Women failing to attend smear tests

[guardianfree]

Women generally but young women in particular - 1 in 3 not attending.

www.independent.co.uk/news/uk/home-news/jos-cervical-cancer-trust-charity-smear-tests-terminal-illness-health-wellbeing-hospitals-a8171011.html

I know they're unpleasant (and often feel humiliating) but what can we do to reassure women that they can be life savers?

I found it easy and painless. I wish I could say the same about mammogram but you can't have everything.

Snowdrop why does it sadden you, isn't it a good thing that not everyone finds it painful?

She means that when people fail to understand that just because something is easy and painless for them it doesn't mean it is for everyone,

The "why wouldn't you go?" bit.

At least that's what I took it to mean.

Not that she wants women to be in pain and it makes her sad when they aren't!

She means, why are women who have a negative experience ignored and why isnt their reality acknowledged? Instead it sets up a narrative in which women are silenced and invisible.

You weren't talking about any of the women on this thread?

Yes, some of the people I referred to were on this thread, why would you think they weren't? Additionally I'm still bemused as to why you think I assume women considering ways to improve uptake don't get smears themselves, in particular how that pertains to the post you quoted when you said that.

Maybe young women wouldn't be so scared if the message was more positive. Bit like childbirth, I don't know why people are constantly telling other women how awful it is. Being scared must make it worse as you can't relax.

I think my first smear was easy as I had just had my first baby, I was beyond embarrassment as the world and his wife seemed to have seen me in various undignified positions and I was relaxed. When I came to my second smear I was relaxed as I expected it to be easy. Obviously some people have physical reasons why it is going to be more difficult/painful but for lots of people being relaxed and confident might make it easier.

I still do my "breathing" from my first ante natal classes in 1971 when I am having anything done that might be uncomfortable e.g. root canal filling, colonoscopy. It does seem to help me.

to be clear, yes, I am annoyed that so many people say that and don't seem to have any recognition that it is not easy or painless for so many ....but also, frankly, I think some of those women are lying. It's like the threads we have here where women say "oh I wouldn't tell anyone about the hell of childbirth in case it put them off"

in fact now I have been honest with friends about not going any more, suddenly I get "oh, actually, it wasn't painless". they were fucking lying!! What is the point?

It also really saddens me when we get posts here with people saying "I'm dreading it but I must go". Must you? What are your chances of getting it? Do you have any signs of it? Do you know it's not a diagnostic test?

Ridiculous.

One of the criteria for screening tests is that it is an 'acceptable' and 'easy to perform' test. For many women, cervical screening is neither.

Women are good at being guilted into painful procedures, for the good of their family. You can see people doing this with smears- 'you couldn't leave your children without a mother!'

I think the fact that young women appear to be liberated enough that they're saying 'Hey! This test is NOT acceptable to me!' is a positive thing for feminism.

Instead of the patriarchy sitting there saying 'why won't these women do as they're told, like the used to???!' They should be listening to women, and finding an acceptable test- self testing, or blood screening. A self test would be possible when the cervix is nice and low just before your period, and would have the added benefit of teaching women about their anatomy. Allowing a self test, with a teaching appointment, or a nurse to do it, would mean no more appointments than the current system, and I wonder if any more failures than the current system, if you count the number of women who are dragged back to their surgery several times because their cervix is difficult to find.

A screen for men requiring an invasive test into the urethra, or even a routine rectal speculum, would not be deemed acceptable.

The fact that such an invasive test is deemed 'acceptable' is very much a feminist issue, as it appears men decided it was acceptable way back when, and women have done as they were told.

Not to mention the lack of accurate information etc on whether women who have never have HPV, had the vaccine, etc, actually have any benefits that outweigh the risks of unnecessary treatment.

another point - I haven't even had biological children but of course the first request for a smear test came to me when I was very young because I was on the Pill at 17.

I swear they think it is easier to harangue a young woman into having it and try really hard because of the financial incentive.

then later on I got "well it you will go through a lot worse when you have children" - why do they assume every woman is going to have children?

it is all part of a culture where women are simply supposed to do what they are told. I am disappointed that we don't have more doctors speaking out against it but this will be a lot to do with the financial incentives attached to it. In fact when I mentioned that to a doctor she went purple with rage that I'd dared to mention it.

Snowdrop well I'm not lying I never found it painful, not even uncomfortable. Childbirth? Well I have had the lot, emertency C Section, forceps, horrible stitches (found them worse than the actual birth) and one totally painless birth. Different people have different experiences, sometimes the same person has a different experience. I don't see why it is wrong for me to say I found it painless, it in no way means I don't know that some people find it painful or that others find it embarrassing.

smearsforfears, back in the day women wanted the test, we also wanted mammograms. I don't think that was the patriarchy. It should be a choice and of course it is as no one is going to drag you there and force you to have it.

I've always had my smears and mammograms but I refused prenatal screening, one doctor went mad, lecturing me as it was obviously particularly important as I was nearing 40. I did find it upsetting, and had a cry on the way home, but no way was I going to be bullied into tests I didn't want. I have no idea why he thought his bullying was a good way to deal with what he saw as a difficult patient. The midwife who was with him quietly asked me if I was nervous and if I was she promised she would be with me and it would be OK. I told her I wasn't nervous, just not prepared to have it and she was fine with that.

To be honest I think that is doctors, male or female, they always think they know best or I should say lots of them do. There are some reasonable ones out there.

granny, it's not wrong, but when someone admits they were lying in order to encourage women to go, it's infuriating.

also, as i said, is there any data on it? - yet the doctors will keep saying "most women find it painless". Do we actually know this?

Well, the testing is going to change (number of tests in a lifetime and at what intervals) as the epidemiological data after the roll-out of the HPV vaccine is amassed and assessed.

