Cervical Smears, Cancer and Intimate Lady Chat

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You would have to been living under a rock to not have heard that Jade Goody (who started life as a Big Brother contestant) has terminal Cervical Cancer. No matter what you think of her now/then it’s difficult not to feel immensely sorry for someone who has terminal cancer as 27 and will be leaving two young children behind.

I have actually been ranting about the importance of Cervical Smears (or Pap Smears in the US) for some time to my friends… I am in my mid twenties and have had two (one last year). Whenever I have had the reminder letter, I haven’t put it off – it only comes through the door once every 3-5 years anyway. I was surprised to find that only ONE of my female friends have had a cervical smear – the rest said they would be too embarassed and found the whole things quite ‘gross’ so couldn’t be bothered.

Can’t blame them really – the idea of a cervical smear isn’t pleasant and the process itself – although different for everyone, varies between ‘ah – that was ok’ and ‘gerrofff me you bearded freak!’. Nevertheless, this isn’t an optional test, its something you have to do when the time arrives.

(I think we are particularaly bad for this in the UK. In the US I think, going to a gynaecolgist is more of a normal thing – in England you would only go when something is wrong.)

The friend of mine – the only one who had been for a smear actually comes from a family prone to this illness – which is why she had been fairly good with visits….although she was told on a visit that she had some mild abnormalities and had to go back fairly soon for another check up. She put it off…as you do….when she finally did go back, the cells had developed further because of the delay, not to cancer, but heading that way. She had to have evasive surgery to have some cells removed and still has to go back in the next few months too see if it has come back. She’s only 26.

Jade Goody had also ignored warning signs, being too frightened to go back to the doctors “When I heard I had more abnormal cells, I thought this is the fourth time I have been told I need to have the same operation now,” she told Heat Magazine. “Once you have them burnt off they should not come back, but I was too scared,” she added.

It was after she collapsed from blood loss for the fourth time in four years, that she realised she couldn’t ignore her condition. “The doctors were doing tests for my blood loss but they seemed unclear about what it could be. It was then that I was told I must have another operation on the dodgy cells on my cervix. They had sent a letter to me ages ago, telling that I needed to go in for an operation, but I had been too scared to do anything about it,” Goody confessed.

Technical Info:

Who’s affected

In the UK cervical cancer is the second most common cancer in women under the age of 35. Each year there are around 2,700 new cases.
What are the symptoms?

Often there are no symptoms when abnormal cells have developed or in the early stages of the disease, which is why women are encouraged to attend regular cervical screening.

When symptoms do occur they include:

* Bleeding after sexual intercourse
* Bleeding between menstrual periods
* Bleeding after the menopause
* Discomfort or pain during sex
* Unusual vaginal discharge

How is the smear test done?

* A doctor or nurse will gently open your vagina so they can see your cervix.
* They then use a wooden stick called a spatula, or a thin brush, to gently scrape off some cells from the surface of the cervix.
* The cells are sent away and looked at under a microscope to see if any are abnormal.

In the UK a smear test is free. You can request one from:

1. The GPs
2. Family Planning Clinics if you are under 26 (like Brook)
3. Sexual Health Clinic/Well Woman (there are plenty all over the country that run after work hours)
4. Hospitals FPC

I personally choose a Sexual Health Clinic after work and it was full of older women who I am guessing were getting the same thing done (not to mention a drunk, scary man who wanted to push in front of the queue to get free condoms….)

These clinics are run by women, you will be seen by a woman doctor or nurse so it’s not too bad.

My first experience was great – a doddle. I was about 21 and the doctor was the nicest. My second experience wasn’t as pleasant but not unbearable. Two doctors, one bolshy lady and her rather scared sidekick trainee. ‘Do you mind if my assistant watches?’ ‘Errrr’. Don’t let this put you off. You, like I, can tell this story to others for years…

It was also pushed on by the fact (yes, I had ignored the letter for a few weeks too) that my friend had just had her operation and I really felt that if I had anything like that happened to me – something that is preventable and curable if caught early, it would be my own fault for not looking after my health. After all the reminder was sent, the test is free, I could pretty much be anonymous in the clinic.

I did have to wait around for nearly an hour (that’s how it is with the evening clinics it seems).

Once it’s done (and it lasts for 3 minutes, max. It would be even quicker, but they asked me if I wanted to be tested for X, X and X and since it’s not everyday you lie there, legs akimbo with two women staring at you and a bright light shining down your poonani, I said yes, yes test me for everything, shingles, cradle cap, black lung – everything) you feel AMAZING. You feel kinda proud you did it and see – no one else saw. Now go and buy a lipstick (or five).

