The words “smear”, “pap test” and “cervical screening” can strike dread in some, and nonchalance in others. But it is important, and I’d highly recommend attending screenings when you’re due as it’s not often we get the chance to be on top of possible cell changes that can, in some instances, lead to cancer. That said, I’m also very much of the opinion that this is a personal choice; it is your body and it is up to you whether you attend, and, should abnormal cells need to be dealt with, whether you go ahead with any treatment. There are reasons for and against and only you can make the decision.

In the UK, the age of screening starts at 25, which has been hotly debated. Women under 25, who report gynaecological symptoms, are all too often overlooked for a smear because they’re deemed to be too young. Utterly ridiculous. After 25, you get a letter every 3 years thereafter to return for another test to see whether there have been any changes during that time. When you’re aged 50 – 64, this extends to every 5 years. For women over 65, only those who have had an abnormal result or who haven’t had a screening since 50, will be offered the test.

Disabled Persons Railcard

[  The Screening  ]

When you are due a screening test, you will receive a letter asking you to call your GP to make an appointment. It’s suggested you try to have the test done in the middle of your menstrual cycle, ie. roughly 2 weeks from the start of your last period. The test itself is pretty quick and is regarded as being relatively painless and straightforward. This does, however, vary between women. Your pain threshold is one factor, but there are also issues around where the cervix lies (ie. sometimes it can tilt backwards and make screening difficult, and in some cases women are asked to return for another go another day), pelvic floor dysfunction or implanted mesh etc can also affect the process. Some women find the test a breeze and hardly notice it has been done; a minority may find it uncomfortable or painful.

The test looks at any indication of HPV and cell changes, with the idea being that removing severely abnormal cells can help prevent them turning cancerous in future. The HPV virus sounds worse and more rare than the reality of it: nearly all sexually active men and women will have it at some point in their lives. This virus can cause cell changes (which may thus lead to cancer), so even though that may not be the cause in each case, it’s another reason to consider a smear. Of course, the smear test itself isn’t 100% accurate and sadly doesn’t detect all changes or cancers.

I won’t go in to the ins and outs of the procedure, but should you want to know more about it and prepare yourself or answer some questions you may have, Jo’s Trust has a great article on it here.

My first smear at 25 was fine, no problem whatsoever. Second time around at 28 and I had to return twice for the pap, and twice afterwards for treatment. It was very painful – eye-wateringly so – but I have other issues going on that could account for this. I then ended up having to have the treatment under general anaesthetic, which is only done in a limited number of cases, but I was grateful to have this option so that treatment could go ahead.

[  Results & What They Mean  ] 

Results in the UK via the NHS can take between 2-6 weeks. Most women will receive a “negative” and find that no abnormalities have been found. For 1 in 20 women, a smear may show a change and some low level abnormal cells. Low grade changes (known as CIN1) can resolve on their own sometimes, so treatment isn’t usually needed. For 1 in 100, moderate changes (CIN2) may be found. This is called dyskaryosis. For 1 in 200, high grade/severe dyskaryosis (CIN 3) is detected.

[ Treatment ] 

If CIN2 or CIN3 is discovered, you will be invited to an appointment, likely at a local hospital, for a colposcopy. This appointment is a bit like re-doing the smear and getting confirmation of the diagnosis; if treatment is needed, you’ll likely be offered to have it done there and then. This isn’t a bad idea as you can get it done out of the way and forget about it until your next screening, but there are cautions to consider, which the nurses will discuss with you before you decide. During colposcopy, a biopsy is usually taken and sent away to the lab to get a more definitive diagnosis if needs be. It can go through your head as to whether the cells, especially if you’ve been told you have severe changes, show cancer, and it’s a worry that you can’t really get rid of. That said, it’s incredibly rare for a smear/colposcopy to show cervical cancer.

The most common treatment seems to be the LLETZ procedure (Large loop excision of the transformation zone)You can read more about this and what to expect, along with the other types of treatments, here. After the treatment, more samples are sent away just to re-confirm that the cells were as anticipated. This can take a couple of weeks, and as someone who’s still waiting for her results I can attest to it being something that challenges your patience when you simply want some peace of mind.

