My experience with abnormal cervical smears and the NHS

I thought I would start my own thread, having seen this topic raised in a separate thread.  Here is a history of my experiences having cervical smears in the UK under the NHS:

In January 2005, I had a cervical smear at an NHS clinic in south London, and it came back abnormal.  I was invited to have another smear 6 months later, which also came back abnormal.  I was then referred to my local NHS hospital for a colposcopy. 

In August 2005, I moved to another part of London, and I had gone back to the original clinic for the 2nd smear until my patient records transferred across, then I carried on with my new GP and NHS hospital located in west London.

To make a long story short, I have continued to have abnormal smears, and I continue to be invited to have new smears every 6 months and I have been invited to have 4 colposcopies in total (my fourth one will be next month).

Each time I have had a smear, my results have come back with a detailed letter saying that no cancerous cells have been found (yet), but that they need to continue to check regularly because my body is not returning to normal on its own nor with the help of the colposcopies.

At each colposcopy, the doctor has been very helpful in explaining things to me, and up until my third one, I looked at the monitor as I was invited to do as the doctor was performing the procedure (by the third time, however, I had lost interest).

So what is my point?  I am merely documenting the care that I have received under the NHS, which is that they have invited me to have the smears every 6 months as well as the regular colposcopies to try and stop the irregularities found.  I have no reason to believe that the NHS will not continue to invite me for these regular smears (and colposcopies) for as long as the results are abnormal.

I hope (and would expect) that everyone in my situation would receive the same level of care.  I also hope that this allays any fears people might have about the frequency of smears that someone will be allowed to have under the NHS, once an abnormality has been found.

I have just crossed my 7 year mark of being a UK resident, and I have always (touch wood) had good experiences with the health care that I have received under the NHS.  I have complete respect and admiration for the health care providers and support workers within the NHS and I hope its problems at the top are adequately dealt with so that this country can continue to provide socialised health care for everyone.

I've had a similar experience - abnormal smear followed by colposcopy. Though only once so far thank goodness! I hate having the 6 monthly smears though. I know I need them but for some reason, the nurses always have a really hard time getting what they need.  It is a very uncomfortable experience for me. I'm also a real wimp and got so bent out of shape, I had to have a sedative for the colposcopy.

i've had two "gyn" experiences here in the UK.  one at a smear and the other had a sexual health clinic.  the smear was done by a nurse- no stirups.  the other at the sexual health clinic was done by a rough/male dr- with stirups (i say rough b/c it was the other "exam" i've ever had where i bleed (not spotted/bleed) (sorry if TMI) for a day or so).

i find the no-stirups quite difficult. 

at the smear- the nurse did NOT do a manual exam- (you know with her fingers and the other hand on my tummy).  is that an essential part of the exam? 

all in all... i'm happy with my level of care in terms of my insides.

at the smear- the nurse did NOT do a manual exam- (you know with her fingers and the other hand on my tummy).  is that an essential part of the exam? 

I found that quite strange as well, that they did not examine the ovaries.  As well, there was no anal exam of the ovaries (the doctor can only feel the ovaries properly through digitally feeling them via the anus - gross I know  and I've only had two doctors actually do this and I've had ovarian cysts before)

Proactive health care for healthy people just does not exist here.  However, i am very relieved to hear that they took readings of abnormal cells seriously here and are doing good follow up care. 

The colposcopy is not a treatment for abnormal cells, however.  It's just an examination w/the colposcope and you can have a biopsy as well at the same time.

I don't understand why they wouldn't just do a cryotherapy - if the abnormalities are not so deep - or loop procedure to get rid of the abnormal cells rather than having you go in for smears and colpos over and over.

I've had an abnormal smear test back in the US.  I went to Planned Parenthood because I had no insurance.  I had a colpo and a biopsy at the same time.  My biopsy came back with abnormalities.  I volunteered the sample for research into the development of an HPV vaccine.

Instead of going back for more colpos, I had a LEEP and then a smear 6 months later and once that was clear you could go a year w/o another smear.

The colposcopy is not a treatment for abnormal cells, however.  It's just an examination w/the colposcope and you can have a biopsy as well at the same time.

I don't understand why they wouldn't just do a cryotherapy - if the abnormalities are not so deep - or loop procedure to get rid of the abnormal cells rather than having you go in for smears and colpos over and over.

