Pap tests for people that are ace: are they needed?

[Jess212]

I was really glad to see this discussion. The thought of a Pap test has been giving me serious anxiety for the last few years. I have never had sex or even been fully naked in front of anyone since I was a child and so the idea of it is embarrassing and anxiety inducing. My mum really wants me to have one, she’s of the opinion that it’s better to be safer than sorry, which I get and in a way the peace of mind would be nice. But I just can’t make myself do it , I keep on telling myself I’ll do it next year  ( or when my general level of anxiety that I experience everyday has calmed down, which hasn’t happened) and next year I never do it. Even the thought of talking to my doctor about it makes me feel anxious and a little bit sick. I have been trying to research myself about whether I really need it or not but like you have said the advice varies. I’m still very undecided about whether I will or won’t have one. The thought of it hurting lots also puts me off and whether because I have never had sex this pain could be worse. 

[estherann]

Has anyone in the UK figured out how to get healthcare without submitting to these tests? Every time I go to the GP to discuss (unrelated) health issues that I've had since childhood, most of the appointment is about how I'm "overdue" for a smear test. I've told at least half a dozen doctors at the practice that I will never have one, and have written to the centralised database so I no longer get invitation letters, but every doctor I see is still determined to bully me into it. Last time I had a blood test, the nurse started lecturing me about it while the needle was in my arm collecting blood. I've tried changing surgeries but it didn't help - just meant all my notes were lost so I no longer have a record of the diagnostic investigations I've had so I'm back at square one trying to get help with health problems.

[Sister Mercurial]

1 hour ago, estherann said:

Has anyone in the UK figured out how to get healthcare without submitting to these tests?

I haven't figured out yet how to get healthcare without being hassled about them, but you don't have to submit to them.  My guess for the next thing to try in your case is if it's coming up in your file when you go into your GP surgery, then your file has not been updated with the opt-out you registered with the national database, which is a GDPR breach, so make an official complaint to the practice highlighting that they're breaking the law.  

[aneczyk]

You can get cervical cancer no matter who you do or don't have sex with. Personally I haven't gotten mine out of anxiety so I'm trying to find a gyno who will knock me out during the procedure. 

[everywhere and nowhere]

10 hours ago, aneczyk said:

You can get cervical cancer no matter who you do or don't have sex with.

But it's still much, much, much less likely in people who have never had sex. 99% of cases of cervical cancer are HPV-related. And it's not like taking the sample cannot cause iatrogenic damage by itself, so it makes sense to assume that in people who have a very low risk due to having never had sex, the risk could outweigh the benefits.

My view is that, anyway, anyone has a right to refuse. Caring for one's health can never be obligatory for adult people, they still may choose to make self-harmful or self-endagering decisions and it is within their rights. For some people it's much, much worse than "uncomfortable" and it doesn't make them wrong. For people who do not have extreme aversion to this kind of procedures, extreme nudity aversion and so on - I think that doing the test anyway could be prudent for people with a family history of non-HPV cervical cancer. But for others it's probably really not needed.

[Janus the Fox]

4 hours ago, everywhere and nowhere said:

But it's still much, much, much less likely in people who have never had sex. 99% of cases of cervical cancer are HPV-related. And it's not like taking the sample cannot cause iatrogenic damage by itself, so it makes sense to assume that in people who have a very low risk due to having never had sex, the risk could outweigh the benefits.

With an exception to a family risk, agreed it is a low risk.  Otherwise if any related symptoms arise, things should have to be checked out, even without having sex at all.  Is a good idea to not ignore any symptoms.

[Nern]

7 hours ago, everywhere and nowhere said:

But it's still much, much, much less likely in people who have never had sex. 99% of cases of cervical cancer are HPV-related. And it's not like taking the sample cannot cause iatrogenic damage by itself, so it makes sense to assume that in people who have a very low risk due to having never had sex, the risk could outweigh the benefits.

Agreed. I was reading about ways you can get HPV that aren't sexual, and one of the main ways was from an exam table that's not entirely clean. The other ways were from gyms or saunas, which I rarely go to. The only time I've taken my pants off at the doctor's office was to have a pap test done, so chances are, if I were to get HPV, it would be from getting the test done to check for HPV. How stupid is that?

[trytounderstand]

Just wanted to join the conversation... I live in an Asian country where by policy hospitals and doctors will NOT perform a pap smear on a virgin. I know because I have phoned the three biggest hospitals in my city and been flatly told they will not do it. According to them, if I never become sexually active, I will never have a pap smear. I still worry about HPV although I've never had sexual activity of any kind. In my country, there are labs that provide HPV urine tests, paid out of pocket, so that's what I do. Maybe this is an option for others who can't do pap smears or live in a country where doctors will not do it on virgins. 

[trytounderstand]

In my country, there are labs that provide HPV urine tests, paid out of pocket, so that's what I do. Maybe this is an option for you? Is it available where you live? 

[nanogretchen4]

Sexual orientation is irrelevant to your cervical cancer risk. Sexual activity, whether or not it was desired, enjoyed, or even consented to, can transmit HPV, which significantly increases the risk of cervical cancer. However, anyone with a cervix can get cervical cancer, even without HPV, and the risk increases with age, especially after menopause. That's why when they do a pap smear they test for multiple strains of HPV, but they also check for changes in cervical cells that can occur even if the HPV test is negative.

