If you are under 25 and ask for a smear test, do they have to give you one or can they refuse?

[StudentMadwife]

anyone know?

[madamekoto]

I had my first smear at 20, Had only been sexually active for 6 months.

I was diagnosed with abnormal cells and had laser treatment. If they hadn't have caught it I would not be here now.

[StudentMadwife]

exactly, its flippen ridiculus and baltently about MONEY

[StudentMadwife]

if i ring gp tommorrow and they refuse Im going to phone the other surgery in town who run FPC and ask there, if they refuse can I pay to get smear and results privately?

[Sawyer64]

If you are diagnosed with "Abnormal Cells" this just means they are different to when last checked.It doesnt mean they are Cancerous.

Most cells that are lasered,are Pre-Cancerous Cells which means they may turn cancerous within 10-15 years.They also may not.

It is most definitely NOT to do with money,it is based on Research. Cervical Cancer is virtually non-existent under the age of 25 years.

There will always be exceptions,and that is why anyone who presents with Clinical problems such as bleeding between periods or after sex WOULD have a smear done.

Due to more frequent change of partners etc. under 25 yrs it is more likely you would have STI's,so would be advised to go to an STI Clinic,if the symptoms point that way.

Obviously,Ovarian and Uterine Cancers could strike before the age of 25 yrs,and could represent some of these cases.Sadly,the Smear test can't test for these.

[Sawyer64]

You can pay to have one Privately.

[Sawyer64]

All the surgeries in your area will be governed by the same National Guidelines.

They are obliged/directed to refuse otherwise the "system" gets clogged testing "low risk" patients unnecessarily,whilst patients that have abnormal Cells or worse,are having to wait up to 3 mths as it is for results.

"Unnecessary" Smears slow the system even more.

[StudentMadwife]

I definately dont have an sti/std

[StudentMadwife]

guess I'll just have to search for a private clinic near to me

[Sawyer64]

I know it seems like madness,but it is based on research,not a budget decision.

When abnormal cells are detected,patients are sent for Colposcopy,and if they proceed and treat,it can lead to problems with fertility,and sustaining a pregnancy later in life.

The cells are more likely to be abnormal when you have an "immature Cervix" ie. before the age of 25yrs.

To reduce the risk of unnecessary treatment,and to target the "higher risk" patients these changes have been made.

[CharleeInChains]

I have been refused about 4 times now, i am 21, i thought cod it and booked one anyway, i got to the apt and was turned away.

[Sawyer64]

The Practice nurse will have been on updates and be aware of the guidelines,even if receptionists arent.

I often have to phone patients up to cancel their appts,if I notice they are too young etc. or are at the wrong part of their cycle.

There is a place on the Smear form to put the Clinical problems that have lead to the smear being done,if pt. is too young or it is before 3 years are up etc.

[BellaNoir]

Bleeding can be caused by all sorts of things, national guidelines indicate that women under 40 should have further investigations - which doesn't necessarily mean a pap test as Sawyer rightly says. It's a screening test not a diagnostic test, many women under 25 may have chlamydia so Gu medicine is a useful place to rule out causes such as those.
The 'younger' cervix can be difficult to read the sample due to it being very active with the physiological and hormonal changes taking place. Abnormal cells are also very active, so if you have a sample with inflammation and very active cells, it can be jolly difficult to work out what's causing it, and it therefore risks over- treating women who haven't completed their families yet.

[Sawyer64]

Thanks BellaNoir.Much more "scientifically" explained.

[BellaNoir]

Studentmw, the statistics for England are in a statistic bulletin called kc61, published in Oct each year.
Screening programmes have to work by looking at the population at risk, there are probably 50 women over 80 years old diagnosed with cervical cancer each year but they aren't screened, the cut off is 65. Breast screening doesn't start until you're in your 50s because the younger breast tissue is difficult to interpret. It's the same sort of scenario with the cervix.

[StudentMadwife]

interesting info

Q. Are there different types of cervical cancer?

A. This is one of the few types of cancer where there are clear early stages which can be diagnosed and treated. The first stage is called CIN 1 and simply means that the cells on the cervix are slightly abnormal. This may have several causes and often clears up after a while. CIN 2 is not cancer, but the cells on the surface of the cervix show a number of cancer-like changes which can be seen under the microscope. The third stage, CIN 3, is close to cancer and is also known as 'carcinoma in situ'. If left untreated, CIN 3 has a 50% chance of developing into cancer.

Q. Who is at risk of cervical cancer?

A. Each year, over 40,000 women are found to have CIN 2 or CIN 3. Almost all of them are successfully treated. However, over 3,000 new cases of cervical cancer are diagnosed each year in the UK and 11,000 in the USA. Younger women are more likely to have CIN 3 than older women. The risk is low during the teens but is highest during the ages of 20 to 29, slowly decreasing thereafter.

taken from 2008 Association for International Cancer Research, Registered in Scotland

[BellaNoir]

I have seen abnormalities from the ovary and endometrium on Pap test but as Sawyer says it's not designed for that - I'd be a bit worried if a sample taker had managed to reach your ovary when sampling the cervix.

Cheers Sawyer

[StudentMadwife]

eh?

[BellaNoir]

CIN= cervical intraepithelial neoplasia, it is precancerous changes. Most, if not all cin1 will go away by itself.
It's the CIN3 which has more potential to possibly develop into cancer which is why it needs treating, howver, foray women that takes some time. This is why a screening programme is possible, it works best with diseases which have a long precancerous phase, with CIN, it's thought to be between 10-15 years, though it obviously does vary.

[StudentMadwife]

I see

[StudentMadwife]

so why do they screen every 3-5 yrs then, surely they can get away with screening women only once every say 8-10yrs? doesnt make a whole lot of sense and seems like for money reasons they upped it from 20 to 25

[kayzr]

I'd like to book one but I am only 22. I am expecting to be turned away despite having 2 DSes.

[PurpleOne]

I had one at 17 in 1990. As soon as I told the doc I was sexually active, I got smeared there and then.
The next smear at 20 owing to stomach pains wasd the problem. And they found cervical changes so had to have colposcopy.
If they smeared me at 25, good Lordy what would have happened. I feel lucky.

Ive been smeared every three years since they found that.

[PurpleOne]

Oh and they told me I had CIN 2...at 20.

[Missy23]

I have had abnormal bleeding in between periods and after sex for about 4 years now, I definately do not have an STI. I am 23 and my mum was having lazer treatment for cancerous cells at the age of 19! There is a history of cervical cancer in my family too. I have requested a smear several times only to be refused at my mothers disgust! Surely I should be entitled to a smear!

[SmallShips]

Missy you need to demand a smear or go private. I've heard of people under 25 being refused a smear, but not if they have abnormal bleeding.

What did your doc say to you when you went in with the bleeding?