Instead of going back for more colpos, I had a LEEP and then a smear 6 months later and once that was clear you could go a year w/o another smear.

Hi - you are right about the proper treatment, and my memory of the events is incorrect.  The 3rd "colposcopy" I had was actually a LLETZ (which is the same as LEEP), and although I had local anaesthetic, it didn't seem to work because I nearly fainted from the pain (I think this is why I got the story wrong - I blocked the painful memory out of my mind, but it has all come back now  )

Anyway, so after the LLETZ, I had another abnormal smear which is why they've sent me back for a 3rd (not 4th) colposcopy.

Thanks for posting, and helping me to set the record straight!  This is what happens when you get old like me...   

Oh dear lord you have hit the sorest spot I have with anything...much less over here.

About 6 months before I moved here in 2003, I had my routine smear which I get yearly. It was ALWAYS normal based on normal procedure. That visit, my doctor said I could pay extra for a colposcopy. I asked why and why extra. They said it was more accurate than just a smear and currently insurance companies weren't paying for it. I always agree on extra and for $50.00, I thought it was a bargain since I am convinced I'll die without ever having kids.

Anyway, she did the colposcopy and found abnormal cells. She said there was nothing to worry about but to come back in 6 months just before I left to recheck it. Of course, I had a panic and did major research on the subject. I saw it was common but still I worried.

I went back 2 weeks before I left and she said it had grown slightly and to come back in 3 months. I reiterated that I was moving and she said to phone when I got to Ireland so they could send my documents to the new doctor so I could get the LEEP done.

I got here and it took almost a year to even have anyone look at me. They all kept saying since I wasn't entitled to the NHS I couldn't be looked at. They all also said that they would do a smear first and if that was abnormal THEN they would do the colposcopy. Well, even with my OBGYN in the US, my smears were normal but the cells were there so it was going to be difficult.

I started panicing so I signed up for BUPA and paid a few hundred dollars so I could go to someone, anyone here to look at the situation. I found the best doctor who on the first visit did a smear AND a colposcopy. He said I did in fact have abnormal cells and I needed LEEP. He made my appointment for 2 weeks later and I had it done. He told me unless anything major happened with healing, to come back and be seen in 6 months then once a year for 3 years to make sure things were ok. I was completely happy with this. HOWEVER..............

In 6 months, I would be in NY because my visa expired and I had to stay there for a few months. I came back and thought (because they told me so) that BUPA would cover me. Nope, prexisting condition. I was almost back to square one. I had to go back to the original GP who wouldn't listen and they still didn't. It took me until last year to get a doctor to see me. All they would do was give me a smear. Of course, it came back normal. I tried to contact the doctor in Belfast that did the procedure and because the original jerk GP kept telling him they would see me, he said it was easier if I just went to my local GP. Part of that was that my LEEP was done so long ago that I don't think they realised I was never followed up on.

Now I am convinced I have cancer and the like as my period is longer and really painful. I have a new GP but none of them listen and say things like "This isnt the US. We do things differently here. If you get a normal smear, you don't need a colposcopy." They don't understand that I DO need one based on an operative procedure.

I am thinking of family planning now because maybe I can get a woman who will empathise. I just don't know what to do anymore. I can't afford care in NY and no one listens here.

Aw, hun - I'm really sorry to hear about your difficulties.  If I understand correctly, though, it sounds like the LEEP might have cleared things up because your last smear has come back normal?  I'm still waiting to have a normal smear, it's been over two years (with frequent checking during that time) since I've had one.

It does take time for things to change, so if someone would allow you to have another smear 6 months after your last one, I think that is your best bet.  But I am no expert on health care nor anything of a medical nature in any country, so if you want ideas on how to get someone to perform another smear, maybe a separate thread on that subject might attract some good advice?  Or even calling a medical hotline?

I do hope you can have another exam soon, and please try not to worry too much.

If I understand correctly, though, it sounds like the LEEP might have cleared things up because your last smear has come back normal

Actually, I hope that's the case but no smear ever caught the cells. It was a separate colposcopy that did. It's why I am so worried. I never had follow up with the actual procedure so I don't know if it cleared it up, damage was done, etc. I keep trying to explain this to doctors but no one listens and they refuse to get me to a professional even to just shut me up.