[Sister Mercurial]

Update, for attention of @estherann and anyone else in the UK who wants to know: my complaint to the ICO against the GP practice eventually succeeded, because I sent the ICO screenshots of the nuisance texts the practice kept on sending me after I told them to stop (the ICO already had records of my emailing the practice and telling them to stop).  So now, touch wood, GP practice finally seems to have stopped pestering me.  

[MinnieMouse]

Here in Sweden you get an invitation for a pap smear every third year if you’re 23 and oved. I’ve always cancelled beacuse there’s always this info text that says that you don’t have to take the test if you’ve never had sex. I went to a gynecologist earlier this year due to heavy periods and spottings. When I told the doctor I was a virgin he didn’t even suggest a pap smear, but a vaginal ultrasound. It turned out I had uterine polyps so I had surgery a couple of weeks later. 

[MarRister]

I already kind of went over this in another thread, but I feel like the more I look into it the more illogical it is to be pushing pap smears on people who have never had any sexual contact in any form in their lives. I also say 'sexual contact' because any genital contact with another person who has it could potentially spread it, so even if someone has not had penetrative sex, but has had contact in other ways like outer genital contact or genital contact with someone's hands or mouth, then there is still risk of HPV transmission there. 

 

Recent studies have shown that HPV tests are more reliable in detecting cervical precancer than pap smears, so there is some talk about replacing all pap smears with just HPV testing. So if there is no risk of having an HPV infection affecting the cervix, what on earth is the point? Somewhere between 95-99% of cervical cancers are HPV related. Breast cancer is actually the most common cancer in younger women 25-39 (even if considered rare in terms of breast cancer), which means that risk is higher than cervical cancer, yet they don't start pushing mammograms on women until 40 (unless if you have a known family history of breast cancer or are known to carry the genes that make one more susceptible).  Guess there is always the possibility to be that weird 1-5% that is HPV negative with cervical cancer, but they don't really know the causes of it because it is not well studied at all, and if your other risk factors are low it just seems unnecessary to me personally. But if it makes people feel better to have one then go for it, but I really don't think anyone should be pushing those with such low risk into a test that they really don't want and will likely have a bad experience with. 

 

I am no doctor though, and this is based on Googling things lol, but I don't have a lot of trust in GPs actually knowing the in's and out's of specific health issues unless they studied it in depth in their schooling and have kept up with current information (like having a focus on women's reproductive health or something as I have seen in some GPs bios). 

[RedwoodDreams]

This is my first time posting but I wanted to thank everyone in the thread for their thoughts. I am aroace agender and about to turn 21. I need to go to the gyno to get birth control to help moderate my periods but have been dreading it. I am not great at self-advocacy and had been worried about being pressured into a test. Seeing others' thoughts on the subject really helped me recognize that my feelings on the subject are valid. My mom had told me to "just get it over with" and my younger brother (AFAB) told me very directly "you do not have to let anyone touch you". My thoughts were very scattered on the subject and my anxiety kept increasing every time I thought about it. It felt like my emotions were screaming no and my mind was saying that this is normal and I should accept it. This thread definitely helped my anxiety to settle. Seeing that others had issues with this as well as reading what it tests for actually for helped me more than I expected it to. I am low risk and will not get a pap test done, at the very least not in the foreseeable future. I understand the risk but I cannot compromise my mental health right now. It took me time to realize that I am ace and even longer to happen upon this website. I truly cannot express how grateful I am that this community exists and that I can get advice from people who can put into words what I've been struggling to explain.

[Under the Radar]

6 hours ago, RedwoodDreams said:

This is my first time posting but I wanted to thank everyone in the thread for their thoughts. I am aroace agender and about to turn 21. I need to go to the gyno to get birth control to help moderate my periods but have been dreading it. I am not great at self-advocacy and had been worried about being pressured into a test. Seeing others' thoughts on the subject really helped me recognize that my feelings on the subject are valid. My mom had told me to "just get it over with" and my younger brother (AFAB) told me very directly "you do not have to let anyone touch you". My thoughts were very scattered on the subject and my anxiety kept increasing every time I thought about it. It felt like my emotions were screaming no and my mind was saying that this is normal and I should accept it. This thread definitely helped my anxiety to settle. Seeing that others had issues with this as well as reading what it tests for actually for helped me more than I expected it to. I am low risk and will not get a pap test done, at the very least not in the foreseeable future. I understand the risk but I cannot compromise my mental health right now. It took me time to realize that I am ace and even longer to happen upon this website. I truly cannot express how grateful I am that this community exists and that I can get advice from people who can put into words what I've been struggling to explain.

I'm lucky enough to have an excellent primary care doctor and she actually told me that it is not necessary unless I start experiencing symptoms. She told me she asked a gyno why it is necessary for someone who does not have sex to do pelvic exam and the gyno said it's outdated thinking to think that it's neccesary and is not needed. I had a yearly physical with another provider one year since my doctor's schedule was full and I need to renew my birth control prescription (use for the same reasons). She was ready to do pelvic exam and I told her that I'm not sexually active so my primary care doctor says it's not needed. I was nervous about getting pressured to do but she actually just moved onto the next thing and didn't pressure me at all! There's so many things that we could test for on a regular basis but don't because the risk is so low. I'm 30 years old and just had my first pap smear because I was having some abnormal symptoms. Everything came back normal and I don't plan on doing again anytime soon! Also, so you know if you are more comfortable with your primary care doctor you most likely can get birth control prescription through them and skip the gyno all together.