Smear tests only being sent off if HPV is detected.

[Motheroffive999]

Is it correct that smear tests are disposed of rather than being sent away unless the HPV virus is detected?
If so do you think smear tests should be done differently ?
What's your view?
Thank you in advance.

Most cervical cancer is directly linked to two strains of hpv virus so it's fairly safe bet if there's no hpv the cells are ok. There's lots of research on hpv virus coming out over the last few years 😁

However I didn't know if they just dispose of them but they're not further tested 😁

This has been the case for a few years now, my area was a pilot when it started. Studies have shown it gives better outcomes.

Cervical screening tests are sent to the screening lab.
The sample is tested for high risk HPV. If high risk HPV is detected, then the sample is further processed to place cells on a slide.
These cells are then read by cytologists under a microscope. The cytology and HPV results form a composite report. Depending on the composite report and patient history then the management will be 12 month recall, 36 month recall or colposcopy referral.
If high risk HPV is not detected, then the recall will be 36 or 60 month (age dependent) if previous negative history, or may be 12/36 month if on follow up for treatment.
The NHS cervical screening programme has been HPV test first since December 2019 for England.

The samples still go to the lab, that's what they use to do the HPV test
What doesn't happen if you're negative - a microscope slide being made with a smear sample on it, to be looked at by a human.

I don't think women should be subjected to an invasive procedure unless the cells are going to be examined.

They should just do HPV tests first and only collect cells if they are going to be reviewed.

That would make it easier for more women to access screening in the first place.

Yes except you don't need to put someone through that process just to do a HPV test.

Agreed
I think we will do home swabs for HPV eventually

Can you have ‘viral changes’ without it being the high risk version do you know please?

I ask because I had a colposcopy in Feb after some mid cycle bleeding. This showed erosion and a biopsy showed ‘viral changes but no cancerous or pre cancerous cells’. I’m due to have my routine smear in a few weeks so although I was relieved after the colposcopy results, I’m a bit apprehensive/confused about whether the smear will show the viral changes still and whether they’ll check again for anything abnormal etc. I’m a worrier so my mind often goes to the worst case scenario!

Overview of the NHS CSP here https://www.gov.uk/guidance/cervical-screening-programme-overview
Self sampling study results https://nationalscreening.blog.gov.uk/2024/11/08/hpvalidate-cervical-screening-self-sampling-study-publishes-final-results/

But the procedure also enables someone to visually inspect the cervix. I refer many asymptotic women with polyps that have the potential to become cancerous.

This really annoys me, because if they aren't testing them if they don't have HPV they could just do a normal vaginal swab that people could do at home (like STI tests are now) and only call you in for a smear if you have HPV.

If people want to go for a smear, sure, but I bet compliance would be higher without it being mandatory.

I suggest you contact colposcopy to ask what follow up they want you to have and tell them you’re due for a routine test, as they might do different timing.
They’ll also be able to answer specific questions about whether the histology (biopsy) was HPV tested. There’s a difference between seeing changes associated with HPV microscopically and the molecular test used in screening.

The fact that they only test for HPV now is terrifying.

The hpv vaccine first started being offered to the year below me at school. My year was the last to miss it.

I believe that anyone who didn't qualify for the vaccine 35+ year old, should be given the old style smear. Anyone that receives the vaccine should be given the newer style test.

The NHS are risking us older womans' lives by changing the test types for those of us that are unvaccinated. We have no protection and no reliable testing.

I have always been hpv negative however with the old style smear test, on my first ever smear, I was diagnosis with cin3 cells. I received treatment and regular smears following this for 5 years.

Had that happened now, I'd be dead. It's all about saving money and the NHS sadly don't care about woman in general. I now pay for a private smear every 2 years as a result.

This is so true. I wasn’t going to go about my mid cycle bleeding because it didn’t happen often and I had had it for years on and off, and it had also been checked when having scans for PCOS. If it hadn’t been for the nurse at my surgery checking I would have been none the wiser. Being referred under the 2 week rule was worrying but it was absolutely amazing care from start to finish and ultimately put my mind at rest and ruled out anything serious.

Do you believe that your CIN3 wasn’t HPV related then?

Thank you for replying. The consultant just said “make sure you attend your next routine smear” which I had explained was due for May time when I was there having the colposcopy so no other follow up apart from that was mentioned. And all the letter said was to let them know if the irregular bleeding continued (which it hasn’t as yet).

I can ask them about the biopsy though.

Same here, I was HPV negative and had abnormal cells and treatment a few years before the test changed. I really wonder if there’s any point in having a smear now?

I agree.
9-15% of cervical cancers are HPV independent. As in the woman is HPV negative and has no history of ever being HPV positive.

Women with HPV independent cervical cancers tend to be caught at a more advanced stage, have worse outcomes and lower life expectancy since the smear test change where screening for cervical cancer is only done on HPV positive samples.

It isn’t done for any reason other than it’s cheaper.

She was HPV negative, so it’s not a belief but a fact.

They won’t because that’s not the cheapest option.

But in that case, being part of the group that didn't get vaccinated shouldn't change the approach.

I don't agree or disagree with the HPV/review all situation other than if it is HPV only they could allow less invasive methods.

You can do the HPV test privately at home, I used Superdrug. I would go for a smear if that came back positive but don’t see the benefits otherwise. It is painful and intrusive and redundant.

Yeah, I haven't bothered to book my latest smear. I'm not putting myself through it when I know I will be negative and booking the appointment is stressful with limited availability, working full time and irregular periods. It's not worth it IMO.

@ConfessionsOfaSecretAgent how do you know you were hpv negative as in the past they didn't check for hpv in a smear test?