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.

I went to a private gyno who had discovered I had CIN 3 and removed 1 inch of my cervix a long time ago because of it. 10 years plus later when he did a pap smear because I was concerned about abnormal bleeding but I was still only tested for HPV - not abnormal cells.

@Gansy Thank you so much. My nurse wouldn’t explain it to me. You’ve put my mind at rest

You can but it can be quite difficult to find somewhere that will offer the full screening. I had to call around a lot of places to find one that does it. It's much more expensive than the regular hpv testing and they won't always carry one out without reason I.e symptoms or a history of issues. Most will though if you're willing to pay.

Your best bet is to call them all and make sure they offer the full cell check and not just a hpv swab. I've been fooled before due to the wording they used.

I think it's appalling. I know someone having to have treatment for abnormal cells who is hpv negative. She had to pay privately to get tested

Also to add. I read that non hpv cervical cancers make up around 3-11% of cervical cancers.

To put that in numbers, 11% of the uk's female population is around 374000.

How is this allowed. I am thankful and lucky that I am in a position to pay for a private smear. What about those that can't? Do they just get left to die?

This is always in the back of my mind, I still go in the hopes that when doing the smear the nurse would be able to spot anything odd.... But I have never had HPV and had CIN2, cells were removed, worries me that it would recurr and would never be picked up

Yes, 11% is not a small % imo. Definitely not small enough to basically be shrugged off with “oh yeah, that’s pretty rare so we won’t look for that.”

Sorry to go off on a branch here, but I had a smear 2 months ago with the results being HPV detected - test again in 12 months. No mention if high risk strain or not.

And I have just today had a mid cycle bleed for the first time in my life. Should I push for an earlier retesting?

So the virus doesn't shed off your cervix? A few cm down your vaginal wall the virus won't be there? As a biologist I'm amazed. Covid swobs of high up in your nose, virus never come down with the mucus from the mucous membrane?

If a woman can insert a tampon correctly then they can pretty close to their cervix as it's at the very top of your vagina after all. If someone can invent a tampon they can invent a swob to get to the top.

I don’t go anymore for this reason . I am negative last two times for Hpv , not had a sexual partner so don’t see the point .

My last smear was negative for hpv but the nurse spotted a polyp and I was referred for it's removal and testing. Luckily benign but does show the worth of the test. I also had abnormal cells in my 20's but no idea whether it was tied to hpv or not.

The % of non-HPV cancers will rise, as the HPV vaccination does its job and prevents more of the HPV related ones.

Only high risk strains of HPV are looked for in the test. The majority of us will have one or more strains of HPV in the body at some point. If it then leads to abnormal cells and progresses on further this takes several years. This is why it's tested again after a year where it many cases the test is negative.

I've been monitored annually for several years now, positive for HPV, sometimes with low grade abnormal cells which the colposcopist thinks is more due to vaginal atrophy which can cause changes to the cervical cells (common I understand).

There can be a few causes for unexplained bleeding - maybe you are in perimenopause? I'd recommended you mention this to your GP and they can advise www.nhs.uk/conditions/vaginal-bleeding-between-periods-or-after-sex/

HPV strains might sometimes lie dormant for many years. I had a negative result after my last relationship, then the following test was positive and is being monitored annually.

@over50andfab thank you 🙏🏼 I have had the the high risk strains in the past and had colposcopies. Then was clear after having a baby, perhaps a new partner is the reason. It would be useful if they said in the results whether it was a high risk strain, or are you saying they’d send for a colposcopy if they were?

And thank you. Def in peri. Had such a heavy period this time too

No point. The nurse won’t do it and even if she did the lab would bin it as it is classed as off schedule. They have a zero tolerance policy.
See your GP for swabs and a vaginal exam who can refer you if necessary to gynae.

The test only looks for high risk strains - from memory and don’t quote me, but there’s about 13 or 14 and there are loads more strains of HPV (150+) that don’t generally cause any issue.
without checking the Colposcopy guidelines (they they can be found online) I think if no abnormal cells are found we’re referred for another smear test the following year. If abnormal cells are found then we’d be invited for a Colposcopy.
HPV can lie dormant for many years so we don’t tend to know if anything that shows up is from a previous partner from many years ago, or someone more recent.
Really heavy periods can be a pain in perimenopause. I used to get them but then the next one might be very light or none at all. It can be a confusing time for sure and worth monitoring..

This is interesting. I’m now in my 60s and last year it wasn’t possible for me to have a smear. It was too painful. After the first try I started on some kind of HRT which was meant to make it easier, but even with the HRT it wasn’t possible.

Is it possible for me to have a HPV test? Would the GP be able to arrange that, or is there something I can get in a chemist?

Just to discuss the other side of this, many years ago I had a smear and the nurse noticed my cervix looked abnormal and was bleeding, I was HPV negative, but got referred to colposcopy due to the appearance. They did some tests and said a large portion of my cervix showed high grade changes and I need to have the LLETZ procedure urgently. I had a significant portion of my cervix removed and some of it biopsied for analysis.

Results came back and it was only CIN1, which is very normal in a 25 year old. I now have an incompetent cervix. If I was able to swab myself and it was just tested for HPV, I don’t believe this would have happened. So I guess there’s issues with both methods. I appreciate that not being diagnosed with high grade changes when you do have them is obviously much worse though.

You could ask your GP. If they don't do it you can get one from Superdrug for £55.

GPs cannot offer HPV swabs.

Lots of misinformation on here, including the thread title. ALL cervical samples are sent to the lab, where they are tested for primary HPV screening which is looking for high risk HPV. (HR-HPV).

If no evidence of HR-HPV then no cytology will be undertaken, meaning the cells will not be examined. In a woman with negative HR-HPV and no abnormal symptoms the chance of developing cancer is approximately 0.3%.

If you have HR-HPV the cells will be examined. Any abnormalities mean you will be referred to colposcopy.

There is work in progress towards self testing for HR-HPV but they need to be confident it has an acceptable level of effectiveness.

Choosing whether or not to have a smear test is a very personal decision and one that should be made with the understanding of what you are going for. The letters and leaflets are quite clear, and misinformation (like some on this thread including the title) is potentially very damaging.

NB the processes I have written about apply in England. I can’t comment for other countries.

As a women who had non HPV linked cells removed at the age of 24 this new test is going to see women slip through the net and I would be one of them, luckily I was tested from the age of 18 and tested fully that detected CIN 4 cells. As I’m now in my 50s, I’ll be paying privately for a full test, as I know that my cells won’t be fully checked now.

I had my smear last month (a repeat as 3 months earlier the label apparently fell off and it was disposed of ..) and the nurse openly said she could barely see my cervix due to my "tilt". It was a real struggle both times for her to do the smear. So I can't feel confident that she would have been able to look closely enough to see any polyps.

Do you have a link to your statistics and numbers? The ones I have are different.

I also have a tilted cervix. It helps if you put your hands under your lower back during the exam to prop your pelvis up.

If I don't do this, it's always painful and difficult to complete the smear. I just wish someone had told me this sooner!