Cervical Smear!?

Beauty,Yes, HPV can cause abnormal smear tests, but it's a sexually transmitted infection. Almost all HPV clears naturally in a year or two, but in rare cases it can persist eventually leading to cervical cancer. Lots of things can cause an abnormal smear test, inflammation, trauma, hormonal changes etc.

The new Dutch program is 5 HPV primary tests or HPV self testing at ages 30,35,40,50 and 60 and a 5 yearly smear test will only be offered to the roughly 5% who are HPV+ and at risk.

almost all women are HPV- and cannot benefit from smear tests. This program is likely to save more lives and takes most women out of smear tesing seeing over- treatment rates plummet.

 

Not all cancer causing strains of the HPV virus are protected by the vaccination unfortunately and even if you've never had intercourse, the virus is acquired by a skin to skin contact.  That is why Lesbians can get the virus which is also responsible for not only cervical but vaginal, vulvular and anal cancers.   I do agree that smears and paps have been over prescribed in the past and can lead to a lot of false positives but they're still a base source of investigation.   

 

Actually Jade Goody had an even rarer form of cc, adenocarcinoma, usually missed by pap testing, but it's linked to HPV.

The even rarer types of cc, like small cell carcinoma, are also, usually missed by pap testing.

So HPV primary testing and HPV self testing from age 30 is much more likely to catch some of these cancers.

Countries that follow the evidence and make an effort to protect women, exclude them from pap testing and HPV testing until they're 30. Sadly, no country in the world has shown a benefit in terms of incidence or mortality from cc in women under 30, despite cervical screening. Sadly, these very rare cases occur whether you screen or not. Young women tend to get false negatives, which may falsely reassure and lead to a delay seeing a doctor for symptoms. (poorer prognosis) Most of these cancers are diagnosed after the woman becomes symptomatic. (even if she has smears)

But pap testing those under 30, and especially under 25, leads to huge numbers of false positives that can lead to potentially damaging "treatments". Damage to the cervix can lead to premature babies, the need for c-sections and cervical cerclage, miscarriages etc.

The Dutch and Finns have aways protected their young women and excluded them from testing until they're 30. HPV testing should not be offered before age 30 either as about 40% og those under 30 would test HPV+, transient and harmless infections that clear within a year or so, at age 30 about 5% will be HPV+, these are the women who should be offered a pap test.

Following the evidence and targeting those at risk is the best way, IMO, to tackle this fairly rare cancer.

The Dutch and Finns have properly advised their young women too, see a doctor with persistent and unusual symptoms. We tell our young women to have a pap test - falsely reassuring them/misleading them.

Here is Australia we test from about 18 (some even younger) so young women really suffer under our program, it's a highly lucrative source of income though for vested interests, so we'll do HPV testing from age 25 under our new program. You only need to do basic research to find HPV testing is not a good idea before age 30.

Vested interests win again...

So almost all cervical cancer needs HPV infection as a necessary first step, there is some doubt about VERY rare small cell carcinoma...some believe it's linked to HPV, others are not sure...but it seems clear these cancers are also, missed by pap testing. These women are usually diagnosed after they develop symptoms. Some of these women have been screened and received a false negative result.

 

I read somewhere that Goody had the even rarer form of adeno, neuroedocrine small cell which is not linked with HPV per some research. 

 No, it was an adenocarcinoma

Dr Margaret McCartney, Scottish GP, was highly critical of the system using Jade Goody's case to promote pap testing because her form of cancer is usually missed by pap tests/smear tests. So again, giving women misinformation.

We make better decisions when we work with real information, but so much of what we get is spin and marketing, not real information. Some of it is bad medical advice, like our doctors promoting 26 pap tests, serious over-screening, great for them, a lousy deal for women.

I'll link one of McCartney's comments, it might have to go to the moderators first, but will appear shortly.

Personally, I'm convinced all cervical cancer is linked to HPV, and that's why the Dutch won't bother pap testing those women who are HPV-

IF some of the rarer forms of cc ARE related to HPV, pap testing misses them anyway, so I think the best advice is to know our own bodies and to seek medical advice if we develop persistent and unusual symptoms.

(and of course, offer women evidence based screening, respecting our right to choose...as if that will ever happen in the States or Australia!)

I hate the way the symptom-free female body has been demonized and medicalized, like it's out to kill us and needs constant medical surveillance. I reject that idea totally...I feel like I've spent my entire adult life protecting my body from medical meddling.

Nice chatting to you...

Something I read regarding Jade was that her first positive pap came around the age of sixteen she claimed was before she was even sexually active so this would coincide with that rare type of adenocarcinoma even though why she had a pap in the first place if she wasn't sexually active is a question.  She had cells removed twice and then stopped heeding the continued bad paps and treatment.  There are two major types of cc, squamous and adeno, as we know, then a combo of each called adenosquamous and then there are a few rare forms of adeno, clear cell, lymphoma of the cervix, neuroendocrine small and large cell, some sarcomas and even melanoma.   The only ones affected by HPV are the first three, the common ones.  The clear cell is the result of possible the DES exposure and the others aren't quite clear on what causes them.  Could be a rare familial or envirnomental link.   But I do know that children born of HPV positive mothers will carry the virus too so it would do no good to get the vaccine.  I'm a strong believer that viruses are responsible for much of our health problems, even obesity.  Thanks for the intelligent discussion!