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Have been called back for another smear test, should I be worried?

18 replies

Dragonfly74 · 04/06/2009 21:38

Hi, I had a routine smear test on the 25th march and had assumed all was well as I hadn't received any negative result,

Then yesterday a letter arrived stating that the lab had not been able to report a result and that I would need to have another test. I called my GP and have an appointment tomorrow but even though I keep thinking everything will be fine I am really quite worried. My mum had abnormal cells that were thankfully treated when she wasn't much older than me.

Please tell me i'm being silly, If there was anything wrong they wouldn't wait 9 weeks to tell me would they??

OP posts:
Ewe · 04/06/2009 21:40

Not been able to report a result normally means that either you had sex in the preceding 24 hours, too much mucous, wrong time in cycle etc.

Just means they haven't been able to look at the cells, not that they have looked and are concerned iyswim?

jkklpu · 04/06/2009 21:44

no need to be worried, as Ewe points out
can also mean they didn't get enough of a sample: happened to me a few weeks ago as it did the time before, but no negative implications at all

lisad123 · 04/06/2009 21:50

i wouldnt worry just means the lab havent been able to get a result. Normally not been done right, too much mucus, or just not right.

fishie · 04/06/2009 21:53

this has happened to me several times. tell them whenever you go, they can put extra effort into getting enough cells.

jkklpu · 04/06/2009 21:57

and tell them to use the longest speculum they have (they do honestly have different lengths and, if you're tall, it's likely they'll need a long one - I know I do)

Dragonfly74 · 04/06/2009 21:58

Thanks everyone, I feel better now.

Ewe - If you had sex in the proceding 24 hrs!! DH wishes. Lol.

OP posts:
BellaNoir · 04/06/2009 22:15

If the sample was reported as inadequate or unsatisfactory or technically unsuitable (the terminology varies) then it is usually due to one of the following:

  1. Not enough cells - we have minimum number of cells present in a sample to give a result. This happens more frequently in more mature ladies as their cervices are drier and so it is more difficult to scrape the cells off.
The cervex broom is supposed to be turned 5x 360^ in a clockwise rotation to ensure all the bristles splay out across the cervix and take off enough cells.
  1. No endocervical cells present after a glandular abnormality
  2. The cervical cells were covered by inflammatory related cells called neutrophils, this happens less nowwe use LBC
  3. the vial may have been received leaking
  4. An incompatible type of lubricant may have been used, this can block the filter the processor uses and stops the cervical cells from getting on to the slide for reading
  5. The sample taker may have had problems locating your cervix.
  6. Excess blood either from taking the sample or if taken during or soon after your period. Less of a problem with LBC as the process removes most of it

I've never seen a sample called inadequate due to the presence of sperm. There's not usually that many present to get in the way of reading the sample.
The sample taker/ nurse will have a copy of the result which tells them what the problem was to help to improve the next one.
We don't like reporting samples as inadequate but I'd rather ask someone to come back and have another one then send them away for 3 years after a sub-optimal sample.
Hope it goes ok this time OP, I'm afraid many labs had a massive influx of work due to Jade and are starting to catch up now which is why you had quite a wait for your test. Until it's examined under the microscope so it can be reported we don't know that it will need repeating.
Hth

Ewe · 04/06/2009 22:23

I was hoping you would be along to explain properly BellaNoir!

Interesting about the sperm, I was told that it is one of the most common reasons that smear tests are inadequate after having one myself hence why they say don't have sex 24hrs before. Thanks for dispelling that theory, GP obviously not totally clued up on the process.

BellaNoir · 04/06/2009 22:46

Well there might be a post-coital increase in mucus (I am just musing here mind) and if there's a lot of thick mucus it can cause problems, rather than the sperm/semen itself Sorry if TMI! If you tend to have PCB (post-coital bleeding) it would be best avoided taking one then too.
Mucus can 'gum up' the filter which means either the cells don't stick to it or it forms a thick clump on the slide. This can then be very difficult to see into properly, so you can't be certain as what all the cells are doing.
That makes it sound like they're moving about, they're not , I guess I tend think of them in that way though!

Dragonfly74 · 05/06/2009 19:41

Well I went for my test today and was told that I didn't need one as they don't re test you until 6 months after the original test
That can't be right surely??

I explained about the letter I had received and the nurse pretty much confirmed what you have all said, That a result wouldn't have been reported if there were not enough cells.

But if the test was inconclusive surely they would re test immediately, What if I do have abnormal cells which are now going to be ignored until september.

would it be unreasonable of me to demand a re test??