Once you get the letter saying everything is a-ok it gives you a great sense of comfort and you are ok for a few years! (Obviously – you still have to take care of yourself! Eat well! Practice celibacy!). If things aren’t so good – well at least you can do something about it. The worst thing would be leaving it so late that nothing can be done for you – as we’ve seen with Jade, that is a tragedy.

So if you haven’t had one yet, you should go, tell me what it was like!

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Comments

  1. says

    I don’t know about the rest of the girls in the US, but for me, I’ve had a pap smear done practically once a year since I was 18. Since I went to Planned Parenthood (a free clinic that takes donations) for birth control, they made you get 1 every single year. Now that I go to a private hospital, it’s required every 3 years unless you’ve had abnormal cells before.

    There’s also a HPV vaccination available here in the states that protects against something like 4 different types of HPVs. Since my insurance covers it, my doctor just gave it to me even though I’m married and have had normal pap smears for years.

    I only remember 2 bad experiences. One was my 2nd time getting it done, I was still REALLY young, and the doctor/nurse was super rude and brute. I was scared, and she’s just like, “it’s not like you’ve never had this done.” Yes, I’ve had it done before, but it was my 2nd time and it’s not like getting a metal clamp in your vagina is ever comfortable! I don’t quite remember why the 2nd experience was bad, but I hated it. Otherwise it hasn’t been bothersome. Gentle doctors or nurses who tells you to breathe, relax, etc. Better than getting a brazilian wax done! Well, until they shove your whole hand into your cervix to feel your ovaries or something like that. Then it hurts!

    Oh yea.. 1 of the free clinics I used to go to was located on the same street as Sephora. I really did reward myself to a lipstick/gloss/eyeshadow everytime I went!

    • Row says

      Hey Gloria!

      Sounds like you have it all sorted! I think in the UK now they have pushed the age up (When I was younger I think was invited at 21, now its 25) so really there aren’t that many checks – but if someone is worried it might be wiser to go regularly. As much as I HATE it, I would go every year if this was necessary…

      The HPV vaccination is I think, being tested in the UK on teenage girls. At my cousins school, the girls below her (aged 13) were offered the jab, but strangely enough no one else was. I told her to get it if they did offer it to her year but for some reason they wouldn’t. Ultimately prevention is better than cure – the US seem more on the ball with pushing these things through.

      I have to admit the second time I went I lied and said I hadn’t been before – I wanted them to treat me like a newbie but she was still rough! Had I not have had the first experience (and known what a good dr is like) it would have traumatized me a little.

      Still a clean bill of health is always good :)

  2. Elizabeth says

    I don’t agree with blanket and unconditional recommendations for cancer screening.
    Informed consent is a legal and ethical requirement for all cancer screening for a reason, all screening has risks as well as benefits.
    The pap test is intrinsically unreliable and produces lots of false positives resulting in over-treatment that can be harmful – cervical damage can lead to infertility, miscarriages, more c-sections, high risk pregnancy, premature babies and psych issues.
    Rather than just accept the need, I’d urge all women to do some research – look at your risk profile and the actual facts, sadly the latter won’t be coming from your Dr. In the UK, Australia and NZ, doctors receive bonus payments from the Govt when they reach a screening target for pap tests. (Financial Incentives Legislation)
    It upsets me to see so many women worried about this rare cancer, yes, rare!
    It occurs at the same frequency as mouth cancer and testicular cancer occurs almost as often. Few women benefit from smears – less than 1% (0.65%) BUT false positives are very common. 99.35% derive no benefit from pap tests, including the 0.35% who get false negatives. (R. DeMay article at Dr Sherman’s site)
    Angela Raffle, UK expert, told us in 2003 (BMJ) that, “1000 women need regular smears for 35 years to save ONE woman from cc”. See commentary at, “Why I’ll never have another smear test” by Anna Saybourn (online)
    An UN-screened high risk woman in a developed country has a 1% lifetime risk of cc. Low risk – LESS than 1%
    It’s therefore important not to allow over-screening (if you choose to screen) as that greatly increases the risks.
    Annual and biannual is over-screening and carry a lifetime risk of false positives as follows: 95% of women will be referred for colposcopy and usually some sort of biopsy in their lifetime with annual screening – almost all are false positives or for lesions that would never progress. Even 80% of high grade lesions will not progress or will regress. 2 yearly (Australia) – 77%-78% of their women will be referred…
    Three yearly (UK) – 65%
    This test causes huge over-detection and over-treatment for a very small risk.
    Finland has the lowest rates of cc in the world and just as importantly, sends the fewest women for colposcopy/biopsies – 35%-55% (depending on the research) – they offer women 5 to 7 tests over their lifetime – 5 yearly from age 30. No woman needs more testing than that…

