How is it that in 2014 the only option to detect cervical cancer is by having a smear?

Hi Mrs D

I don't have pap tests, an informed decision made decades ago, I was content with my near zero risk of cc, rather than a 77% lifetime risk of colposcopy and biopsy (or a "treatment") with the Australian program. Now I understand I'm HPV- and cannot benefit from pap testing, like MOST women. I didn't get the information I needed from my doctor or the Govt, I had to do my own research.

Many women feel as you do, but until sufficient numbers demand something better, population pap testing will continue. In my opinion, population pap testing means HUGE profits for vested interests, so they'll fight to keep population pap testing in place and better options OUT.

The shameful thing is smarter testing would save more lives from this rare cancer and spare huge numbers from unnecessary biopsies and over-treatment. (which can damage the cervix and lead to miscarriages, premature babies, c-sections, infertility etc.)

Why confine testing to the 5% actually at risk when you can drag almost all women into testing and then many of them into excess biopsies and over-treatment?

I read on a health forum a couple of years ago that the blood test (CSA) was blocked, that wouldn't surprise me at all. Tampap (the HPV self-test) was locked behind a doctor's script in this country while our GPs are paid to reach pap testing targets, needless to say, few women got their hands on Tampap. It now seems to have disappeared completely. GPs do not disclose this potential conflict of interest to women, (target payments) I consider this unethical conduct.

In my opinion, women have always been denied informed consent, our legal right, we're just expected to screen with no/little real information or misleading information, and some women are coerced or pressured into testing. (no consent at all) The emphasis has been coverage, not informed consent. This should be a scandal.

When you screen for a rare cancer with an unreliable test you must get about 80% of women to screen, that's why we see the most pressure to screen for a rare cancer, to justify the huge expense of this program.

There are far greater risks to our health that are neglected while this rare cancer gets most of the attention and funding. (heart disease is the No. 1 killer of women, 0.65% is the lifetime risk of cc)

Some countries have managed to put women and the evidence first, you may be interested to hear about the new program recommended by the Dutch Health Council. Now they'll scrap population pap testing and offer instead, 5 HPV primary  tests (OR HPV self-testing with the Delphi Screener) at ages 30,35,40,50 and 60 and ONLY the roughly 5% who are HPV+ will be offered a 5 yearly pap test. MOST women are HPV- and having unnecessary pap testing, this carries the risk of a false positive, excess biopsy or being over-treated.

The new Dutch program will save more lives and takes most women out of pap testing and harms way.

I know some Australian women are now ordering HPV self-testing devices online. The significance of HPV has also, been kept from women, HPV- and you cannot benefit from pap testing, HPV+ and aged 30 to 60 and you have a small chance of benefiting from a pap test. Those women HPV- and no longer sexually active or confidently monogamous might choose to stop all further testing.

You're quite right, men rejected the routine rectal exam and the PSA test appeared fairly quickly. (it's an unreliable test too, many believe the risks of testing exceed the benefit) Too many dismiss the feelings of women, we're TOLD how we should feel and are often ridiculed if we feel differently. (find the test painful, embrrassing) That's disrespectful and unacceptable.  

I'd urge you to do some reading and make an informed decision about screening. It's also, important to find a decent doctor, one who'll respect your right to choose, put YOU first.

Be careful with breast screening as well, I've also, declined breast screening. The Nordic Cochrane Institute has an excellent summary of all of the evidence on their website. Over-diagnosis is a serious concern and it seems any benefit of screening is wiped away by those who die from heart attacks and lung cancer after treatments. Your Prof Michael Baum, UK breast cancer surgeon, has written some informative articles on the topic.

_____ is a community of like-minded women concerned about women's "healthcare", which is often anything but...please join us if you'd like more information or support.

Kind regards 

Elizabeth

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It isn't the only way, as I understand it, but we are often kept in the dark about alternatives, to keep the screening figures up. You can only get cervical cancer if you are HPV positive, and you can get an HPV test done privately. As the above poster says, you can Google Tampap, and request one of their tests, which involves inserting a tampon and sending this off for the cells on it to be analysed in a laboratory. It costs about £50. If you are under 30, the HPV virus is quite common, but nearly always clears up spontaneously, so it's not recommended for younger women, as they would get worried, when the odds are that their bodies will clear the virus in a short time. In my opinion, I think the HPV test should be the first test, which is done and not the smear, as some academics now think:

http://www.qmul.ac.uk/media/news/items/smd/101747.html

If the HPV test is expected to save more lives, why are we still using the painful crank and scrape method?

Please don't think you are alone in your problem, as it is a much more widespread problem than people believe.

 

While I still find the test ok to have, I realise I have been very uninformed about the whole subject. I agree that if there is a better test we should have it, it is totally unacceptable not to.

Also I didnt realise so many women felt this way, so apologies to mrs D. I shall waste no time in contacting my MP and the Health minister for northern ireland and add my voice to the campaign.

I'm one of those women who have had a bad time with smear tests and have also found them painful. The last one was during a postnatal assessment, when I was still very tender, and I found this so painful, I stopped having smears for 17 years after that. I'm no longer eligible for the programme now, due to surgery for other issues. I think it's only when you have problem that you start to think that there must be something better out there. In the UK they don't want women to find out about alternatives, for fear of women leaving the programme, but I think women should have a choice and be offered alternatives to the speculum test. In other countries, women who find this test unacceptable are offered alternative methods, such as the Delphi Screener,

http://www.delphiscreener.com/Home/DelphiScreener/Paginas/default.aspx

but no such luck for us in Britain. We have to put up with that old test, and all the harrassment that goes with not responding.

I do think women should be better informed of alternatives, and allowed to choose alternative self-testing methods if they so wish.

 

I do sympathise with you, next Mrs D, but I think the real reason we are not getting to hear about these new inventions, is that if women break away from the current regime and try out new ways of screening, it's going to collapse the present system, and they won't be able to keep tabs on women anymore. It is all about control, and surveillance over women's bodies. I find it all very big brother like. I can understand that they are desperate not to let any women fall through the net, and die of cancer, but must all women be rounded up like this every few years for all their adult life, and men not have to go through this at all? Are we not all adults

I just attempted having a smear on Friday.  I have been having them for for nearly 30 years and find very few nurses can do them without hurting me a lot!  I tried for my usual nurse who is so gentle that you hardly feel it but the receptonist could not find an appointment with her.  I told the nurse I did get that I find smears very painful and they usually make me bleed.  Before they started using brushes, I used to end up having 3 smears as they always came back obscured by blood.  My gp told me not to go during my period and did not know what to say when I said it was the smear making me bleed as I was not having a period..  The latest nurse said I must always tell them that I find it painful and they will be able to do it without hurting me.  3 attempts later, she told me it was not her as she had done thousands, it was me tensing up.  I told her I only tensed up when she started hurting me and how come one nurse can do it without hurting me.  She said that I must be relaxed with the other nurse.  A load of rubbish.  I have had smears at gynaecology and contaceptive clinics before and some extremely painful and some fine so it definately depends on who does them.  I have an appointment with the nurse who does not hurt me in 2 weeks so fingers crossed!

Thanks to all who replied.

GOOD MORNING

i can also never understand why a alternative test has not been rolled out the smear teast is medieval, barbaric and belongs in the dark ages leaving women at the mercy of sadistic nurses. i was subjected to a serious assault during a smear test which caused me such extreem trauma  i was unable to speak about it for 3 months and when i did complain it was firstly ignored by the practice manager

i then went through the correct complaints procedure but the nurse denied what she had done so its her word against mine. i will never put myself in that position

again.