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Do I REALLY need to have a smear test?

Discussion in 'Health and wellbeing' started by giotto, Mar 11, 2009.

  1. giotto

    giotto New commenter

    I keep getting sent reminders to go for my smear test. The last twice I had one done the nurse said she was having difficulty reaching the neck of the cervix and I wasn't altogether convinced that she'd managed to take a proper sample. However, that's not really my question. I've been married for a very long time (happily married, I might add) and both my husband and I have only ever had sex with each other. Do you know if a smear test is really necessary? What can it tell me?
     
  2. giotto

    giotto New commenter

    I keep getting sent reminders to go for my smear test. The last twice I had one done the nurse said she was having difficulty reaching the neck of the cervix and I wasn't altogether convinced that she'd managed to take a proper sample. However, that's not really my question. I've been married for a very long time (happily married, I might add) and both my husband and I have only ever had sex with each other. Do you know if a smear test is really necessary? What can it tell me?
     
  3. YES!!! it can tell u if u have abnormal cells that may lead to cancer quite simple really
     
  4. giotto

    giotto New commenter

    OK, maybe I've misunderstood or put 2 and 2 together to get 5. Recently there was a campaign in school to vaccinate young teenage girls to protect them from something called human papilloma virus(not sure of spelling) which was linked to cervical cancer. I thought that the emphasis was on vaccinating <u>before</u> the girls would become sexually active. This seemed to me to indicate that the vaccination was designed to prevent disease among those having sex, who would probably have it with several (or even many) partners during their lifetime. I suppose what I'm really asking is if these abnormal cells can occur, say, in a woman of 40 or 50 or even older, who has never had sex or has only had it with one person who has also been sexually faithful to them?. For example, would a fifty year old virgin need to have a smear test?
     
  5. My sister in law went to have one and the nurse couldn't find her cervix so she assured her that she had had 2 babies so defo had one.Next time she went to a special women's clinic to have her smear and said it was brill.they are horrid but only once evry 3 years.
     
  6. qwe

    qwe

    I don't mean it in any way as criticism of your question, but 'need' is an impossible word to define and apply to medical decisions, even though it's done constantly. A blood transfusion is sometimes necessary to prevent death - "need," surely? - but a Jehova's witness might refuse even if death resulted, as for them the (perceived) harm might exceed the benefit.
    Here it is much more clearly a balance of benefit vs harm.
    The benefit in general terms is in reducing the risk of abnormal cells being allowed to progress to invasive cancer. You are quite right that this is strongly linked to HPV, and that you are highly unlikely to have this. Thus the likelihood that you would benefit from screening is lower for you than for most women, but it is not zero.
    The harms I can think of are 1) modest temporary inconvenience, indignity and discomfort - I would hope none of these are prohibitive 2) financial cost to you as a taxpayer: the cost of the overall program is huge, and it would be great if eventually HPV vaccination renders it unnecessary, but for now the program exists and the individualised cost is tiny - so should not cross your mind 3) the possibility that unexpectedly HPV IS found, throwing up all sorts of uncomfortable doubts which ruin your current contentment (but of course any positive findings increase the likelihood that there will be a longer-term health benefit, albeit both one you could rarely prove for an individual as opposed to a population) 4) the possibility that abnormal cells are found for which, because docs are not clairvoyant, you undergo further treatment with all its attendant harms when if left alone these would have spontaneously regressed to normal (for young women these harms include an increased risk of subsequent miscarriage and premature delivery) 5) the mysterious effect by which screening, stastically proven to protect our health, actually leaves us more anxious about our health, which can be a major detriment to quality of life.
    I am sure others will think of more harms. Some will feel that none of these non-fatal harms to many women (unless you count miscarriage/prematurity) could compare with the possibility of saving a life or radical surgery in a much smaller number of women. Others will not.
    The NHS makes great claims of 'informed consent,' but once it has decided to implement a screening policy such as mammography or cervical smears the information provided, whilst not untrue, does tend to be written in such a way as to encourage "compliance." This is perhaps understandable as both the statistically-determined health benefits and acceptable financial efficiency are only achievable if uptake is high enough.
    It is for every woman to make her own individual assessment of the harms and benefits, make her own decision, be prepared to change it, and try not to regret it. Do not let anyone tell you what to do.

    PS I believe smear tests are not done on virgins of any age, although definitions are not as easy as you might think. Historically, lesbians have been regarded as in less 'need' (see, doing it myself!) but, depending upon exact sexual practises and whether they or any of their partners have ever has sex with a man, they may have a higher than average risk of invasive cervical cancer. Finally, a smear test requires insertion of a speculum. This is not generally inflicted on ladies who have not have 'foreign bodies' of one form or another inserted previously.
     