This test was not imposed by the patriarchy. It was very much campaigned for by women.

it is easy to perform, and should be painless, though it may be uncomfortable. I am not convinced that self-testing is the way ahead, as if you cannot see the cervix how would you be sure that you have collected only from the correct places?

As there seems to be widespread concern that the test is not being performed to standard - by being unnecessarily painful, performed in an undignified manner etc, then that is exactly the sort of feedback that needs to be fed back in to the system.

Because right now, this is the only means there is of spotting early cancerous changes and this can be life-saving.

The question of over-treatment on borderline results or disinclination to use watchful wait, are separate questions, which are really only relevant to those who are having the test. because the nature of treatment is an issue for people once they know there is something which is potentially treatable.

Questions of over-treatment are a full or partial reason why some women don't get tested, so they're not only relevant to those having the test. Some women decide the risk of over-treatment is a factor they wish to weigh into their decision making. You can disagree with the decision those women are making but it's important to understand that they exist.

Snowdrop I don't think people should lie but I don't think it is wrong for those of us who find it painless to say so.

I must admit I find it odd that more women don't complain about mammograms, my friends don't seem to find that painful but I found it terribly painful, I think you said your mother did as well. I wouldn't try to put anyone off though, maybe because of my family heritage with BRCA1 I do see the pain as being worth it. I am looking forward to finding out if I do have the gene mutation as if I do I will go on to CT scans instead of mammograms and if I don't then I have got less worry about it. I only have two more due on the screening programme but if I have the BRCA1 then I have the choice of mastectomy or annual screening. I am waiting for Consultant appointment as have been through the rest of the referral procedure. Hope it doesn't take too long.

I had a smear today and it took seconds and didn't hurt at all - I don't know if that's because I had a baby last year so I'm comparing it to that. But I just can't believe people think they're that unpleasant.

Oh, gilderoy because you've had a quick and easy one clearly means everyone does, and that anyone else is lying?

Obviously.

People are all the same, after all.

the question of over treatment or unnecessary treatment is definitely more widely discussed

my impression was also that women campaigned for this test to be more available but I was a child at the time so don't remember much

it's mostly doctors and nurses who should be more honest about it. Once you start refusing it, every Pill check - often with a different nurse - is "oh you should have it, it's not painful" - ARGH!!!

re mammograms, I've heard a few women saying it's painful.

there's a general taboo around the refusal to have screening of all kinds because we're not allowed to say "hey, I've got to die of something" anymore. I am absolutely terrified of long life. My family has a huge problem with longevity before any of this medical intervention even happened - many relatives living to 90 when 70 was considered amazing.

my mum is nearly 80 and refused a pacemaker and OMD, the attitude she got because of it. Sorry, I'm digressing, but it is a factor in screening and preventative treatment.

Medical procedures are often described by medics as 'uncomfortable' when the patient would say 'painful'. It seems a lack of willingness to understand that everyone's body is different and pain is subjective (not because some people are wimps, but because their pain perception may be stronger, or various other reasons). Perhaps for some people, it means they don't worry in advance about the procedure so it hurts less. But for others it means they are taken by surprise that something is, in fact, painful, plus they then feel that the medic has deceived them (whether intentionally or not).

For some people smear tests are painless, but doctors insisting "oh this should be painless" and therefore implying it's the patient's fault if it hurts is really wrong.

But I just can't believe people think they're that unpleasant.

Really?

I do find that very odd because isn't it common knowledge that people have different pain thresholds, different triggers and, well, different genitals and cervixes? Even if all practitioners were equally skilled, which we know they're not.

I don't mind the dentist much but it doesn't require too much of me to think of factors that might make that different for other people.

Women campaigned because it was the only test available then, with the knowledge had then. The patriarchy deemed the test acceptable, and still does. I believe that this test is no longer acceptable, and many women appear to be agreeing!

We have cells scraped from our cervixes that are mostly never looked at, because as long as you're negative for HPV, they're thrown away.

So why not a self test, or blood test for HPV, and smears only for those where they wouldn't get thrown in the bin?

Why are we subjected to an undignified test where the samples have a large chance of being discarded?

Very true, Spartacus, or ordered to 'relax' in a situation where it may be physically impossible to do so.

I always found smears very painful, which I assumed was because I'd never had children - interesting that so many posters have suffered pain. You would think in the 21st century that a less painful way of obtaining samples could be devised.

Spartacus "Medical procedures are often described by medics as 'uncomfortable' when the patient would say 'painful'."

You just reminded me something...after my mum refused the pacemaker, another friend of hers had one fitted and was told it was very easy and straightforward.

the lady had her daughter with her the whole time, and she's one of the most down to earth, not complaining types I know. But she found the whole experience really traumatic and was quite upset afterwards because she felt that it had not been explained to her how awful it would be. I think they told her "uncomfortable" as well.

just looking at the NHS cervical cancer info - hopefully more women are reading this? I wish I had seen this when I was 25!

Cervical screening isn't a test for cancer, it's a test to check the health of the cells of the cervix.Most women's test results show that everything is normal, but for around 1 in 20 women the test shows some abnormal changes in the cells of the cervix. Most of these changes won't lead to cervical cancer and the cells may go back to normal on their own. But in some cases, the abnormal cells need to be removed so they can't become cancerous.

it's like screaming "It's not a diagnostic test" essentially.

Very true, Snowdrop. My father who is nearly 82 has refused some procedures. He has a heart condition, hard to control blood pressure and has had prostate cancer twice. He's getting very slow, can no longer drive and is no longer interested in life-prolonging procedures. His life, his choice. He's a very forthright person, though, so when he says 'NO' to offered procedures he usually just gets raised eyebrows in return and tutting.