    Women under 25 (some say 30) do not benefit at all from smears, but produce LOTS of false positives. Cancer is very rare indeed in this age group and the very rare case that happens tends to be missed by the pap test. (false negative)
    This is possibly because a very rare form of cervical cancer, adenocarcinoma, is often missed by the pap test. These women may be disadvantaged by the false reassurance and receive a later diagnosis.
    1 in 3 paps are “abnormal” in the under 25 age group and 1 in 14 in older women – almost all are false positives. If you get an “abnormal pap” remember there is less than a 1% chance it’s cancer or a real problem.
    You can get an abnormal pap for infection, inflammation, irritation (condoms, tampons, frequent sex), hormonal changes (pregnancy, menopause) trauma (childbirth) and for perfectly normal changes to the cervix in women under 25 and in older women. Never allow a pap test if you’re pregnant or within 6mths to a year of giving birth – a false positive is very likely.
    Jade Goody was probably high risk for cervical cancer, but I believe the medical profession is to blame for her demise. Women have never received honest information about this testing and as such – we’re often making decisions in a vacuum of ignorance or being pushed into testing and treatment by doctors. (often doctors chasing target payments)
    No girl should be tested at 16, sexually active or not – it is VERY likely to be a false positive and then she may face traumatic and invasive OVER-treatment or a painful biopsy. This can cause damage to the maturing cervix, avoidance behaviour in the traumatized girl and even PTSD.
    An early very bad experience explains why some women ignore symptoms, even severe symptoms.
    I’m not surprised Jade Goody avoided more “treatment” for abnormal pap tests after an early distressing experience.
    No asymptomatic young woman should ever be tested – no testing before 25 or even 30 protects these women from harm.
    As a low risk woman, my risk of cc is near zero, but the risk of a false positive quite high – I have always declined screening – an informed decision. Pap tests are not a law, they can only be an option. It is your decision, not your doctor’s decision, the Govt’s or your friend’s…YOUR decision.
    I find it sad that many women falsely believe this cancer is rampant – it’s not, false positives and unnecessary treatments and biopsies are common, cervical cancer is rare. Many women walk away from biopsies thinking they had cancer…when all along they had a false positive.
    Always get your pathology so you know where you stand and don’t agree to a cone biopsy until a punch biopsy has confirmed it’s necessary.
    Avoid LEEP as it conceals over-treatment – there is nothing left for pathology – these women often believe they are “cancer survivors” – MOST unlikely.

    Be careful with mammograms as well, once again, we haven’t been told the truth.
    Fortunately, the Nordic Cochrane Institute have produced something to inform women. “The risks and benefits of mammograms” appears at their website – a rare and unbiased summary. Although the English are lucky to have honest and ethical doctors like Professor Michael Baum, Angela Raffle, Dr Margaret McCartney and others.
    Anyone interested in reading up and making an informed decision – go to Dr Joel Sherman’s medical privacy forum and under women’s privacy issues you’ll find the holy grail of REAL information on screening.

    • Row says

      Hi Elizabeth

      You obviously know a lot about this subject, and have a lot of facts and figures and it makes for interesting reading. Do I understand all of it? Honestly, no. But I’ll do my best to respond.

      I agree that these tests are scary and false diagnoses are dangerous and can lead to unnecessary treatments. I totally agree with you that women need a second opinion and further tests before doing something that could be unnecessary and dangerous that risks their health more in the future.

      I don’t agree that doctors out there are all reaching for targets and is motivated only by money – plus, in this country I can get tested by a nurse, not a doctor and I’m pretty sure the nurse isn’t getting any big bonus for doing the routine procedure. One thing I like about the NHS is that doctors won’t just give me medicine because I am paying handsomely for it – they will turn you away if they think the medicine isn’t needed (perhaps sometimes, too often!).

      We get letters every 4 years or so in the UK and although we are informed of cervical smears at the age of 18, when a lot of people become sexually active, the literature does say that the chances of getting cervical cancer is low for women below a certain age but IF you want to have the test, you can. IF.

      After that treatments are not that regular. You never feel forced, in the UK and no one is going to chase you down the road to the clinic if you don’t want to have a smear (I know many women who have reached their 40s and never bothered to go for screening because of fear of the results).

      I disagree that ignorance is bliss. I don’t think the trauma and moments of uncomfortableness is better than being tested. This is MY opinion. If you feel you are low risk and and don’t want or need these tests then I wish you a long life and good health. There are surely though, other factors which can affect someone’s chances of getting cervical cancer. What if you have low risk but have many sexual partners without any protection, for example? Rare cancer doesn’t mean non-existent.