  7. giotto

    giotto New commenter

    Thanks for the post, gwe. Lots to think about.
    giotto
     
  8. lapinrose

    lapinrose Lead commenter

    Please have it done, What it shows is whether or not there are any cellspresent in an abnormal state, which may, or may not, be pre-cancerous. This has nothing to do with the number of sexual partners you have had or how long ago any may have been. Read the information in the link and do have one.

    http://www.womenshealthlondon.org.uk/leaflets/cervical/cervical.html
     
  9. qwe

    qwe

    The likelihood of HPV, abnormal cells and cancer IS related to sexual history. Indeed, the link confirms this, at least for one "extreme" end of the sexual history spectrum - celibacy - by confirming that smears are not recommended.
    The link (from 2003) is quite good, but is out of date in at least one respect. Deparment of Health now doesn't recommend smears until 25. This is because at younger ages there was a high incidence of abnormal resuls which didn't really matter but were leading to unnecessary treatments with associated risk of complications in pregnancy - it was felt to be doing more harm than good, although all such decisions have an element of subjectivity/value judgement.
     
  10. Jade Goody's sad situation should have you taking up the appointment for a smear test.
     
  11. Whilst most cases of cervical cancer are caused by HPV, in rare cases it can be caused by other factors. One of my friends had malignant cells removed following an abnormal smear which was done six months after she had started having sex. The consultant said it was extremely unlikely that the cells could have progressed so far in six months, and therefore it must have started whilst she was still a virgin. Please have the test - go to a GUM clinic if necessary, they have lots of experience of taking awkward samples.
     
  12. The current HPV vaccine only covers 2 (16 and 18 i think) strands of the virus, and while they are the most common they are not the only ones out there. Furthermore, the virus is not just passed on through sex, it can be through 'contact', so its not just about penerative sexual partners you've had..........without being more graphic!
    While HPV is not counted as an STI it is kinda like one. It's in the wart family and it encourages the cells to alter to become cancerous, however, it can be overcome by an immune system and often does in a year or so.
    I had abnormal smears in my early 20s, back when they started checking at 21......after 2 years of stress i finially had lazer treatment and have been clear ever since. But i NEVER ignored the appointtments, they would not go to the effort to screen for the potential of cancer for no reason, please put your health first. Cervical cancer is one of the most treatable, but only if its caught early. Sadly, Jade Goody is an example of what can happen if you ignore the appointments...... please go
     
  13. Of course you don't NEED to have one. Especially if you're a gambling kind of person. The majority of us will never have cervical cancer, however many partners we have. But it's staistics, innit. If you've only ever had sexual contact with a man who reckons he's never had sexual contact with anyone but you, then statistically, you're doing a lot better than me. But my mother and her mother both smoked forty fags a day all of their adult lives and neither of them had as much as a cough. My next door neighbour however nevr smoked and died of lung cancer last October.
    Are youy feeling lucky, punk?
     
  14. Go and get one done for peace of mind.
     
  15. Doitforfree

    Doitforfree Senior commenter

    It's hardly going to be peace of mind if you get a false result and end up having lots of unnecessary treatment.

    I think what the questioner was getting at was how likely someone is to get cervical cancer in her circumctances (very low) balanced against the likelihood of having to have treatment she doesn't need which may be invasive/painful/damaging to health.
     
  16. I agree you should not gamble with your health. I went for my first when when I was 18 or 19. Dreaded it and put it off but eventually did it. I have now had 3 appointments, some of which I have had to go back for. Once for example a sufficient sample was not taken as I have a problem called erosion of the cervix (due to the pill). My point being, they are not nice and you do feel like you're exposed but my thought is, it will be a hell of a lot worse when I have children. Dignity will not be an issue then so I would rather look after my health. The worse thing you can do is tense yourself up as that makes your experience that whole lot worse!
     
  17. gruoch

    gruoch Occasional commenter

    To reiterate, not all cervical cancers are caused by HPV but those that aren't are virulent.
    I have known two young women who developed pre-cancerous cells and actual cancer and neither was exactly generous with her favours. One was married to a monogamous partner and the other had had one partner for less than 6 months.
    It is, however, true that most cervical cancers are an STD
    And, to be highly specific, you are at far less risk of developing cervical cancer if your partner has been circumcised.
    Smear tests are not routinely offered to older women - I'm not sure of the actual cut off age, but I know I'm past it. I still have them, though, as I did have an abnormal smear some years ago.
     
  18. The school nurses (we have three apparently!) came in to explain the HPV vaccine to the Y11s last week. One of them said that the virus transfers through genital contact, so even lesbians should get checked regularly.


    (She also said that the smear was 'painless' and that 'a little brush' was inserted...omitted to mention the other device that gets the brush up there. all the teachers were shaking their heads. )
     
  19. Most cervical cancers are an STD?!
    Umm, HPV is passed through sexual contact, however, it is not classed as an STI as it can develop of its own accord, and go away of its own accord. Please note the use of STI now instead of STD.....infections not diseases.......
    Furthermore, i'd be careful with statements like that, STIs have a certain amount of blame attached to them, and it could be inferred that someone who gets cervical cancer got it because they were easy and its their fault - as condoms don't protect against HPV i think thats unfair, apart from living like a nun there's not much someone can do!




     
  20. I can't really understand why anyone would not bother to have a screening which is reasonably freely available, which costs you nothing personally, and which takes only a few minutes.
     

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