Jade Goody

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. 

Agreed.  Denial is very powerful.

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.

I heard the same thing.

I could be wrong here (and don't have time right now to look it up), but I vaguely remember something about being able to have more frequent tests on the NHS if you have a family history, etc. I believe there are circumstances which will allow you to have a test more than the usually allotted once every three years. Anyone?

I know a few women who had strange cells show up and they had to go back yearly (Not sure for how long though)  I'd hope that if there was a history the same would apply.

I'm thinking of paying for it privately, though not sure how much it costs.

I could be wrong here (and don't have time right now to look it up), but I vaguely remember something about being able to have more frequent tests on the NHS if you have a family history, etc. I believe there are circumstances which will allow you to have a test more than the usually allotted once every three years. Anyone?

It's only if you have a history of abnormal smear and/or have had treatment in the past for dysplasia because most cervical cancer does not result from any sort of hereditary strain but from HPV, which is usually contracted through sexual contact.

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

This is my experience.  I've only been once and I know it's stupid but I just can't bear it again.  I'd rather have a tooth pulled without a shot than go.  I'm just in total denial about the whole thing at the moment but I know i'm an idiot. 

I know a few women who had strange cells show up and they had to go back yearly (Not sure for how long though)  I'd hope that if there was a history the same would apply.

It's only if you have a history of abnormal smear and/or have had treatment in the past for dysplasia

Ah. Thank you! 

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.

Yes! I was just about to say that. While all the smears I've had before were at worst uncomfortable, the last one was so painful I nearly cried! I don't think I'll ever take that gyno chair with stirrups for granted again.

If I hadn't known that they were not all like this, I think going back would have been problematic for me.

I heard the same thing.

I could be wrong here (and don't have time right now to look it up), but I vaguely remember something about being able to have more frequent tests on the NHS if you have a family history, etc. I believe there are circumstances which will allow you to have a test more than the usually allotted once every three years. Anyone?

My mum had some odd cells when we were kids and I was made to go every two years on the NHS from the age of 16 to be checked also...which was actually early compared to the norm of getting checked from the age of 21 at the time.

I heard the same thing.

I could be wrong here (and don't have time right now to look it up), but I vaguely remember something about being able to have more frequent tests on the NHS if you have a family history, etc. I believe there are circumstances which will allow you to have a test more than the usually allotted once every three years. Anyone?

I had a dodgy smear result in January 2005, resulting in being invited for a retest, followed by two colposcopies, followed by a LEEP procedure.  I've been invited for retests at least once per year in the past four years, and to give anyone out there hope who may be worried on your own behalfs, I can say that I've been clear for the past few smear results, and the NHS continues to invite me back every year instead of every three years, given my history.

I asked an English colleague about this subject, and she said when she was younger, she was a hypochrondriac and used to ask her GP for all sorts of tests (convinced that any symptom she had was the indication of something disastrous).  She was able to get a cervical smear before she was 25 just by asking for it.  Her belief is that if you request a smear, they will give it to you.  She also said that if that wasn't the case for all PCTs, one could always go to a sexual health clinic and ask for one there.  Whether anyone in the UK can in fact walk into their PCT or a sexual health clinic and arrange a cervical smear regardless of whether they are over 25 or have already had one in the past three years, remember the sayings "if you don't ask, you don't get", "the worst they can say is no" and "it doesn't hurt to ask". 

Good luck everyone.

The thing I hate about having a smear here is the fact that its done so casually, I would prefer to be in a gyno situation, I hate going to see the nurse and lying on the table, its not the smear I hate, I have had a baby! I can take the pain of the smear! Its just the informality of the situation that I find a bit embarassing (she says, just having had a bikini wax done by a stranger)

I've got a long history of abnormal smear results and the NHS were having me back every 6 months, no questions asked. As a matter of fact, my last nurse made sure I knew I should have one in March after I moved back to the US.

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

Thanks, Courtney.  I'm one of those people who always has to know "why?"

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.

I know that the NHS has to be concerned with the collective good and work with statistics, but just the thought that you might be that one statistical abnormality is scary. I agree, you always have the option to go private, and I will request an annual smear test when I move to the UK, even if I have to pay for them myself.

I went to get my first UK smear test yesterday and it took all of three minutes.

I was a bit surprised that a nurse did it, as well as what else was missing that I'm used to (certain womanly checks - breasts, etc..). 

In any case, I can honestly say that I was nervous about nothing. 

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.

Personally, I know nothing about the official guidelines and I don't care about the official guidelines - since when have any official guidelines been anything but bureacracy that often has little to do with what really happens and what is really needed?

All I can say is, when I lived in the US, I went to Planned Parenthood once a year for a routine check-up which included a routine annual pap smear and clearance for another year of being prescribed my birth control pill. It was my Planned Parenthood clinic who told me their normal policy is an annual check-up including the pap smear, even if it came back "normal" the previous year. This was my clinic's policy both when I paid for the privilege and aslo when I went to a "sliding scale" fee which, depending on my self-emplyed income which could vary from year to year, was sometimes next to nothing in fees -- but still for the health of the women they asked us to come back same time every year, sliding scale charity case or not, normal result or not.

I felt very safe with that routine.

I was glad to be on a schedule in which I was expected back same time next year to check everything out thoroughly; I felt my health was being well taken care of. I just don't feel comfortable with the idea of only every three years for a pap smear. After yearly care that just feels dangerously neglectful to me. A lot can happen in three years, especially if the "normal" result of the previous year was close to borderline -- that happens.

The thing I hate about having a smear here is the fact that its done so casually, I would prefer to be in a gyno situation, I hate going to see the nurse and lying on the table, its not the smear I hate, I have had a baby! I can take the pain of the smear! Its just the informality of the situation that I find a bit embarassing (she says, just having had a bikini wax done by a stranger)

Not sure what you mean by 'casually' and 'informality'?