      Jady Goody – god rest her soul – was obviously traumatized by previous treatments, who can blame her for being scared? But they also warned her, she knew she was high risk, she should’ve had her womb removed and she chose not to and that cost her her life and unfortunately 2 little boys, their mother.

      Ultimately it is a woman’s choice and I am not saying that the tests are perfect. But if you do get an abnormal smear at least you can decide what steps to take next. And I don’t think that all women will crumble at the sight of a ‘abnormal’ result – I know my attitude would be ok, there *could* be something wrong, what do I do next to make it better?

      I am speaking as someone who had a friend who was low risk and never went for a smear because she found it humiliating, and because (her justification) she never had that many boyfriends anyway, because she was generally in good health – well, it turned out to have cervical cancer caught too late and she died at 31. She may be of that tiny percentage you mentioned but she was still a significant person to many people and the loss at times, is unbearable. IF she had gone for a test, even a few years earlier they would’ve found something. She *might* be here today.

  3. Elizabeth says

    Row, Your doctors (and nurses attached to these clinics) receive financial incentives to reach screening targets. There were some shocking examples of unethical conduct in the UK when the targets were very high – women were regularly insulted, bullied, harassed…things have improved in the last few years thanks to some amazing advocates for women’s right you have in the UK.

    In the States, Germany and Australia, women are over-screened and that sends huge numbers for colposcopy and usually some sort of biopsy in their lifetime – almost all are unnecessary and some women are left with issues as a result.
    It concerns me that most women have no idea what they’re agreeing to with cervical or breast cancer screening.
    I’m low risk based on my and my husband’s sexual history, but even if I were higher risk, I wouldn’t have pap tests – I’m not interested in an unreliable test for a rare cancer – even 5 yearly testing from age 30 carries high risks.
    I would not be happy to have LEEP or cone biopsy after a false positive. I know women who’ve been through that ordeal.
    My health is important to me and, in my opinion, the risks are too high for such a tiny risk.
    Of course, I respect every woman’s right to make an informed decision, but it concerns me that few women are making informed decisions, most are acting out of fear and on misinformation. I don’t blame women, we’ve never received a balanced assessment of this testing – in fact, the screening campaigns are very one-sided and really don’t provide women with anywhere near the amount of information they need to make a proper decision. Many women are simply pushed into testing or are coerced into screening to get the Pill (The States) and that is unacceptable.
    I’ve seen so many women harmed by this testing over the years.
    We’re now seeing the fallout with women having issues getting and staying pregnant, premature babies and sadly, some women lose their babies when their cervix fails…
    Almost all of these outcomes could have been avoided…
    Women given the facts might make different decisions, low risk women might choose not to screen or screen infrequently & high risk might follow the Finnish program. No woman needs more than 5 to 7 tests over her lifetime – 5 yearly from age 30. Women should understand the risks with testing which are many, many times more likely than a diagnosis of rare cervical cancer. Given the facts, women could reduce the risk of false positives and harmful over-treatment. At the moment we have women testing every year or 2 yearly and when they’re under 25 and that carries very high risks for no/little benefit or women testing believing they’re having a reliable, risk free test for a common cancer – wrong!
    Whenever I get an opportunity I try to warn women about the risk of testing and not to allow over-testing or inappropriate testing – it’s a rare cancer and over-reacting to this tiny risk is likely to harm you.
    One third (at least and possibly up to a half) of the very small number who get cervical cancer have had a normal pap smear or a series of them – every woman should watch for symptoms whether she tests or not and even if her last pap test was normal.
    Women greatly over-estimate the risk from this cancer – almost every other cancer occurs more often. I find it amazing that women will have yearly pap tests BUT SMOKE – lung cancer is the No 1 cancer killer and takes a LOT more lives than rare cervical cancer.
    Sadly, the obsession with this rare cancer often diverts our attention from the real threats to our health.
    Sadly, the “watch and wait” approach isn’t working in Australia, women getting “abnormal” paps usually panic and want to be referred straight away. (according to my GP and the statistics) Few women realize many harmless things can cause an abnormal pap and cancer or a real problem is MOST unlikely. (less than a 1% chance of cancer or a real issue)
    Anyway, more women want the facts and thankfully, we have access to them today at Dr Sherman’s site and at the “Blogcritics and Unnecessary pap smears” site. The Violet to Blue site is also a great source of references.
    In the end, it’s a very personal decision, but making an “informed” decision to screen or not to screen or to screen less often, is always the right decision.
    I urge every woman to do her own research and make up her own mind about testing, it should be YOUR decision.
    Good luck, everyone….

