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    (Original post by myblueheaven339)
    when i saw the doctor about the contraceptive pill i was told i should have a smear test within 6 months of becomming sexually active. this was four years ago and i have been denied one. personally i think any young woman should have access to one if they request it. my mum had to be treated at age 22 because she had an abnormal smear, if she'd had to wait until she was 25 she might have died. cervical cancer usually has no symptoms until it can be fatal.
    Cervical cancer is usually only asymptomatic in it's early stages. Later on (while still often treatable) it can present with vaginal bleeding, pain etc.
    Smears don't strictly detect cancer, they detect changes in cells which may, in about 10 or 15 years, turn into cancer (but they may not). So if someone would have had a first abnormal smear at 22, it's unlikely that at 25, when it would now be picked up, it would have changed in a way that would have altered prognosis.
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    (Original post by myblueheaven339)
    when i saw the doctor about the contraceptive pill i was told i should have a smear test within 6 months of becomming sexually active. this was four years ago and i have been denied one. personally i think any young woman should have access to one if they request it. my mum had to be treated at age 22 because she had an abnormal smear, if she'd had to wait until she was 25 she might have died. cervical cancer usually has no symptoms until it can be fatal.
    can't you go back to that doctor and he make a request that you have one or go to a different sexual health clinic? If it runs in your family in that sense you should definitely be allowed to have one now, surely?
    I'd personally try other doctors, since I've had issues with the health centre I'm registered with here, it's useless. i'm sure that is not true of all health centres though. I received excellent care from every other doctor in the UK, except the ones at my college, who are more than just useless, i think they are the worst doctors on earth.
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    (Original post by Spencer Wells)
    No. The NHS guidelines suggest that you don't have a smear until you're 25, but if you present with symptoms such as post coital bleed and you are younger than 25, you will still be offered one. The reason that normal screening doesn't start until you're 25 is that cervical cancer and it's premalignant changes that you can detect aren't usually seen in women younger than this age, so it's not cost-effective. If, however, you have a family history of cervical cancer, you should request smears from an earlier age.
    Ahh really? I'm getting a bit worried about it myself as a lot of the women on one side of my family have been treated for cervical cancer at some point, my mum when she was 18
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    (Original post by Adarah)
    can't you go back to that doctor and he make a request that you have one or go to a different sexual health clinic? If it runs in your family in that sense you should definitely be allowed to have one now, surely?
    I'd personally try other doctors, since I've had issues with the health centre I'm registered with here, it's useless. i'm sure that is not true of all health centres though. I received excellent care from every other doctor in the UK, except the ones at my college, who are more than just useless, i think they are the worst doctors on earth.
    he's retired! i keep getting told to wait til im 25!
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    (Original post by Spencer Wells)
    Cervical cancer is usually only asymptomatic in it's early stages. Later on (while still often treatable) it can present with vaginal bleeding, pain etc.
    Smears don't strictly detect cancer, they detect changes in cells which may, in about 10 or 15 years, turn into cancer (but they may not). So if someone would have had a first abnormal smear at 22, it's unlikely that at 25, when it would now be picked up, it would have changed in a way that would have altered prognosis.
    I'm a bit confused about this, as I'm not a medic.
    I've read that Jade Goody had abnormal smears since she was 16, so it was a known problem and although she went for regular check ups it seems it was allowed to develop into cancer. does that mean that the smears are actually bloody useless since they only actually do a proper check when something goes wrong - which would generally imply the cancer's been growing for quite some time and might not be treatable any more.
    It just makes we wonder what the point in the smears is? Surely once you have such a smear, the thing to do would be not to have smears again and again every year then, since it's known you have potential cancer cells already, but to have an ultrasound and some other kind of check up that actually is able to detect cancer rather than some smear test that can't? I've done some medical physics courses, so yes, I know ultrasound can't detect cancer, but it can detect abnormalities, which, if they show up in your cervix, should be cut out and examined straight away if you are known to be at risk.
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    (Original post by myblueheaven339)
    he's retired! i keep getting told to wait til im 25!
    have you tried a sexual health clinic and told them you are worried? I'm just asking, cause the people there seem to be a hell of a lot more understanding than any GPs. I find GPs quite pointless if it's anything more than a fever.
    Best thing is to get yourself a gynecologist.

