Do not fear the smear: how to overcome anxiety about cervical screening

[MsTiggywinkletoyou]

"Many women, particularly those who have survived sexual abuse, are scared of being tested. But there are ways to change this, from asking for a smaller speculum to singing Frozen hits" - and apparently self-sampling, which already exists in other countries.

www.theguardian.com/lifeandstyle/2019/mar/18/do-not-fear-the-smear-how-to-overcome-anxiety-about-cervical-screening

No mention of trans issues. I really hope that the NHS and charities will promote cervical testing to women, not "cervix-havers", because a lot of people don't know whether or not they have a cervix. (Many men are surprisingly ignorant about the human body; speaking generally, they avoid encounters with doctors.) And that is especially true for women who speak English as another language.

Rose George covers interesting stories, from toilets and sanitation to menstrual huts. Some of her stories touch on universal themes, some on "thank god I'm not a woman there".

I wish there were more clinics offering specialised smears for women following abuse or rape. For these women it can be extremely traumatic, not merely slightly uncomfortable. I know the clinics offering this service give longer appointments, can help with flashbacks, dissociating and grounding.

Having forgiving understanding healthcare professionals when you burst into tears at the sight of a penis-shaped device would be helpful.

And how does one overcome the pain?

It’s very slow movement on the newly designed speculum or a home kit or urine test? How about actually improving the damn method of testing rather than yet again telling women they have to overcome their discomfort and/or pain?

www.theatlantic.com/technology/archive/2018/03/women-redesigning-speculum/555167/

How about actually improving the damn method of testing rather than yet again telling women they have to overcome their discomfort and/or pain?

I know it's very different,but dh had a blood test instead of an internal examination to check for prostate cancer. I don't think he would have had the test otherwise.

Hopefully blood testing for cervical cancer won't be too far behind.

Unfortunately, the way we are built means that once it starts to go wrong, we clamp up, and it gets worse and worse from there. I don’t know what the answer to that is, but having had 20 years’ worth of completely painless smears, my last one was awful. The nurse must have got the angle a bit wrong or something, and couldn’t get it in, and started banging it around and retrying, and the longer it took the more it hurt. And of course once you’ve had one bad experience you go into the next one already tense, so onto a loser from the start. I can’t help thinking that the answer is to train nurses to be less shit at doing them, rather than haranguing women to be better at relaxing.

Personally, I’m happy to see a Guardian article about cervical smears which uses the word woman throughout.

It’s a miracle!

Hopefully blood testing for cervical cancer won't be too far behind.

There's a blood test for prostate cancer because PSA (Prostate Specific Antigen) appears in the blood even when the cancer is in its earliest stages.

The same isn't true when it comes to cervical cancer - or most other cancers for that matter. This means you can test negatively for all the cervical cancer markers and still have the cancer, so this isn't a good alternative to pap smear.

Urine tests are supposed to be just as effective aren’t they? So when are they being offered?

So I found some at home HPV kits and wondered how effective they are, they’re used in other countries. I found this article but does anyone else know?

www.google.co.uk/amp/s/medicalxpress.com/news/2018-11-at-home-hpv-powerful-tool-hard-to-reach.amp

www.gynaehealthuk.com/news/85-hpv-test-proves-more-accurate-for-cervical-cancer-screening

A PSA test alone can’t diagnose prostate cancer and that is one of the main reasons why there isn’t a prostate cancer screening service. The test isn’t good enough and doesn’t meet the criteria for a screening test.

I try and encourage my patients to attend for a smear and to discuss reasons why they might not have attended before to try and help resolve those issues if I can. Unfortunately there’s still a lot of mis-information about who needs a smear test, not helped by the “cervix-havers” crap.

HPV testing in the UK is done on smear samples that are abnormal. Samples that show abnormal cells and are HPV positive are less likely to revert to normal if left untreated and an abnormal result with positive HPV result will automatically mean a woman is referred to a gynaecology clinic for further assessment. Primary HPV testing (testing for HPV first) is being discussed but whether this will replace smear testing and what effect the HPV vaccine which is currently offered to teenage girls will have on the need for younger women to have smear tests is uncertain. I went to an update recently that discussed whether in future women may only have 2 or possibly 3 smear tests in their lifetime in association with primary HPV testing so hopefully change is coming and will be positive for many women.

Muststopfaffing

Sorry if I sound thick, but from the articles I found, the HPV home kits look to be quite reliable, as an alternative? Have I got that wrong?

Muststop, primary HPV testing is currently carried out in lots of areas of the UK at the moment.
The cervical screening programme is currently in consultation with Public Health England to completely convert to primary HPV testing and will see the current 40odd laboratories reduced to 9 by the end of the year.