    • Row says

      Hi Elizabeth

      Yes I am sure the doctors do get targets and financial incentives but that doesn’t mean that every doctor that encourages women to get tested is just financially motivated to do so, especially if they truly believe in screening. Women were insulted and bullied into getting cervical smears? If that is the case it is wrong – but I certainly know of no one who has been treated this way – as I said earlier, in the UK you get a letter then the ball is in your court.

      I agree with you that women should be provided with the facts, and should decide for themselves what to do. I agree that getting an abnormal result would be scary but I know from my own mother, who got one of these results, that she was told to wait 3 months, then 6 months to see if there were any changes…they didn’t rush into treatment.

      You keep saying it’s a rare cancer – I just don’t believe it is quite as rare as you say. I asked this question on my twitter and the amount of girls that responded to my question saying they knew someone who had died of cervical cancer or has been diagnosed with a pretty high percentage of a small number of women I was talking to.

      “I find it amazing that women will have yearly pap tests BUT SMOKE – lung cancer is the No 1 cancer killer and takes a LOT more lives than rare cervical cancer.”

      - These things are give and take I guess – we all have vices whether it’s drinking alcohol or eating too much and being overweight. Just because someone smokes doesn’t mean they can’t be concerned about other aspects of their health. I don’t smoke, I wouldn’t like to get lung cancer but I can’t get tested for lung cancer, I can get tested for cervical cancer. Rare or not I know enough people who have been affected by it for it to matter. It doesn’t matter if you tell me one person in a million gets it, because if that person is someone important to be then it’s devastating. Rare isn’t none existent.

      You have mentioned a few Drs and Sites and if ladies are interested they can research and look into this and decide what to do next. It will always be an individuals choice but I, personally, would always like to know what is happening with my body. If I were never tested and god forbid I should ever get the disease, because who can say?, I would be forever regretful of my decision not to get a 10 minute test.
      Sadly, the obsession with this rare cancer often diverts our attention from the real threats to our health.

  4. Elizabeth says

    Row,
    It’s entirely up to you whether you test or not.
    I would never tell another woman what to do, but I demand she be told the truth and given all the facts. That doesn’t happens with breast or cervical screening.
    My objection is the misinformation women receive from the Govt and doctors – also the lack of risk information.
    Almost all women who have a scare or think they had cervical cancer have had a false positive or treatment for lesions that would never progress…the cancer simply doesn’t occur that often, but false positives do…
    I firmly believe all women are entitled to the truth and an opportunity to decide for themselves free of pressure.
    I know women who’ve been harmed by this testing…and all were completely unaware of the risks before they tested and had no idea fewer than 1% of women benefit from the test. We can all gauge our level of risk…
    Even high risk women given accurate information can make changes to minimize the risk of false positives and over-treatment.
    Maybe you have never experienced the pressure to screen because you agree to screen, but I can assure you thousands of women resent the pressure and coercion they face to screen…that is unacceptable.
    Informed consent applies to women as well as men…
    The thing about incentive payments and treating women like targets – it places our doctors in a potential conflict of interest situation. These targets payments are worth thousands and are a strong motivator to get women into screening. If there is nothing unethical about these payments, they should be mentioned in waiting rooms and in brochures.
    Anyway, good luck with your screening, but I’ll continue to spread the word wherever I can – ultimately it’s up to each woman, but I hope in the future, more women will make informed decisions.

  5. Elizabeth says

    One last point and I’ll be off for good.

    “Nevertheless, this isn’t an optional test, its something you have to do when the time arrives.”

    I’m sorry, Row…BUT, that is an appalling thing to say to women. We are not sheep…of course it’s an optional test – all cancer screening is optional.
    ALL cancer screening tests carry risk to the healthy population and that is why informed consent is a legal and ethical requirement.

    I just wanted to add…don’t look to America – the over-screening and inappropriate screening of women sends 95% of them for colposcopy and usually some form of biopsy in their lifetime – shocking over-treatment for a rare cancer. The American well-woman exam is not evidence based and not recommended in asymptomatic women – they also carry risk – more unnecessary procedures and even surgery. 1 in 3 US women will have a hysterectomy by age 60. American women can’t get the Pill unless they agree to pap tests, bimanual pelvic exams, sometimes a rectal exam and a breast check. Many women feel they have no option but to get “used” to seeing a gynaecologist – all totally unnecessary and harmful. You should read some of the comments on blogcritics – I find it quite upsetting, so many women harmed…
    Our doctors do not recommend these things at all in asymptomatic women (apart from the pap tests) – also many US doctors require annual pap tests from teens (against their recommendations of 2 yearly from age 21 and 3 yearly from 30) and that greatly increases the risks.

