Jade Goody

Just read an interesting opinion on all this:

http://www.guardian.co.uk/media/2009/feb/17/jade-goody-cancer

That is interesting, but I disagree with some of it. It says, "Let's hope that the people who called her Miss Piggy and an "evil" racist are now wishing they had not done so." Why? The fact that she did and said some despicably racist things has absolutely nothing to do with her cancer. There are two completely unrelated things. I can on one hand loathe her racism and on the other hand feel dreadfully sorry for what's happening to her now. I don't regret calling her an evil racist, however.

Upon returning to England I was shocked to be told that an NHS cervical smear test is scheduled for women only once every three years, compared to the US recomendation of an annual smear test.

I don't care if they say it's slow growing, as someone mentioned, it depends on the immune system and other factors, and I believe three years could go a hell of a way in advancing cancer present. It ought to be brought donw to once a year just like the US -- this is one thing I prefer about the US way of doing things. As it is, I'm willing to pay for an annual but I firmly believe that this is something the NHS needs to change priority on.

Good points Chary.

Why be hypocrytical?  I don't like the girl, she is a thick opportunistic chav, but this doesn't mean I don't feel desperately sorry for her and her family.  Then again, I felt sorry for her children anyway.

Vicky

What concerns me about the UK system is that according to this thread, http://talk.uk-yankee.com/index.php?topic=35048.0, women are not invited to their first smear test until they are 25 years old. My American gynecologist advised me to have my first smear test at age 18 or when I became sexually active, whichever came first. In the UK, are women advised to have a smear test when they become sexually active, or is it 25 no matter what? Because cervical cancer is usually caused by HPV, I am worried that an HPV infection may go undetected (not all strains cause genital warts, and those that don't cause most cases of cervical cancer) in a sexually active woman younger than 25. I was shocked at how aggressive my dysplasia/dyskaryosis was, and my first abnormal smear test ever was less than a year ago. I just turned 26.

She's no age at all.  She'll never live to see 30.

I had a LEEP procedure, too, before I had children.

And given the NHS has raised the minimum age for a smear test to 25 despite the fact that girls are becoming sexually active at younger and younger ages, the future may sadly see more Jade Goody's. :\\\'(

If it's been more than a year since my pap smear, I try to go to Planned Parenthood and get one done when I'm in NY.

Upon returning to England I was shocked to be told that an NHS cervical smear test is scheduled for women only once every three years, compared to the US recomendation of an annual smear test.

My insurance was with Kaiser Permanente (in the US) until recently. Their current policy is that if your pap comes back okay, you don't need to be tested again for 3 years.

[I don't know *exactly* what 'okay' means, though; or what constitutes 'not okay' in their eyes. But I certainly wasn't covered to get one for 3 more years. ]
 

When I was 22 I scheduled a smear test because I had never had one, and I'd heard you were supposed to have them annually.  The doctor asked me why I wanted the test, which really surprised me.  I said I thought I should have one to be sure I was healthy, and he just shrugged.  I haven't had one since.  Can you get them on the NHS, or do you have to go to a private ob/gyn?

These cost-cutting measures by private and public insurance entities worry me. In my opinion, three years between smear tests and/or waiting until you are 25 for your first one is taking a gamble with your health.

***

As I write this, I am researching the screening guidelines. Apparently, the US recommendation of first test at 18 or onset of sexual activity is out of date. Now, the recommendation is within three years of first intercourse or at the age of 21. The medical community says that many young women will contract HPV in their first few years of sexual activity. For most of them, their immune system will clear the infection within a year. A screening during this infection "window" will reveal abnormalities that might clear up on their own. Increasing the age of first screening will have given the body enough time to defeat the infection and eliminate the need for unnecessary medical procedures.

Here is the link to the article I paraphrased: http://www.olsoncenter.com/home/index.php?option=com_content&task=view&id=153&Itemid=32,

But what if you are in the group that doesn't clear the virus? Let's say you are a 21 year old girl eligible for the NHS, you contract HPV, but your body doesn't clear the infection. You will go four years before your first screening! What might your cervix look like then?!

loveaturtle, I am really impressed that you took the time to research the screening guidelines.

The UK system is never going to be like the US system and it comes down to money. It is based on statistics and cost analysis.

The official answer to your why 25 query is on page 8 of this: http://www.cancerscreening.nhs.uk/cervical/publications/cervical-annual-review-2008.pdf

If you up for some dry, official reading, here is the policy itself: http://www.cancerscreening.nhs.uk/cervical/publications/nhscsp18.pdf

I can't defend the policy completely, but for most cases, it does work. I have not followed Ms. Goody's story, but my guess is that she had the unfortunate luck to have been exposed to an aggressive strain of HPV early. It can/does happen. But don't forget that there are millions of women who have benefited from the NHS screening programme since it's start only 20 years ago.

The research in this area is ongoing and active. Our lab already tests samples for evidence of high risk HPV (as a group), and other labs can test for specific subtypes. This will become key as the testing becomes more affordable as women will be able to treated on an individual basis rather than as a statistic. The reality though, is that it is still a few years away due to the cost of these tests.

Remember, it cannot hurt to ask your GP to test you more often. You may or may not get anywhere, but the option of going private remains.

I can't defend the policy completely, but for most cases, it does work. I have not followed Ms. Goody's story, but my guess is that she had the unfortunate luck to have been exposed to an aggressive strain of HPV early. It can/does happen. But don't forget that there are millions of women who have benefited from the NHS screening programme since it's start only 20 years ago.

I'm not blaming the victim here (as anyone could have done the same thing, no one is perfect, etc.) but I read in the paper yesterday that Jade Goody did receive a letter from the NHS saying she had abnormal cells, inviting her to the next stage of treatment, and she is said to have thrown the letter away and not followed up on this medical advice.

If she did, it's not surprising. There are loads of women who hate going in for smears/treatment. My colleague, who is finishing her Master's in Cellular Pathology and is in charge of our HPV testing loathes to go in and she knows better. Another person in our department is in her 30's and has only been once in her life and only because we harassed her when we found out she had never been.

We are all ostriches about something. 

Could it have to do with the way their smears have been performed?

I have had very varied gynecological experiences - ranging from was barely aware anything was happening to exceedingly and unnecessarily uncomfortable and painful.

I've known women who have been to a gynecologist once and then been put off ever going back.