To not have my smears ever again?

[smearfears]

Just for context. Am 36, husband 37. We have been together since we were 17 & 18 and have only ever been together, only kissed eachother and no sexual contact or sex itself with anyone else either.

I was more than willing to go for my smear tests when they checked for abnormal cells. But now they only check for HPV I'm thinking it is pointless. My risk of having HPV is non existent seeing as it is passed on through sexual contact.

I've always found smear tests awful. Painful, difficult to get samples. I need double appointments and even then they can't always get the sample and I have to go back. I spend the time in the run up to the appointment feeling panicky and sick and then the rest of the day after the appointment with awful abdominal pain and nausea.

I see all these comments about "it's life saving, just get on with it" or "it doesn't hurt that much just crack on" but in my case, yes it really does hurt that much. And no, it doesn't seem to me that in my case it would save my life as it won't check my cells, just if I have HPV which I'm not going to have due to sexual history.

Does anyone have any insight into whether I'm ok to not go? Does anyone else not go?

Thank you

I actually know someone who has been with her husband 8 years, went to a smear recently and it showed abnormalities. She’s had it sorted now, but it was scary.

It’s something to work on on for other issues later in life. I have to explain many times why I find it difficult and have them go as slow S physically possible and count down. I agree it can be painful but you can sort it and honestly like some of the others have said, there are still so many some dying from this thsf we all need to do it.

Every woman thinks their partner hasn't cheated on them...until they do...and then it's too late...he's passed HPV on to you. You cannot 100% guarantee your partner hasn't been with anyone else.
At least do the at home HPV test to check you are negative if you don't want to go for a smear. I have recurring HPV (positive, then clear, then positive again etc) so it's possible even if you were negative years ago it can reactivate.

I think it must have been a mass invitation day (I got mine today)

Honest question - why? Because they picked it up with a previous partner? Because they were cheated on? Or can HPV be transmitted non sexually and then transferred to the genital area eg on dirty hands?

I have often wondered. The medical staff are certain it has been transmitted sexually at one point or another (it can be undetected for many years). But honestly I have sometimes wondered if there must not be some other way! Probably naive.

This change is a GOOD thing and based on scientific evidence and is not a cost cutting exercise.

The procedure has changed and now the ‘smear’ is instead predominantly a screening process for high risk HPV (human papilloma virus) in a hope to detect those people at risk of developing cervical cancer even before the cells might start changing. The old smear (cytology) could only detect abnormal cells once changes had already happened.

99.7% of cervical cancer is caused by HPV. Of course, this leaves a very small proportion where it is not and people are urged to seek advice if they experience any symptoms such as bleeding between periods or after sex or pelvic pain as per usual advice. After all, HPV testing and cytology are only screening tests for cervical cancer for those without symptoms and is not a diagnostic test. No screening test is 100% perfect but this really is pretty good!

So back to HPV - the new screening test assesses for the presence of high risk HPV types. As development of cervical cancer after contracting HPV usually takes 10 years and the presence of precancerous cells 5-10 years then having a negative HPV test means that it is totally fine to wait 5 years before the next test and may actually improve uptake amongst patients. If high risk HPV is found then you will have a repeat smear after only one year, even without the presence of cell changes, which is actually improved monitoring.

A U.K. pilot study showed that this new testing had a greater sensitivity for picking up both precancerous and cancerous cells than the old cytology testing alone.

Therefore, with this new change to screening AND the HPV vaccine in full swing we are really improving the fight against cervical cancer!

I hope this is helpful 😊

If you read the thread properly I'm not advocating people don't go.

I'm thinking I'm "probably" in the very small minority that have only ever had sexual contact with one person who has also only had sexual contact with one person and as a result the HPV risk is pretty non existent and that is all they check for initially at smears.

To have to go through something that, for me, is so invasive and traumatic, for them to essentially do a swab for something I'm unlikely to never ever test positive for is why I'm asking whether I should go.