    Clearly I disagree with several of your statements and believe they constitute
    poor and disrespectful advice to women – we’re not sheep who can be told to just have things done…nor is it wise to act out of fear.
    We should all act on the facts…
    It’s a shame that many women never look at the facts for themselves.
    You write well, you could make an amazing contribution by presenting women with the facts – the actual facts….if you look at Dr Sherman’s site – it’s all there for you to read.
    If after doing your research, you still feel the same way, that’s fine, but at least you’d see it isn’t a black and white issue and every woman should make her own decision. I don’t screen and never will – that is my informed decision – I disagree with the implication that the “right” decision is to screen – for many informed women the right decision is NOT to screen.
    Whether we screen or not is not all that important, as long as we have made an informed decision.
    Thanks for your responses anyway…
    I felt it was important to clarify that point.

    • Row says

      Hi Elizabeth

      Sorry but I don’t think my comment is “appalling” at all. I think it is appalling to scare a woman off having a smear test (god knows it’s quite a daunting thing to do anyway) and if there WAS something wrong with her – then I would feel awful. Women who read this site are smart enough to make their own choices. No one can be dragged to the clinic to have a smear test (in the UK) but friends and family can gently nudge. These are my beliefs, and you are of course welcome to yours.

      Of course cancer screening is optional. If anything, in the UK people find cancer too late unless they are good with doctors appointments – because apart from tests like the cervical smear, there are no routine cancer checks for the average citizen for cancer – the NHS can’t afford it. That’s a shame because quite frankly I would love to be offered regular check ups and exams. The way the system works here, a lot of working busy people don’t get themselves checked out until there is quite clearly something wrong.

      As for the US – I don’t know how it works over there so can’t comment.

      This blog is for opinions – that is the point of a blog. People do not always agree with me, I didn’t say – If you don’t go for a smear you are a moron who should be strangled….I said, girls, honestly if you can get tested, I think you should. Because this is my belief. If someone disagrees with me, they won’t go. But to say that I am talking to women like they are sheep is wrong – I don’t view women as sheep and quite frankly the ladies on here are smart cookies who can decide for themselves.

      You can disagree with my statements as I can disagree with yours. I actually think some of your views are dangerous but was polite enough to not call your views “appalling”.

      My friend who DIED at 32 from cervical cancer was terrified of cervical smears and the fact that she had other friends who had never been tested and told her it was “kinda gross” didn’t help even though I tried to nudge her the right way. She never tested, now she is dead before she even had the chance to truly live. Obviously this will not happen to everyone. But it DID happen to someone close to me, that is the fact. That is someone with low risk, that is someone who was in good health. It happens.

      You obviously have far more “facts” and “stats” than I do and I get that you are highly clued up on this topic and your choice not to screen is an informed one. Good for you. As I said in all my replies to you, women have a CHOICE. I never said they didn’t. I even said, if people want they can look up your sources and decide for themselves. I agree that over treatment is a bad thing. I don’t think that doctors should be given bonuses for reaching screening targets. If a woman doesn’t want to screen then that is her choice, I won’t judge. Will I make sure my aunts, mother, best friends continue to test? Yes I will. Once every 4 years they are invited and I will always encourage them to go because if they are in that 1% then I want them to have correct treatment so that I have them that little longer.

      Obviously we will have to agree to disagree here. Thanks for the interesting debate!

  6. Katie says

    I’d rather over-treat than under-treat. I’m in the US and I get a pap smear every year during my annual gyn visit. I think it’s a good idea to have an annual visit at my age because I want to know what’s up with my body and make sure things will still be in good order when I want to start a family. Visits are also important if you want to discuss birth control pills, IUDs, etc.

    I’ve known plenty of girls and women who had abnormal cervical growth, cervical cancer, uterine cancer, uterine fibroids, or ovarian cancer. Some of them were my age and some of them were older. I’d rather be safe than sorry!

  7. Mindy says

    Elizabeth

    “we’re not sheep who can be told to just have things done…nor is it wise to act out of fear.”

    You just spent loads of time scaring the hell out of me with the:
    “cervical damage can lead to infertility, miscarriages, more c-sections, high risk pregnancy, premature babies and psych issues.”

  8. EvilAngel says

    Sounds like someone get’s their “facts” from a conspiracy website.

    In the US doctors are paid by health insurance or work in free clinics so there are no financial incentives to undue Pap smears here. We have them beging at age 18 or when sexual activity is begun. Then we have them annually unless not sexually active, post menopause, or have had a total hysterectomy…then it is every 3-5 years depending on age and other risk factors.

    Birthcontrol can increase the risk of cervical cancer as can multiple sexual partners, early sexual activity, smoking, STD infections increase the possibility, as do family history, Diabetes, multiple births and many others.