OP posts:
jkklpu · 05/06/2009 20:15

I've always been asked to re-test straight away - both 3 years ago and now, for the 2nd bloody time, after the one due this Spring, so have to go back AGAIN. As you say, it makes no sense to delay for 6 months, as long as you haven't had a baby recently.

Dragonfly74 · 05/06/2009 20:26

Hi jkklpu my youngest DC is 14 mths so I really can't understand why they won't re test.

I think i'm going to call my GP on monday. When I phoned to make the appointment I told the receptionist that I needed a re test due to no results being reported and she didn't mention that I would have to wait 6 mths.

Tbh I feel annoyed that i've wasted my time today.

OP posts:
Dragonfly74 · 05/06/2009 20:38

I would be interested in BellaNoirs opinion on this!!

OP posts:
BellaNoir · 05/06/2009 23:52

Ok I have 2 questions:

  1. Who did you get the result letter from and what exactly did it say?
  2. What result did the surgery say you had?
Did it actually say inconclusive? I think you need to talk to the GP to check what the result actually is. The suggested repeat times are 3 months (or can be less) for inadequate samples and 6 months for a minor or low grade abnormality; so you really need to find out what the result is.

You asked earlier about waiting for the result. When there's a backlog of tests, the samples are processed and made into slides to be read. The slides are then kept in order of when they are received to be read in turn. Until someone actually picks up the slide to examine it under the microscope we don't know what the result will be.
Sorry I can't be more specific but it really does have to be your GP/practice nurse who goes through your test results with you.

Dragonfly74 · 06/06/2009 14:08

Hi BellaNoir thanks for the reply.

The letter was on NHS headed paper so I assume it came from the lab!

It said "unfortunately we have been unable to report a result, This is not unusual but it will mean that you will need to have another test"

When I spoke to the nurse yesterday she said that no results have been returned to the practice. When she was looking at my notes she said she could see that I had had my test on the 25th march but there is no other information yet! I'm really confused.

So I think I will be speaking with my GP on monday.

OP posts:
BellaNoir · 06/06/2009 17:21

There are a few variations on who sends result letters and when, this is how we do it where I work to give you an idea.

E.g.
Monday: I report a test.
It goes electronically overnight to the health authority/PCT computer, to the screening office.
Tuesday:
The screening office staff (aka call/recall) process the results onto their system and if everything matches, a result letter to the patient is generated and sent out (either business post or hopefully soon 1st class)
Meanwhile in the lab, reports are printed out and sent out to the GPs, some of whom also have electronic links (but not all)
Wednesday/Thursday/Friday - depending on transport/courier/hospital post/royal mail both you and the surgery may have the result letter or the lab report.

When the paper copies are received into the surgery it's generally one person who deals with them. Any straightforward negatives are usually out onto the computer but any report which has anything else on it would go to either the practice nurse, person who deals with cervical screening or quite often to your GP to see and check the management. Your result may be either on it's way to the practice (sometimes they only have deliveries a couple of times a week from the hospital transport) or waiting to be put onto the computer.
This difference in how the reports vs the result letters are sent out is why you have got the result of your test before the practice has.

The screening office is where the invite letters are sent out from, it will usually say 'on behalf of dragonfly's doctors name'.

In some places, individual practices choose to send out invite/smear appointments letters either as well as or instead of the screening office (PCT/HA) letters. They may also choose to send result letters to patients, as well as/instead of.
It does vary which is why it's tricky for me to say for certain who sent you the letter! Under the NHS logo it might say screening services, PCT, call/recall, which would be the centralised office for your area.
It's quite rare for the lab to do the patient letters because of the additional work involved, particularly keeping the patient database up-to-date.
The nhs cervical screening website has more info about results and what they mean. It also has a section with publications and guidance for how the screening programme is run. There is a publication devoted to communication with women about screening, which is quite interesting.

I think it is best for you to speak to the GP, as me trying to work out what the result letter means is guesswork without seeing it, which isn't a good idea for you or me!
However, if it is an inadequate test (rather a abnormal result) then usually we suggest a repeat in 3 months, which as you had your test in late March, would mean you are about due to have one.

Hope you get an explanation!

Dragonfly74 · 06/06/2009 17:52

Thankyou BellaNoir Hopefully I will get some answers on Monday.

OP posts:
Stusy · 21/02/2013 12:05

Hey guys I know this old but I have just been reading it today. I have received a letter saying that the sample was unsuitable and that I need to re take the rest but I have to wait 3 months now. The letter was sent byh go surgery but I actually did the test at the family planning centre so now I'm a bit confused as why my gp will be the ones sending me the letter.

@bellanoir is this something usual??

Thanks in advance for the reply

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