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?

dont have to lie there like a passive mute really? That never occurred to me?
So saying please stop that’s sore. Does that count? Asking them not to lean their weight on your thigh. And being told no, that’s how they always do it.
And as for asking them not to open the speculum the whole way, ha! I often have to ask for lube to be told the don’t need it.

I've heard of it on numerous occasions.

Here's the thing, a GP is not allowed to remove you from their list because you do not have a treatment or investigation. The threat of doing so if you do not do X is unethical as it is coercive and undermines the principles of consent.

I know there was a spate of it going on, as dodgy GP surgeries wanted to hit their smear targets and get their bonuses for doing so.

I personally got harassed and harassed by my previous GP. I eventually stopped responding to letters as they were so aggressive and was struck off the books for not responding. I was not willing to reregister with the same surgery which proved a problem.

"But I had a colpo with no pain relief, Mirena insertion and told just to take paracetamol before coming in. I've had multiple surgeries on my knees and one on my ankle, again, loads of reassurance and pain relief, but when it comes to GYN pain, you're told to suck it up."

This.

I have 2 kids but never been in labour. Maybe mirena wasn't such a good choice? It was a hell of a job getting it in. The (nice) consultant I had to see after the strings got "Lost" said, your cervix is closed very tight, it must have been awful having this put in...

At least my cervix wasn't "incompetent" then...

Incompetent?!!!

I mean fuck off.

If it cheers anyone up to hear about men and pain I can tell you about when one of my kids had an op. They were screaming blue murder and I was rushed through to recovery and try and calm her down. There was obviously a series of male ops that afternoon, they were being wheeled into recovery, legs akimbo (is that a word or have I made it up?) and all moaning and groaning. The nurses were killing themselves and talking about how useless men were and how the human race would die out if men had babies. So men and their pain do get dismissed, and even laughed at.

I must admit it didn't seem very professional but I could see their point.

Oh wow I missed this

"You don't have to lie there passive and mute while someone does this."

Who are YOU to tell other women how to react when they are in a vulnerable position with a stranger who has inserted an object into their cunt???

I can imagine a number of reasons why a woman who was experiencing pain and distress might not be able to / feel able to vocalise it.

Jesus some people.

No, that doesn't cheer me up because no one should be suffering needless pain when there is so much available to assuage it. That's barbaric and wrong.

granny that sounds awful. I hope the men couldn't hear them.

And the human race wouldn't die out because for so many women & girls it's not really a choice. For a variety of reasons.

expat "I've had multiple surgeries on my knees and one on my ankle, again, loads of reassurance and pain relief, but when it comes to GYN pain, you're told to suck it up."

i really noticed there was a massive difference in how these types of pain are treated - in fact I was told I wasn't taking enough painkillers with a broken bone (they were kind of right but all the painkillers shredded my stomach).

however, the difference again - as with the flu jab - the sympathy was very very striking. But over the years, any professional linked up to promoting a cervical smear test was completely & utterly dismissive.

also I don't have bio children but someone may know - a friend told me you get the same dosage of epidural regardless of any physical factors? She's 5ft and tiny so the nurse said to her "at least you'll get max benefit from this universal dosage"? I wondered if it was true because if so, it's insane.

Part of my role at work involves the cervical screening programme. It is not normal for a smear test to be agony. Slight discomfort may occur but nothing more. In cases where the patient finds it too uncomfortable a referral should be made to get the smear performed at colposcopy

Why? Surely a colposcopy is just as uncomfortable as a smear test. My gp has offered to drug me so he perform a smear and I don't think this is uncommon. Not much has been said on this thread about how there is a financial motivation for gp surgeries to hit targets.

granny - no it's not cheering at all to hear that medical professionals are laughing at pain, that doesn't even sound like a "dark humour" thing.

That comments really pissed me off.

I was 16 when I was told to have my first smear. And when I had a colp.

I tried not to show pain because that is the sort of person I am.

How would I have even known to ask for different speculums and whatever. And they would have listened? To a child? Like fuck.

That's made me quite angry. Why can't the HCPs be nice and gentle and ask and assess what sort of speculum to use? They're the professionals for god's sake the average woman has no idea what alternative equipment is available.

Agree v hard to book.
My last employer paid for cancer screening for women over 40 and covered the time off. So in about an hour and a half i had smear test and full mamogram.

'I really don't know why the fuss over smears. I'm in my 60s and have had loads as well as vaginal surgery. Sometimes a smear was a bit ouch but it lasts for a few seconds.

being nervous makes it worse. You can ask for a smaller speculum, ask them not to crank it open too far if it's hurting, ask them to be gentle.

You don't have to lie there passive and mute while someone does this.'