    This is a great US based site dedicated to cancer prevention. http://www.cancer.org/Cancer/CervicalCancer/DetailedGuide/cervical-cancer-risk-factors

    Every woman over 18 should have a Pap smear….that is not my opinion it is proven fact. Early detection is key. Cervical cancer has a 99% survival rate with early detection. Why would anyone in their right mind risk their life for no reason?

    I thank you for reminding ladies to take care of their health.
    I do not appreciate someone giving false information because they are obviously anti pap smear.
    It is rare for a woman in the US to have a hysterectomy these days. They treat women to avoid hysterectomies. Of all of my friends here in the US 1 has had a hysterectomy and that was due to HPV that caused Cancer in her uterine walls.
    I am 37, have 4 children and have had a Pap smear every year since I was 16….I have never had anything but healthy results and have never been reccomended any of the paranoid excessive treayments suggested by the other poster. And I actually am considered high risk. So those US facts are totally false and my bet is made up by some website overseas.

    I will never understand why some people refuse to see through the paranoid ramblings and just find the REAL facts for themselves. I guesswhen she or someone she loves is afflicted perhaps she’ll see that someone handed her a load of crap!

    I applaud you for caring and reaching out!

  9. niki says

    Evil Angel Would you call the Australian Government a conspiracy site?
    http://www.nhmrc.gov.au/_files_nhmrc/file/publications/synopses/wh39.pdf Look at paragraph 3.2 “Cervical cancer is a rare outcome of HPV infection
    While persisting infection of the cervix with a high-risk HPV is necessary for the
    development of cervical cancer, it is certainly not sufficient.”
    And from the same paragraph:” ‘Furthermore, less than 0.2% of cervical
    cancers occur in women under 25″
    Paragraph 3.5.1:
    “The incidence of HSIL is highest among women in their twenties and declines rapidly
    with age. Even in the absence of screening, cancer is an uncommon outcome of these
    lesions. The combination of the uncommon cancer outcome and the falling incidence with
    age implies that there is a very significant rate of regression.
    Recent modelling data from the United Kingdom also suggest that at least 80% of
    high-grade intraepithelial abnormalities will regress without intervention (Raffle et al
    2003).”
    “most HPV infections acquired by
    women resolve without medical intervention”. (Forward iv.)
    Paragraph 6.11 6.11″ Balancing the risks of investigation and treatment with the risk of cervical cancer.
    Invasive cervical cancer is a rare disease. The annual incidence was below 15 per 100,000 in Australia even before the National Cervical Screening Program began (see Figure 2.2),but current screening is detecting some kind of abnormality in about 5000 women of every 100,000 screened”
    “one recent large retrospective cohort study has suggested that treatment by either laser conisation or loop electro-excisional procedure (LEEP) is associated with premature rupture of membranes resulting in preterm delivery (Sadler et al 2004). In support of this, a systematic review also concluded that women who had undergone LEEP were morelikely to have a preterm delivery (Crane 2003).
    Finally, concern has been raised that treatment may adversely affect fertility (Hammond and Edmonds 1990, Fox and Cahill 1991, Kennedy et al 1993) but this concern has not been confirmed.”

    Did you read that statistic? There was less than 15 per 100,000 before screening was introduced.
    I’m afraid Elizabeth is right.

  10. Dotty says

    I had somehow missed my smear for 6years, even though after the birth of my son i had asked about it, the response i got was ‘we’ll call you when it’s time for your smear’. In my stupidity i didn’t realise that it was something i could just book and have. I ended up being asked by my GP to go for a smear test after complaining of very low back pain. The smear itself, well the same as always, you lie there and talk to the nurse as though she’s a hairdresser and then it’s over. 3 weeks later i discovered i was pregnant, i was so happy! Then i had a phone call from the GP saying my smear test results were back and they had discovered severe changes of the cells, this is not cancer, but in need of attention. Having been to colposcopy clinic several times now, i’m due to be treated 3months after the birth, and although i know that currently the changes are not getting worse, they are certainly not improving either. I always thought that because i had not slept around my likely hood of getting changes in my cervix or cervical cancer were very low, and as such it never worried me, silly silly me.
    Please do not wait for symptoms, just go and get the smear done! It is no different to checking your breasts for lumps, and you wouldn’t not do that would you? If i had gone earlier I would not be faced with such an invasive procedure as i am now.

