New Smear Tests

[Magenta82]

I'm wondering if anyone can help me understand the way the new way they test smear tests works. It's my understanding that they now test for HPV and only check for abnormal cells if you are positive.

I'm to old to have been vaccinated and caught HPV in my 20s. It cleared up and hasn't reoccurred since.

A few years back I had a colposcopy due to some abnormal bleeding. Some changes were noticed but the biopsy came back fine.

So if they now don't check for abnormal cells, only for a positive case of HPV how can that pick up changes that came about because of a previous case of HPV that has now cleared up?

I hate smear tests, I have huge anxiety about them, they are painful and I usually end up bleeding and in pain for several days after. I have to really force myself to go, but I'm finding it really hard to do that now that I know they do t check them all for changes. Understanding how it works might help me build up the courage.

I thought I’d read that a new “smear” test was available that just involves a wee sample 🤷‍♀️

I've not heard that, it would be a massive improvement! But I'm guessing there isn't much chance I'll get one any time soon.

My understanding of the new smear tests is that the reason why they only check for an active HPV infection is because that is the primary driver behind the vast, vast majority of cell changes. Nobody truly clears a HPV infection once they've contracted it, your immune system fights it into dormancy however should your immune system become compromised (for whatever reason, could be from something as minor as getting a cold), there's a chance that old HPV infection could wake up from dormancy and reactivate itself. Sometimes it is when this old HPV infection wakes up that the cell changes happen. If the HPV infection then goes back into dormancy, the cell changes stop however there's a caveat - if the cell changes have reached a more developed point, they could continue changing without HPV. In this latter situation, it is thought that the rate at which most people experience these particular cell changes is quite slow so, provided you attend your smears timely, then the HPV infection that originally drove the changes should have been picked up at a smear, at which point they'll have you in the system with more regular smears to monitor the progress of the new / reactivated infection and intervene swiftly if necessary. Bit of a long winded answer - hope it's helped. For what it's worth, I absolutely hate smears, find them painful and get myself so wound up over them but I reason that the appointment is usually quite short and I'd rather know if something was wrong and get it sorted ASAP, even if the treatment isn't exactly relaxing on a beach in the Med (which is where I'd much rather be most days tbf).

I'd also like to add that whilst an active HPV infection is the driver behind most cell changes, there are still individuals where the cell changes have been caused by other things which is why you should always get anything unusual for you down there checked out.