looking under a microscope for abnormal cells) will only be done on samples which have tested positive for high risk HPV infection.

This is concerning because:

1. there are some cervical cancers, albeit a small number) which are not associated with HPV infection. These women are left vulnerable, as their pre-cancer changes will NOT be picked up in screening.
2. the HPV test is not comprehensive for all high risk types of HPV. There are at least 14 strains of HPV which have been associated with varying degrees, with cervical cancer and different strains of HPV are sometimes discovered or reclassified. The women who have pre-cancerous changes due to persistent infection with a strain of HPV not included in the new HPV test, will NOT be covered by the new method screening.

That women will fall through the cracks is very concerning.

timeforaction.org.uk/campaign-news/open-letter-complaint-bbc-hpv-vaccination-screening/

They have piloted this new method in multiple countries and have found it reduces overall the cases of cervical cancer.

This is because a substantial proportion of women who have normal cytology will have HPV that might cause cervical lesions in the future (I think around 10%).

Currently around ~30% of women who have cervical cancer have a history of clear cytology.

However it is also true to say that a small proportion of women who currently are found to have lesions through the existing protocol may lose out in the future.

The point is that the number of those who will benefit through having more pre-cancerous lesions detected is greater than those that will be missed through not testing for HPV.

I recently had a smear under the new system (checking for HVP only). I had instantly the same worries as canon but did some googling into research and it appears that overall, this new system is better than cytology and reduces the number of CC cases.

I thought it was bad enough they refuse to smear test under 25s is it? I was refused one in my early 20s when they were trying to diagnose the cause of my uterine problems on the grounds my GP would get told off! I thought the whole point of screening for things was to save lives not to cut as many corners as possible...

thought the whole point of screening for things was to save lives not to cut as many corners as possible...

have you actually read anything about it? if you read research comparing cytology Vs hvp testing, it seems that the latter one is actually the better test. But this is what I read. If you have any scientific insight, could you share it?
I do worry the hvp testing is not as good but Google says otherwise .