  11. Deb says

    Dotty, Look at abnormal pap tests in pregnancy on the CancerResearchUK site, hormonal fluctuation when you’re pregnant causes false alarms. Doctors shouldn’t test pregnant women and should wait for about a year after delivery before testing. The stress to the cervix during delivery causes false alarms as well.
    It will be nothing, this sort of thing is really common, but is almost always a false alarm.
    Try not to worry and enjoy your pregnancy.
    I had two very abnormal smears, painful punch biopsies and a cone biopsy, false alarms, all my path results were normal. My Dr said condoms might have caused slight inflammation and the test saw that as abnormal. I’ve lost some cervix and will have to be watched during pregnancy, I’m at risk of premature rupture of my cervix. I might need a cervical cerclage and that might cause an infection which could also threaten the pregnancy.
    I have very mixed feelings about this test. I don’t test anymore, I couldn’t go through any more and if condoms can send me off for all that, what is the point? I never knew the cancer was rare, but looking at the doctor’s forum, I can see it is…that’s comforting to know.
    Thanks for the info.
    Dolly, have a look at that site and it will put your mind to rest – it’s not good for you or your baby to be worrying about cancer when it is bound to be a false alarm.

  12. says

    Great post. I’m a HUGE believer in smear tests. Every woman should take up their appointment when they get it.

    I had to have laser treatment a couple of years ago and I dread to think what would have happened if I had put off my test even a couple of months.

    Please go to your appointments ladies. And if you have been putting it off- please make that appointment today

  13. says

    I gave birth to my 2nd son in January 2005, and soon after that began to get reminders that my smear test was due. Stresses of being a new mum again I put those letters to the back of my mind, it’ll never happen to me, right?

    In April 2006 I went for a smear test after I began having some symptoms, my smear came back abnormal and I was sent for a colposcopy, they took a biopsy and performed a Lletz, I thought no more of it.

    2 weeks later on May 19th 2006 I was called to the hospital where I was given the news “I’m sorry you have cancer.” my misconception that only old people and people get cancer was blown through the roof, I was 26 and fit and well. People say it’s like getting hit by a bus, words cannot describe how I felt when that devastating news was delivered, but thoughts quickly turned to “am I going to die?” I was given a brief outline of my condition and an appointment was made for me to see Mr Herod, who would be my consultant.

    A few days later I went to see Mr Herod who told me the cancer was confined to my cervix but I would need an MRI and a cystoscopy to confirm this. My options were a trachelectomy or a radical hysterectomy. After having 2 sons I decided my best chance of survival was to have the hysterectomy, and on June 27th 2006 the surgery was performed. A radical hysterectomy is where they remove the cervix, uterus, part of the vagina and lymph nodes in the area, as well as some extra tissue around them. I stayed in hospital for 8 days.

    It has been almost 5 years since I was given my diagnosis, and if things go to plan I’ll be taken off my consultants books in July. Do I want this to happen? No I don’t, everyday I think my cancer will come back, I get a cold and I worry needlessly that it’s returned, all because I became complacent with my body.

    A great source of info and support is http://www.jostrust.org.uk I have made some wonderful friends through this site, some of whom are no longer here.

    A smear test may not be the best thing in the world and so what if your embarrassed for all of 5 minutes, but those 5 minutes may just save your life.

    Cervical cancer in young women isn’t as “rare” as you think. I believe that all women should have the right to a smear test even under 25, do these women not deserve a shot at life too?

  14. Colette says

    ‘Deb’, who the hell are you to tell someone you don’t know that it’s ‘bound to be a false alarm’? You are in no position to say that to anyone just because this is how it was in your case.
    It would be great if every scare or abnormal smear was a false alarm but unfortunately this is not the case.
    It is better to be cautious and follow things through rather than thinking, it’s rare so it won’t happen.
    Fair enough if you don’t wish to be tested but you shouldn’t try and tell other women there’s no point getting tests done when clearly there is. Cervical cancer DOES claim lives and women shouldn’t be put off a simple examination.

  15. Row says

    There is someone posting on this thread under a selection of names, but with the same IP address. Whilst I appreciate that different people have different views, once you have shared your opinion it is NOT FAIR to comment under ‘disguise’ in order to trash other peoples experiences and opinions no matter how much you believe in your own. YOU HAVE ALREADY MADE YOUR POINT.

    Everyone needs to accept that people are ALLOWED, 100% to have their views and are allowed to share their experiences here. Any further obvious comments left by the same person shouting out the same old view points (and I have so far allowed all comments to stay up) will lead to removal of all comments and the closing of this thread.

  16. Elizabeth says

    Well here ia am wide awake and wirried because of ascheduled biopsy and colposcopy on Wednesday mornig. In my 20s I had pre cancerous cells removed after acolposcopy. Now I have tested positive for HPV , have an abnormal pap smear and I am nervous. I have had “abnormal pap results a number of times over the years and have been told “not to worry”
    I am worried.Just wondering what you think inmy situation. what are the chances they are going to find cancer? and how much higher are the chances because I already had pre cancerous cells removed 30 years ago? I am 52 years young.