Don’t understand smear testing

[Smearywindowsagain]

Can someone please explain how smear testing works?
I’ve always gone for regular smears. I actually started early and had my first at 21. Recently I’ve realised that they now only test for HPV and not cancerous cells. How does this work though? I thought that HPV was something that can come and go because it’s a virus. Isn’t it possible that you could have had HPV, it caused changes in cells but the virus itself clears and you’re left with the cell changes which aren't picked up because they only test for HPV. Am I being thick here?

@Invisimamma I had this too - I tested negative for HPV the following year so am back to the normal 3 yearly recall now

@Invisimamma i had that and I couldn’t go back the year after as I was pregnant. I went back about 18 months later instead and was clear

My gp reckons the smear test will eventually be replaced with a swab at home test and only positives for HPV will be called in for an actual smear.

Thank you for that info

@Techno56 that so makes sense

In other countries I'm sure it's a blood test for HPV or that there is someone developing this so they can reduce smears for diagnostics

God, I would really celebrate if that was the case. If I have has two smears since I last had sex yes, really does that mean I am highly unlikely to have it so can avoid the horror of another smear attempt?!

🙂 for once gov.uk contains useful information 🤣

I told my GP I wasn't going to go for smears any more.

I explained my sexual history, and she agreed.

Why should I go through a painful (and yes, for some of us it is painful) procedure, which only tests for HPV?

@mikado1 I have a friend who is a virgin (by choice- single) who is over 40. Her GP keeps sending her letters saying she should have a smear. She used to go, and found it very difficult and painful. When she realised that they only test for HPV she was very upset.
She called her surgery- they basically said 'well you're in your 40s, so we know you aren't a virgin. So you have to have smears. She said 'I've never had sex' and they laughed and said well that's what they all say'

The thing I don't really get with testing for HPV is that HPV also causes warts and veruccas.

I had warts on my hands as a child, DD has had veruccas so does that mean it lays dormant like the cold sore herpes virus, reactivating occasionally. Or can that version not cause cervical cancer?

That's very interesting, thank you. It is painful but so much so last time that after 3 attempts we had to stop 😔 nurse very nice but previous gp was more sure and definite and quick and just got it done. Anyway I'll talk more with gp.

Plus, we've been vaccinating girls against HPV for 10 years or more. So if vaccination rates keep high, the number of people with HPV will decrease as years go on.

Different HPV strains cause different things. The ones that can give you warts (genital or other skin warts) and verrucas are not the same type that can cause cervical cancer.

There are over 100 strains, I think there's about 4-5 main culprits for cervical cancer and those are the ones that children are now vaccinated against.

@mikado1 I live in hope 🤞🏻 you can bet if men had to get a similar procedure 🍆 every 3-5 years a less invasive test would've been developed and signed off quicker than fast ❤️

As someone who has endo, I get really frustrated with any pelvic exams and they always seem to have an entourage with them too 🙄

I had mine last week and queried this with the nurse. She said I should still come as HPV can stay dormant for many years and I felt rushed so didn’t tell her about my situation. I’ve only had one sexual partner who is now my husband and same for him. We’ve been married 24 years now. Unless this result comes back with hpv(doubtful) I can’t see the point in going back.

@mikado1 my experience is similar to that of @User129867588 in terms of sexual history.
I was seeing the GP about something else. She brought up the smears. I was very clear about my past, and she said she understood my point of view and was happy with it.

Good question. I queried this at my GP surgery and worryingly, no one had an answer.

I tested positive for hpv and cell changes. Saw the gynaecologist who said the cell changes were minor, so they would monitor the situation by giving me smears every year.

Next smear, tested negative for hpv, so they didn't even look at the cell changes to check if they were still there. As I no longer had hpv I was moved back onto the normal screening timings🤨

My question was - yes, so the hpv has cleared up now.but does that mean that the cell changes have been rectified? No one at my GP surgery could tell me!

@mikado1 I will bear that in mind. I don’t go to the drs very often but at moment I’m still on the 3 yearly testing so in 3 years time I will query it. Who knows what it will be like then lol

A few years ago I had tests due to spotting and they found ‘unusual cells’. They didn’t think they were worrying at that time but said they wanted to keep an eye on me via smears and noted that my next one was due the following year. Between that appointment and the smear they changed to the system of checking cells only if you test positive for hpv (I’m not in England, they brought it in earlier here). Which I tested negative for, so they wouldn’t check my cells despite me telling them about my history. I’ve been with the same partner for 24 years so am unlikely to ever test positive for it, and it’s very worrying that I won’t be checked, especially as I still get the spotting. It feels pointless going for smears now (for me).

That’s an absolute disgrace, worthy of a complaint. The GP is calling the patient a liar and trying to coerce her - she absolutely does not have to have one if she doesn’t want one.

I've been on annual smears for the last 6 years due to being HPV positive. No abnormal cells. Went for a second colposcopy earlier this month and got the all clear - yay! - and she said I could go back on 3 yearly testing.
I was delighted at the time but thinking about it more im slightly apprehensive that something could develop in the 3 year gap.

That's terrible! I was a virgin till I was 33 and I later had a friend who was a virgin till 40, so definitely possible!

It's very worrying that this is essentially a HPV test, not a Pap smear.

There are other risk factors for cervical cancer beside HPV - smoking, exposure to DES, HIV infection, corticosteroid use..

Am I right in thinking that the rarer types of cervical cancer that are not caused by HPV would not show up on a smear anyway? I find this subject interesting as unfortunately I have a pretty extreme phobia of smear tests. I have been prescribed diazepam to try and cope with it. My last smear without diazepam was terrible.

@BelaLug0si I am interested in your opinion on home HPV testing, I know I have read your posts on smear tests before and you are very knowledgeable. Is it a good substitute for a smear?