You don't? Seriously? I've had them since I was 18. I had to get one to get the Pill in the US in 1989 and then had to have one every year to get further prescription. I'm a rape survivor, but thankfully have not experienced pain with smear tests. I had a very abnormal one when I was 29, resulting in colpo and LEETZ when I was 30. I donated my tissue samples to research into HPV vaccine. I've had 3 vaginal births, one with forceps, one with ventouse and one with nothing at all as it was quick. I've had multiple smears due to my history, now on 3-yearly ones. I went for one when called, a month after my 9-year-old daughter had died from leukaemia.

And I can totally see why some if not many women find them intolerable. I can understand the 'fuss' over them, and women willing to risk their health to avoid them, or not if they have weighed up the risks and decided to forgo of their own accord. Completely.

It's not rocket science. It's just simple empathy and realising that my experience is not universal.

batteriesallgone I’m not saying that I don’t believe that for many women it is not painful. I’m saying it’s not normal and shouldn’t be accepted as normal. That anything above mild discomfort shouldn’t be acceptable and these women should be seen by colposcopists who have better equipment that a practice nurse is going to have.

I have had 3. My first was painful but the result was fine. My second was horrible and I was faint. I got recalled for abnormal cells, only on the second screening they were fine afterall. There are numerous cases of Trusts sending out incorrect results etc.

I have been told off for missing one when my child was in hospital and patronised. They threatened to remove me from the list so that I'd no longer receive the reminders, I said "Oh, is that an option? Then yes please, do that."

That was 17 years ago. I haven't been since.

My eldest is 19. I haven't had one in his lifetime and I never will again.

For the record, I keep myself 'tidy' in a way that I feel happy and comfortable with, so that isn't an issue either. I am also quite happy with the appearance of my vulva and I smell as I believe a woman should. So it's nothing to do with that either.

I have my reasons for not having one and I am more than comfortable with my decision. It's not something I ever give a second thought to, tbh.

Going forward, I suspect that if nurses with stubble and a deep voice are on the rise, the uptake will be even less.

There are so many things that could be done to address this if the NHS/government really care about women's health. The first thing could be listening to women.

Grannietomine,

I get your point, I do... 23andme uses SNPs as proxy for genes, they are looking for particular mutations (usually the common ones), but they are updating and adding new ones all the time (not just for cancers, for many conditions). Not perfect but could be a powerful, and cheap screening. My family has no history of brac 1 or 2 related cancers so I wouldn’t get nhs genetic testing as things stand.

DH and DC1 are both drs and very much of the opinion that personal genome testing is the way of the (near) future and will revolutionise medicine, while putting the patient in charge of their own information (newly qualified DC thinks extensive genetic analysis (not SNP testing as with 23andme) will be available for a few hundred pounds within a decade- it costs about £4K atm iirc.

If it cheers anyone up to hear about men and pain...

What a ridiculous thing to say!

Why on earth would it cheer anyone up to hear about men being in pain and treated disrespectfully?

I hope they couldn't hear it either. Whatever the patriarchy might be responsible for, I wouldn't wish pain on an individual man

Sorry but it is rather funny that people are complaining of smears being wicked painful, which I'm sure they can be when so many younger women happily let someone rip out ALL their pubic hair on a regular basis.......now THAT has got to be painful and embarrassing!

Sorry but it is rather funny that people are complaining of smears being wicked painful, which I'm sure they can be when so many younger women happily let someone rip out ALL their pubic hair on a regular basis.......now THAT has got to be painful and embarrassing!

If they would rather do that then have a smear, then perhaps its because:

1. the bedside manner of the person doing it is better
2. its actually less painful
3. its less invasive
4. plenty of young people don't do this

But yes, reduce it back to young women being stupid.

Why would what some women's choice re their pubic hair have any bearing on my personal choice for an invasive medical procedure?

actually WalkingDead it depends how deep your hair roots are or something, I don't find waxing painful at all.

but I never assume it won't be painful for anyone else.

similarly I think for some of us, internal and external procedures are a planet away from each other in terms of pain or general stress.

Walkingdead, I think you're being ridiculous.

'Why? Surely a colposcopy is just as uncomfortable as a smear test. '

It's worse. The cervix is stained with a solution, to show up the abnormalities, and samples are snipped from those areas to go to the lab to test. It is a biopsy. Can you imagine any other form of biopsy performed with no pain relief?

Some women's vaginas are stitched after childbirth with no pain relief. Again, where else does this happen? I've cut my head open, one of my hands, and had to be stitched, but was given local pain relief. That should just NOT be happening. No one should be given potentially painful medical procedures without being offered pain relief unless in case of dire emergency and even then, well, most often outside of GYN they are given pain relief.

I was even given pain relief to take before physio after ortho surgery. My surgeon assured me, the body will not heal itself properly if it is in pain. I even got pain relieving eye drops before my cornea had to be scraped after I scratched it accidentally with a climbing rope that I flung across my face.

And again, you're referred to colpo clinic after your smear test has come back as abnormal. How are you supposed to manage a referral to colpo clinic, where again, plenty of colpos are done with no pain relief, for a smear test?