    I grew up in Germany - health care seemed so much simpler there at times (although often a lot more annoying too, mind you, with all the beauracracy (can never spell that word)). Every second GP has an ultra sound and there are plenty of gynecologists anyone can sign up to for life, so you have one woman doctor who has one file on you who will know everything about you and treat you well. Here I've never walked past a surgery that said: 'gynecologist' now that i think about it. I'm sure they exist though, they are just hiding though.
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    jade goody was misdiagnosed three times, and now she has to have a hysterectomy
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    i might try a GUM clinic, but im moving to a different area in a fe weeks, so will try the GP there
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    Smears detect abnormalities in cells, termed "dyskaryosis." This roughly related to another system called "cervical intraepithelial neoplasia" (CIN). Dyskaryosis is graded as mild, moderate or severe, CIN is graded as CIN I, CIN II and CIN III. There are many reasons that smear cells can look abnormal, including precancerous changes, but also infection, puberty, and taking the OCP or other hormonal contraception.
    If the dyskaryosis is mild, the usual course of action is to repeat the smear in 6 months. Chances are that this repeat smear will be entirely normal. If it is not, you are referred for colposcopy, where a colposcopist will look at the cervix with a microscope directly to look for abnormalities. If the smear shows moderate or severe dyskaryosis, a referral to colposcopy is made immediately, without waiting for a second smear result.
    The results of colposcopy will advise management. For some people, it may be increased frequency of smears, for some people, it might by referral to a gynaecologist for their opinion, possibly resulting in surgery.
    Cancer is a diagnosis that can only be made after biopsy, which can be done by a colposcopist.
    I can't comment on Jade Goody because I don't know the details of her diagnosis.
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    (Original post by Hedgehunter)
    Well we think that colon cancer runs in the family, so my Dad and his siblings have a full check up every 5 years, which involves sending a camera up their anus (!) all the way to the colon which is painful...I will have the same I guess once I'm a certain age, its worth it of course.
    You're sedated at the time, which in most people totally knocks you out as far as you're concerned, so there isn't really any pain involved.

    There are multiple strains of HPV, and not every one is associated with cancer, and then only a few people exposed to the cancer-causing strains will actually develop problems. The vaccine is useful provided that you've not been exposed to the strains it protects against, so it's not as if any sexual contact automatically equals the vaccine being useful - it's less likely to be useful though.

    I also think they should offer it to males, considering it can cause cancer there too - and also it would enhance "herd immunity", ideally knocking HPV down to a very low level once most people are vaccinated. If the target is only to vaccinate 50% of the population, there's no way that will be achieved. Unfortunately I'm both too old and too male to be considered!
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    (Original post by Adarah)
    I'm a bit confused about this, as I'm not a medic.
    I've read that Jade Goody had abnormal smears since she was 16, so it was a known problem and although she went for regular check ups it seems it was allowed to develop into cancer. does that mean that the smears are actually bloody useless since they only actually do a proper check when something goes wrong - which would generally imply the cancer's been growing for quite some time and might not be treatable any more.
    It just makes we wonder what the point in the smears is? Surely once you have such a smear, the thing to do would be not to have smears again and again every year then, since it's known you have potential cancer cells already, but to have an ultrasound and some other kind of check up that actually is able to detect cancer rather than some smear test that can't? I've done some medical physics courses, so yes, I know ultrasound can't detect cancer, but it can detect abnormalities, which, if they show up in your cervix, should be cut out and examined straight away if you are known to be at risk.
    Have you ever seen pictures from an ultrasound next to pictures from a cervical smear (or, more importantly, from a cervical biopsy, which gets done if a potential abnormality is detected)? The biopsies are SO much clearer and minor abnormalities are far more obvious than they would be on ultrasound - in fact I'm not sure why they'd ever use ultrasound to detect cervical cancer. Given you can see the cervix with the right equipment, there's really no need for ultrasound there.

    I don't know the story of what happened with Jade Goody, but in general women with abnormal smears are followed up and given appropriate investigations (colposcopy, biopsy etc). It's not just a case of having to keep coming back for smears. The reason you have to go back every three years is because things change over that time (both towards and away from malignancy, interestingly).

    I really do get sick to death of defending the UK smear programme and trying to explain that it's not some "budget" version, it's based on proper evidence!
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    (Original post by fivebyfive)
    I think you can still get it through private clinics in the UK, as far as i'm aware it costs like £600 though! Chances are high that you were exposed to at least one strain the first time you had sex. Nevertheless, the jab does offer protection against many of the strains. Wouldn't worry about it too much though, most immune systems clear it within two years.
    i don't think it costs that much, i was going to go private but then my gp said she'd do it anyway (evne thogh i'm 16)
    i thought it was more like £300 (approx £100 per jab, depending on which brand you get. Merc is more expensive than Glaxo, but it covers an extra 2 types of hpv, which cause genital warts)
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    I've had genital warts before and I wasn't offered a smear test, can I demand one?
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    (Original post by Mithent)
    You're sedated at the time, which in most people totally knocks you out as far as you're concerned, so there isn't really any pain involved.

