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 tested positive for HPV in 2021, no abnormal cells detected and so I had a repeat test the following year and the HPV had cleared. My most recent test came back negative too (so therefore my cells were not checked) but the nurse said my cervix looked suspicious and I was then referred on the 2 week pathway. I am awaiting biopsy results.

There is research that suggests that those who have tested positive for HPV in the past and have a subsequent negative test are still at higher risk of developing CIN.

@ConfessionsOfaSecretAgent

https://cks.nice.org.uk/topics/cervical-screening/management/cervical-screening/#:~:text=Cytology%20is%20the%20triage%20test,more%20frequently%20hrHPV%20is%20found.

https://gpnotebook.com/en-GB/pages/gynaecology/cin-screening

https://www.gov.uk/government/publications/cervical-screening-primary-hpv-screening-implementation/cervical-screening-implementation-guide-for-primary-hpv-screening#fn:1

Quite a few references embedded in those links.

me too - 20 years later dr told me to tell the pap smear nurses to head for my bum - things improved a lot!

I think the message needs to be clearer that a smear is also a visual check of the cervix. I have never had HPV but I have been referred to colposcopy following smears as my cervix looked dodgy (it was fine, I had an entropion but I’m glad it was checked). Moving to home testing would mean women missing out on the visual check which is an important part of the process.

In terms of the possibility of cases of cancer not caused by HPV - what do the overall numbers of cases of cervical cancer in the population look like now compared to 2019? I would assume lower overall due to the number of younger women who have now been vaccinated against HPV, but there will be a “control” group of older women (like me) who have never been vaccinated. We should be able to compare rates of cancer in women aged 40+ now with rates in women aged 40+ from 2018, and that would indicate if more cases are now being missed or not?

Actually, while the accuracy of self testing might not have been looked at here, Dutch Finnish and I believe Australian women, have had the self test option for years now, Holland and Finlands rates and deaths of cervical cancer are amongst the lowest in the world, and I really don't think Brit women are any different!? Dutch and Finnish women also have less screens unless they show HPV+. I really don't understand why our NHS prefers to spend money chasing non screeners and on more awareness campaigns when they could be using the money to roll out self testing. Those who want a visual check by all means get one but I'm sure most women would prefer to self test

The self test is a swab on a long stick you insert yourself. It doesn't look at cervical cells but for traces of HPV in vaginal fluid and secretion. HPV can also be detected in menstrual blood. If you can get the swab up there you can take the self test

Something was seen by the nurse at my smear. She got lots of colleagues to come and have a look as it was unusual. All sorted years ago and fine but without that look could have got much worse I assume.

Have met so many women who don’t like smears and some who won’t even go but I prefer a qualified medical professional to examine me especially after my cervical issue was picked up. I think self testing as base level and then if you want a medical examination it should be an option.

It's for every woman to do as she decides best, but surely the self test might catch more cases down the line? A woman who won't do the speculum test if she knows it's not going to be read further if negative for HPV might self test and seek help? Surely if the aim is to help women, there's a place for self test? Are the NHS preferred methods ATM, which seems to be awareness campaigns (is anyone actually UNAWARE) or chasing non screeners, increasing uptake?

I don’t trust this process. I read somewhere that 8 percent of cervical cancers aren’t caused by HPV and they tend to be the more aggressive
types.

a few years ago I had high risk HPV with cell changes. My gyno told me I needed smears every 6 months. However, the next smear I had, tested negative for HPV, so wasn’t sent for microscopy and my GP said that as it was clear, I could go back to the normal screening routine. No-one can give me a straight answer on whether the HPV clearing up means that the cell changes have also gone away. I’ll never know because without HPV, my sample won’t get looked at. In addition, I have developed something that looks like cervical ectropion (though no one can be sure by eyeballing it), which was only discovered because I have pain and bleeding between period I.e the symptoms of cervical cancer!

What’s CIN4?

I hate them, find them incredibly painful despite having tried most of the suggestions for tilted nothing works. and am sad that money made them change the procedure years ago. Surely it could be better and we should be offered better options. I might pay to get it all done properly.

Yes same, very painful for me despite putting my hands under my bottom etc. However while going through IVF I never had any discomfort from a speculum. It seemed unbelievable. I can only assume it's because this was always done by experienced Gynae Consultants; they must have fitted speculums every day of the week and had done for years. Nurses at GP surgeries won't have had the same level of training and experience.

Anal cancer is the same though - 91% of cases caused by HPV.

I went for my smear today and my vaginal muscles refused to widen for the speculum, she just couldn't get it wide enough to get the brush in. She was lovely but couldn't do it. Mind you she only tried twice and I wonder if she should have had a third go, third time lucky and all that. She's booked me in for two weeks' time for another go. She did do it successfully last time, about 3.5 years ago.

This is my first failed test. I've never had an abnormal result.

I am now wondering whether to bother with the repeat and whether to get the home test and then only go back if it's positive. It seems a bit silly to put myself through it if I don't need to.

I just use the super drug HPV tests now. I don't bother with smears

I've ordered a test and will decide what to do following the result.

I looked for the Superdrug test kits and no joy. Online or in stores?

Here you are: https://onlinedoctor.superdrug.com/hpv-test.html

Or you can try Daye. https://www.yourdaye.com/products/at-home-hpv-screening/

It worries me that they are mo longer checking for cell changes. Not all cervical cancer is HPV related and it’s one if the cancers with non-specific symptoms so often identified far too late when not picked up via a smear.

@TooManyNiblings Good advice from @dementedpixie. You should have your cervical screening. I've been married 38 yrs, no other sexual contact for either of us. No infidelity. Together since very young. I've tested pos for HPV. We would both swear on the lives of our children that I didn't get it sexually. There are clearly other ways the virus can spread. Unfortunately not enough cells to test for abnormal cells so I've had to wait 3 months before I can have another smear. Booked in for next week. ALL women and trans men should have all their cervical smear tests.