Anyone who has had more than one sexual partner or been with a sexual partner who has then I absolutely see the logic in going

Yeah I just came home to an invite as well - I was HPV positive last year, been with my DH 25 years. But I didn't meet him until I was 25 and I had multiple partners before then, including one who gave me very visible HPV (and HSV2, sadly) when I was 18!

I'm assuming it's just been lurking all that time and has popped up because they've started testing for it. DH did give me side-eye though.

We have ours done yearly here. Just had mine and came back hpv positive.

I've been single and celibate for 8 years, so you cannot say with certainty that you won't test positive just due to your sexual history. It lays dormant and just flares up at times.

I don't understand either why you aren't being offered a full smear. But a hpv swab and a cervical smear scrape are two different things are they not? I haven't ever experienced pain, but then again a gynae does mine, so I'm sure that is a factor. So how are they taking the sample? (if it's hpv + is the same swab sent off or are you called back for the cervical smear)?

It's just an important test. I don't understand the nhs new system for this.

@SausageMonkey2
Massively helpful, thank you!

I'm so so sorry you had to go through this. It sounds horrific and cannot even begin to comprehend the trauma you experienced at such a young age x

Another who always advocates going for a smear. It how I realised I had vaginal atrophy.

I would always encourage someone to have a smear. It can save your life. I hate the fact they aren't annual for me anymore due to finding problems from my first one at 18.

Thank you for the explanation.

This is very useful thank you

For the sake of 5 mins every 3 years why wouldn't you go for something that may save your life one day.

HPV can be dormant, sometimes for decades.
If your DH has ever had even one teenage fumble and never mentioned it, there’s every chance you could still get cervical cancer one day. Is it really worth the risk?

I think there’s been some pretty poor public health messaging about this change which is leading to confusion and people thinking they don’t need smears. @SausageMonkey2 ’s post is a great explanation but the NHS needs to be making that really clear when they invite people for their smears so they don’t dismiss the need for one.

*And nobody seems to have an answer to "why are the only checking for cell changes if HPV positive?"

It can only be a money issue, and it seems that women are being badly let down here*

I was googling urine test alternatives and found the following info from a site which offers HPV urine tests for women who don't want to do SMEAR tests:

"A smear test is a medical examination of the cervix that primarily tests for a virus called Human Papillomavirus (HPV). It is a common, sexually transmitted virus responsible for up to 99% of cervical cancer cases worldwide."

So I guess the chances of having cervical cancer without HPV is extremely rare.

A missed smear test resulted in my SIL dying at 34. She left a 10 year old. Like you, in a committed relationship since a teen. I never understand why people miss screening. There was thread a few months ago and somebody was saying she would never take up a mammo invite. I've had breast cancer, why on Earth wouldn't you do this?

I understand and sympathise that it may be difficult to do but please try and do it. It's not worth the risk.

Last year I had a positive HPV and I've been in a relationship for 15 years. I'm as certain as anyone can be that he's not been unfaithful and I haven't. As others have said it can lay dormant for ages.

No one told me about this change before my last smear and I felt my consent had been taken under false pretences. I was extremely upset and angry, especially as it was a painful business that took 3 attempts and 2 people.

When my smear falls due I will get an HOV test that I can do at home. Exactly the same as the NHS do now but without the need for pain and unpleasantness. They were trialling these before Covid as an alternative to smears but it seems to have gone quiet. No idea why: surely take-up would be so much higher, and we are all used to twiddling swabs post-pandemic!

HPV

I had an abnormal smear and had to have bits removed and did not test positive for hpv so do not understand this at all.

If high risk HPV is found then you will have a repeat smear after only one year, even without the presence of cell changes, which is actually improved monitoring.

If high risk HPV is found, are your cells looked at after your next smear, even if by then you are testing negative for HPV?

I tested positive for HPV a few years ago (before this policy change), no abnormal cells. At my last smear I tested negative. Do I need to worry that the HPV caused abnormal cells before going away, that now won't be looked at because I'm testing negative? Is that a thing?

Nobody has to have any cancer screening, if they don't want to. It is down to personal choice. No judgement either way.