    There are multiple strains of HPV, and not every one is associated with cancer, and then only a few people exposed to the cancer-causing strains will actually develop problems. The vaccine is useful provided that you've not been exposed to the strains it protects against, so it's not as if any sexual contact automatically equals the vaccine being useful - it's less likely to be useful though.

    I also think they should offer it to males, considering it can cause cancer there too - and also it would enhance "herd immunity", ideally knocking HPV down to a very low level once most people are vaccinated. If the target is only to vaccinate 50% of the population, there's no way that will be achieved. Unfortunately I'm both too old and too male to be considered!

    How would you know, I don't though my Dad said that even though they do give you something for the pain (probably something crap like N2O) you are not fully sedated and can still feel it, especially since the procedure will last for at least 20mins unless they find something.
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    No patient in the NHS has the right to demand any treatment, only request it.
    The viruses that cause genital warts are not the same strains that usually cause cancer, so having genital warts does not in itself increase the risk. However, if you've been exposed to the wart-causing virus, then you may have also been exposed to the cancer-causing virus. Unless you have a proper reason to request a smear earlier (like a strong family history of cervical cancer, or symptoms) then it's recommended that you wait until you're 25 and are invited by the screening programme.
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    (Original post by Hedgehunter)
    How would you know, I don't though my Dad said that even though they do give you something for the pain (probably something crap like N2O) you are not fully sedated and can still feel it, especially since the procedure will last for at least 20mins unless they find something.
    I was under the impression it was morphine and midazolam, but could be wrong.

    (Original post by Anonymous)
    I've had genital warts before and I wasn't offered a smear test, can I demand one?
    Yes. You can also ask nicely.
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    (Original post by Hedgehunter)
    How would you know, I don't though my Dad said that even though they do give you something for the pain (probably something crap like N2O) you are not fully sedated and can still feel it, especially since the procedure will last for at least 20mins unless they find something.
    The standard line is "it's uncomfortable, but it isn't really painful" but I've heard mixed reports from patients from "I felt nothing" up to "It was the most painful experience of my life." Patients undergoing colonoscopy are frequently given sedatives such as benzodiazepines, which are also amnesics, so the patients don't remember the discomfort as being that bad.
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    (Original post by Helenia)
    Have you ever seen pictures from an ultrasound next to pictures from a cervical smear (or, more importantly, from a cervical biopsy, which gets done if a potential abnormality is detected)? The biopsies are SO much clearer and minor abnormalities are far more obvious than they would be on ultrasound - in fact I'm not sure why they'd ever use ultrasound to detect cervical cancer. Given you can see the cervix with the right equipment, there's really no need for ultrasound there.

    I don't know the story of what happened with Jade Goody, but in general women with abnormal smears are followed up and given appropriate investigations (colposcopy, biopsy etc). It's not just a case of having to keep coming back for smears. The reason you have to go back every three years is because things change over that time (both towards and away from malignancy, interestingly).

    I really do get sick to death of defending the UK smear programme and trying to explain that it's not some "budget" version, it's based on proper evidence!
    I'm sorry, i didn't mean to sound so agressive against the NHS or anything. I'm very much aware that smears are standard all over the world! It's just some times very frustrating for us non medics as we don't understand what is going on and things don't make sense to us. It's alright saying: 'just trust us doctors' when you're the doctor with the knowledge, but when you're a patient who is worried and things don't make sense to them, it can be frustrating.
    it's not just medicine though, nearlly all sciences suffer from this lack of communication. It can be hard make lay people understand why things are the way they are without being patronising or just worse still, just telling them not to worry and trust in them. It's hard to trust a source you've been let down by in the past, especially as they didn't even explain why they let you down, say sorry, or worst, not even admit they made a mistake!
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    (Original post by Spencer Wells)
    The standard line is "it's uncomfortable, but it isn't really painful" but I've heard mixed reports from patients from "I felt nothing" up to "It was the most painful experience of my life." Patients undergoing colonoscopy are frequently given sedatives such as benzodiazepines, which are also amnesics, so the patients don't remember the discomfort as being that bad.
    Ok, well I'm not in the medical field and neither is my Dad so perhaps he was just complaining of only a discomfort (albeit a big one). Meh, though Im interested in drugs that cause confusion, clever idea.
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    I think us men should scream sexism - the women would if we got the vaccine & they didn't :p:
 
 
 
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