GYNO!

The jury is still out on how often a smear should be done. If you are not high-risk, there really is nothing wrong with every 3 years. Cervical cancer is very slow growing and women with access to screenings rarely die from it anymore. I am a screener and I only seen invasive cancer once a year if I am lucky. One reason that many women get them every year in the US is because it's a billable expense. The screening system in the UK also differs slightly as 100% of the cases are checked by two screeners. If you are a higher risk patient, then once a year or even more often can be warranted.

But this is exactly why I think it should be done more often in the U.K, as it's so slow-growing and you have only one smear test every 3 years, you only have that one shot of catching it and as we have had mis-read slide issues here too, high risk or not (aren't most cervixes pretty high risk, given the nature of the viral start to most cervical cancers?) I would prefer to have an annual shot at unusual changes being caught than wait for another 2 years.

TYou are right! The vast majority of cervical cancers are now thought to be caused by a virus that is sexually transmitted. If you are in a monogamous relationship with both partners remaining faithful, or practicing safe sex if you have more than one partner, technically you should be fine. But the truth is, we don't know if the virus can/does remain latent and there may be other factors as well. Your best defense is to remain a virgin your entire life.   

I am not advocating either system. I don't think either is a one-size-fits all methodology. I'm just saying that the majority of cases that I sign out as abnormal are mild, easily treatable cases. I see a handful of more severe, but still treatable cases regularly. Invasive cases are so rare that when someone in the office finds one, it is usually passed around so we don't forget what cancer looks like! The patients who come in regularly (1-3 years) are the ones who have things caught. The invasive ones are usually older patients with no listed history.

I see what you are saying Sheril, and I don't disagree. But I do know that there is no perfect system when you're trying to balance costs vs. patient care. The fact that the UK is switching to liquid based preparations will not help the NHS with costs either as both private companies that exist charge a LOT for their supplies/machines. Does it make reading the slides easier/more accurate? Maybe, maybe not. But here in the US, the difference between what the lab can bill an insurance company for a conventional smear vs a machine processed, liquid based smear is amazing! The last I heard, it was about $20 for a conventional smear made by the doc, and $70+ for a liquid based prep. Factor that out over the number of women getting smears each year and you can see why places with socialized medicine are looking for ways to trim costs.

This is only a tiny slice of the issues facing medicine and how it is practiced worldwide. We as human beings need to face some tough questions about who will be treated and how.

Wholeheartedly agree with what you are saying re: tough questions. Unfortunately, with the NHS, we hear about the finance being put into the services, then practically speaking, at GP level we see a very different story

It's incredibly useful to have your professional as well as personal input on this kind of thread- we're lucky- thank you for your responses I have enjoyed reading them.

No problem. I am WAY too happy to ramble on about it ad naseum.   

I am just finding this thread.  Does anyone know if they do thin prep here or not?  Also, how much is a visit to a gyno if you don't have health insurance?

The UK is switching to liquid based preps which includes both ThinPrep and SurePath (competeing companies~similar technology). How soon is another story. Some of the Trusts have already made the switch and others are in the process. Eventually they are all supposed to convert but it's quite costly. Just ask your GP. They should know.

Do you mean private insurance or NHS?

 

I guess either...  I've only been here a month or so, so haven't been yet.  I'm just trying to be as informed as I can on all of the options and then see what I'm most comfortable with.

I am going to let someone who is better informed step in here as I am still in the states BUT I THINK everyone is covered for their routine GYN exam under the NHS.

More experienced folk? Help? 

Your routine paps will be covered by the NHS.  They won't be done by a gyno, though.  If you want to see a gyno on the NHS, you'll need a referral from your GP.  Otherwise, you can go private and pay.

Your routine paps will be covered by the NHS. 

And dont forget... it's not called a 'pap' here... it's just a 'smear test'.
They might not know what you mean if you ask for a 'pap'.   

Does anyone know how much it is privately?  And, if I ask for an NHS referral and my GP gives one, but does recommend that he/she do the test, would that cost $$?  If so, how much?

 

Does anyone know how much it is privately? And, if I ask for an NHS referral and my GP gives one, but does recommend that he/she do the test, would that cost $$? If so, how much?

Hi Allison,
It is free. There isn't much point in paying for a private doctor unless you have the money to burn, really. I am quite picky about my healthcare and have been very satisfied with my treatment through the NHS. The surgeries (this is what we call doctor's office) might not look beautiful, but I have never had to wait very long, getting an appointment is easy and the doctors and nurses have all been really great.

NY NY - When I first got here I was really worried about getting appropriate gynelogical care, as I have had minor issues in the past.  I actually had a british friend back in the states who was a British trained OB/GYN and I asked him for his recommendation.  I wish I still had his email because it was really reassuring.  He said that he was very confident in the current system of having the GP's do the smear tests.  But that if I was nervous, to tell them all my concerns and just be informed.  He did say that if I  wanted to see a Gyn, that there are plenty of private doctors near Harley street in London and that an exam would cost £100-£200.  Certainly not a fortune, but I personally decided to give the GP a shot before shelling out cash for something that is covered by the NHS.  I was very pleased with my visit.  Even though my Dr doesn't seem to have all the whizzy gadgets like the Gyn back home, the test was the same, just no stirrups, but who says that is a bad thing!  Good Luck 

My GP uses the 'thin prep' smear test just like the one in the States.  She also works w/all the ladies, pregnant women and babies/children.  I've always felt confident about the care I get when I see her.  This is my second pregnancy w/her.

I have to say that I am very happy about the fact that in the UK routine gyn exams and smears are done by GPs.

I have gynecological problems and in the States, I always had to wait months for an appointment because I was put in a queue behind women having routine exams and women having uncomplicated pregnancies.

When I had my first gyn exam with a GP, I was immediately referred to a gynecologist, and my wait for an appointment was much shorter than the waits I had in the States.