Treatment can reduce the risk of cervical cancer developing by 95%, which is quite reassuring. If you’ve had abnormal results and/or treatment, you will likely be more carefully monitored and have more regular smears too, just to ensure everything is going okay.

[  Say Yes To Screening & Treatment?  ]  

What I will say in favour of the process of getting a smear and treatment is that things are far more efficient these days and whilst it will of course vary, I was fortunate in finding nurses and specialists to be very reassuring, gentle and pleasant. They stress that the choices are up to you and that you are in control. If you want the test to be stopped, just say so. If it hurts, speak up and let them know. If you have a question, you are given the time and space in which to ask it. They know that smears and cancers and tests are words that instil worry and panic, which is often what makes women apprehensive to go for screening. Once you realise that the process is made as painless as possible, as comfortable as possible, and that even though you think it may be embarrassing they really have seen it all, it becomes more bearable.

I personally think it is a good opportunity because it’s not often a test is offered that can detect cell changes and give you a slight upper hand in dealing with them, giving you a chance to take some control back over your health. I also understand, however, why some may not wish to have screening or treatment. The risks, all be them fairly minimal, with treatment are still risks nonetheless. The likelihood of pre-cancerous cells turning cancerous is debatable and there is a belief that perhaps screening can cause stress and worry unnecessarily. From my perspective, I’m glad I had the smear done and grateful to have had the treatment, despite not having the best of experiences with either.



 

 

12 thoughts on “Ladies – Let’s Talk Smears!”

  1. I’m not sure how it ‘officially’ works in NZ, but I started getting reminders when I went to a Family planning clinic. I was told that once you’re ‘sexually active’, that it’s a good idea to start getting checks. I say just get it done, it’s awkward and uncomfortable, but it’s better to make sure everything is good

  2. Such an important topic-well done for addressing it. I remember seeing Jade Goody fall so ill so quickly, it was frightening. Personally I think women should be offered the option of smear tests as soon as they become sexually active. Would save a lot of bother in the long run.
    Great informative post 🙂 x

  3. Such a great, informative post. I am 44 and just had my pap and mammo done the past few months. Had a lump and was so scared but it all turned out well. It was very tempting to just ignore it though and I can see why a lot of women do, because it is scary. But we have to stay strong ladies! Early detection is a life saver!

  4. OMG you posted this blog on the exact day I had to go in for the test! What are the odds right? Anyway, I went in and we decided to talk everything through and do the actual test the next morning (i.e. this morning). But then overnight I had my period, probably due to all the stress over the procedure, which means we had to postpone for a week… So I’m booked for next week now, wish me luck. Sending my love, Ana

    1. What a coincidence! All the best for next week, you’ll be fine Ana. Hopefully you’ll get nurses as nice as the ones I had (which makes a change) so you can feel at ease and let them know to gentle or if you need them to stop at any point. xx

  5. I had to have a colposcopy and biopsy a few years ago now with this and I’m so glad I went, the slight discomfort of the treatment was way better than the alternative!

  6. I love your post, we are in control of our bodies and, as we can do what we want, we also have a responsibility towards ourselves. x

  7. I don’t have a choice, well I do, but my mom died of ovarian cancer so I’m at risk, or so they say. If I remember though they’ve recently changed it from every 3 years to every 5 years but my doctor may have been talking about something else. Mammograms used to be started at 40 but now it’s 50 I think. They are every 2 years accept me, because of mom. Thanks mom; every year for me. I used to ask my doctor every time if I could do every 2 years and every time she said no. I quit asking.

    It’s extraordinarily painful for me, physically, and also emotionally difficult because of trauma, even though my doctor is a woman. I always have to waste a therapy session on that. Any intrusion to my body is traumatic but at my age, there are various procedures all the time. It is what it is. Thank goodness I have a good therapist!!

    1. I’m so sorry about your mom, I can only imagine how tough smears and talk of cancer and ovaries must be. Just wanted to send you a hug and thank you for sharing that in your comment. It’s important because it’s our bodies, and everyone will have a different experience and different thoughts attached to having it done. xx

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