HPV and smear test

[Ggina55]

Looking for some advice. I am wondering if anyone knows if you have an HPV Test do you still need to have a smear test? I’m not sure I understand why you would need both as I was under the impression that the smear test checks for abnormal cells and then if they are abnormal will check for HPV, therefore if you have a clear HPV test why would you need a smear test too ?

HPV is not the only cause of cervical cancer

But is the main cause?

All I keep reading is that cervical cancer is from changes caused by HPV

I went for a smear test a few months ago and got a letter back saying they tested the swab fot hpv first and because I don't have it they didn't look for abnormal cells. Apparently this is something they are rolling out on the NHS now. I always thought you could still get cervical cancer anyway

That’s strange I had an HPV test which came back clear and they said I should still have a normal smear test as well even though it’s clear. Confused as to why I would need a smear of HPV was clear anyway...

That is weird. I am south east, so probably a regional thing. I am also not sure if I need to keep going for smears now if I am with the same partner and don't have hpv. What would be the point?

The point is that hpv is not the only cause of cervical cancer. Its the main cause.

As i understand it, if abormal cells are found they test for hpv and if positive they act more quickly than just a repeat smear.

If screening such as this is available why would you not have it? Yes its uncomfortable and undignified but it can save your life.

That’s what I wonder if HPV free then why would you need to maybe it is a regional thing then

Its to check for abnormal cells not picked up by the HPV test, because as PP said, HPV isn’t the only cause.

My Mum didn’t have HPV but did have cervical cancer, picked up by a smear.

There’s a programme being rolled out called primary hpv testing. Samples are tested for hpv first and if that’s negative, the cells aren’t examined.

It seems counter intuitive but the evidence shows it’s better for picking up harmful changes.

It’s very strange that you’ve been invited for a smear if HPV was negative. That’s not part of the standard protocol.

In our area when you go for smear test they only test for HPV, if you don't have HPV then they don't test for abnormal cells - as a layperson this seems bizarre because I though HPV was only one cause of abnormal cells/cervical cancer.

Lem - I think you didn't read my post properly. I'm asking what is the point going to more smears if all they will do is look for hpv and when it's negative not look for abnormal cells.

Celery - fair point however i am in the south east also and am pretty sure they only test if abnormal cells present

Maybe where you are but definitely not what happened when I went about a month ago. I have always gone to every smear that has been offered but if it's just an hpv test for me from now on what is the point.

Hi OP
Was the HPV test done privately by any chance? If so, you are still entitled to your NHS test which (depending on your area) could be a cytology first test.

As an explanation for the other pondering about HPV testing. The majority of cervical cancer is high risk HPV related.
Primary HPV testing uses the same sample as the traditional smear test. It's tested for high risk HPV. If high risk HPV is not found then no further testing is done. That's because you are at low risk of developing cervical cancer in the next 3-5 years.
If high HPV is detected then a slide is made to check whether abnormal cells are present. You can be hrHPV positive and still have no abnormal cells. If abnormal cells are seen then you're referred to colposcopy. If no abnormal cells are seen then the follow up depends on your screening history.

smear in November and same letter as #celeryeater ...I'm in NW England. can't say overly impressed by that NHS change in practice as I'd been having break through bleeding so wanted reassurance of cells being looked at .... seems a waste of time going for smear really if you aren't going to look at it....

This is really interesting and helpful information I didn’t know that things were different depending on the area you’re from.

OP - was your HPV test done privately?

@happytoday73 - a smear test is not an appropriate investigation for breakthrough bleeding. The GP would usually consider gynae investigation.
There's information on Jo's trust about the difference between "smear" tests and primary HPV testing www.jostrust.org.uk/about-cervical-cancer/cervical-screening/what-happens-after-cervical-screening

Some areas have already implemented primary HPV either as part of the pilot rollout or to help cope with not having enough screening staff.
As around 80% of samples test hrHPV negative, the results can be sent out quicker because they don't need staff to look at the cells.
They are making the change because of HPV vaccination which will reduce the number of abnormal cells (good) but makes screening (looking at cells) harder as it means you're looking for a smaller number of needles in the haystack.