(0)
0 Items £0.00

Over 50s - interesting article in bmj

5 posts / 0 new
Last post
55
Over 50s - interesting article in bmj

https://doi.org/10.1136/bmj.n280

Hello everyone

I don't think I have managed to create a proper link above but I found this article in the BMJ published Feb 2021. It's by Clare Gilham, Emma J Crosbie and Julian Peto about cervical screening for older people who may have been missed before HPV first screening was introduced. There aren't very many of us over 50 on this forum but it might be worth sharing this information with your older friends and relatives! 

Best wishes to you all

A x

Abnormal smear hpv & severe high grade dyskaryosis lletz Sept 2019 polyp & nabothian cyst. Results hpv & mild cell changes polyp innocent Repeat colposcopy Dec 2019 test of cure January 2020 no high risk HPV present , colposcopy June because of discrepancy between initial smear & lletz- June 2020 colposcopy  all clear; next smear in 3 yrs August 2020 post menopausal bleed; TV scan; bleed hrt related & found small ovarian cyst said will check in 4 months; Letter from hospital saying no longer needed 4 month check as cyst under 2cm & contact them if I develop pain (if cyst bursts?)

Jazza
Jazza's picture

Hi 55

Many thanks for the link (btw it works fine) - very interesting.  I get very frustrated that the UK seems to lag behind a lot of other countries when it come to gynaecological health.  Deviating from the subject a little, I recently had an interesting discussion on social media with a lady from Belgium in which I mentioned that routine NHS gynaecological care in the UK simply consists of a smear test every 3 or 5 years depending on age.  The following is a precis of her reply:

'that's an awful system! I have to pay for everything but I can see a doctor or specialist (gynaecologist) whenever I want. I don't need a referral. I can also get a second or third opinion with other doctors. We have a system with doctors that have signed a convention and are only allowed to ask the social security agreed fee. Those who did not sign, can ask extra. Usually that is around €20 to €30 extra. We still get reimbursed the basic fee. Thankfully, we are encouraged to have a general yearly gynecology check up.

 

x

  • Feb 04:  (age 47y) Smear test normal
  • Stopped going for smears!
  • Summer 16: persistent watery yellow vaginal discharge
  • Dec 16: PMB
  • Jan 17: Hysteroscopy under GA for ?fibroids - abnormal cervix observed -multiple biopsies taken, 1B1 (1B2 on new FIGO) squamous cell cc diagnosed - confirmed by MRI/PET scans
  • Feb 17: pelvic lymphadenectomy - nodes negative, Da Vinci radical hysterectomy- close anterior margin/LVSI/PNI, restaged to 2A1 (2A1 on new FIGO)
  • Apr/May 17: 6 chemo, 25 external radio, 2 brachy
  • May 20:  NED.  Side effects notably hypotonic bladder since hysterectomy - ongoing ISC, unilateral lymphoedema lower abdo/groin/leg/ankle/foot
55

Hi Jazza

I agree; I have family and friends who come from other countries where all women have their own gynaecologist and some of them are quite shocked at the difference here; having said that a recent report by the RCOG acknowledged the need for improved health education and health services for women in the UK - it is called "Better for women" - I have to say I find many of my friends from abroad talk much more openly about their health and I think in the UK we tend to be shier about this - so I feel some of the responsibility lies with families to talk openly - watching "It's a sin" recently reminded me of how taboo sex was in the 1980s in the UK - I think things have progressed since then but we have a way to go. One thing that has shocked me in my journey on here is how low my health literacy was - I am quite squeamish about health stuff (you won't catch me looking at a colposcopy screen! ) but I am generally well educated - however although I had heard of HPV because of the vaccine I had no idea what it was. I am a great believer in vaccines so my daughter has had the vaccine but after my diagnosis last year I had a steep learning curve (as it seems have most women on here). Having read up on health literacy it seems the average reading age in the UK is aged 9 and health literacy is particularly low amongst over 65s who have limited or no internet access. I have discovered the NHS app which I find invaluable when I am ill and when caring for elderly relatives. I feel apps are probably the way to go with health education for the younger generations but those of us over 50 are I feel more difficult to reach unless we have the internet. To quote Columbo - and one more thing! Who is it that makes the decisions about women's health care and the frequency of screening & also the cut off point for the HPV vaccine being 45? Is it public health England or the NHS? My consultant told me that once you have HPV you have it so the best thing is to keep it dormant by looking after your immune system & practising safe sex so presumably there would be no point getting vaccinated even if I was young enough (?) - I have been celibate for more than 20 years and so the only reason I can think of it popping up out of dormancy is the extreme stress I was under a couple of years ago and the onset of menopause which apparently also weakens the immune system - I am doing my best to look after my health but wonder how many other women are out there sitting on a ticking time bomb in blissful ignorance? I do quite miss being blissfully ignorant but would welcome the self sampling being made a thing. I would like to see the screening age raised to 74. From my research I have discovered there are international conferences for discussing the screening programmes such as those lead by the WHO. I am also grateful that we have the screening programme in the UK as I understand the mortality rate in some other countries is extremely high because there is little or no screening and vaccination. I am quite worried that I have to wait a few more years until my next screening but am considering going privately for an annual check or odering a self sampling kit online. However if I tested positive again would the NHS treat me if I wasn't yet due for a screening? I can't afford the treatment privately and would not be covered under the insurance because of my former treatment and so would have to ask for NHS care.  For the time being - now that I am over the worry and shock of last year I am trying to reduce my stress levels and definitely be more proactive about my health. Sorry for the long rambling vent! I do sometimes feel I should stop coming on here and get on with my life but this is the only place where I don't feel alone with it!! Let's hear it for Jo's! Thanks again for your reply

A x

Abnormal smear hpv & severe high grade dyskaryosis lletz Sept 2019 polyp & nabothian cyst. Results hpv & mild cell changes polyp innocent Repeat colposcopy Dec 2019 test of cure January 2020 no high risk HPV present , colposcopy June because of discrepancy between initial smear & lletz- June 2020 colposcopy  all clear; next smear in 3 yrs August 2020 post menopausal bleed; TV scan; bleed hrt related & found small ovarian cyst said will check in 4 months; Letter from hospital saying no longer needed 4 month check as cyst under 2cm & contact them if I develop pain (if cyst bursts?)

Jazza
Jazza's picture

Hi 55

To pick up on your point about self sampling being made a thing; I gave a loud cheer when, just yesterday, an NHS trial of HPV self sampling on 31,000 women hit the main news.  So now the 'world' has heard - let's hope there's not too long to wait before it becomes mainstream.

I also agree about the screening age being raised.  The following article, which relates to the Danish screening programme, states that mortality rate for cervical cancer is 5 times higher among women age 75-79 compared to those age 40-45!:  https://www.sciencedaily.com/releases/2019/04/190403101105.htm

x

  • Feb 04:  (age 47y) Smear test normal
  • Stopped going for smears!
  • Summer 16: persistent watery yellow vaginal discharge
  • Dec 16: PMB
  • Jan 17: Hysteroscopy under GA for ?fibroids - abnormal cervix observed -multiple biopsies taken, 1B1 (1B2 on new FIGO) squamous cell cc diagnosed - confirmed by MRI/PET scans
  • Feb 17: pelvic lymphadenectomy - nodes negative, Da Vinci radical hysterectomy- close anterior margin/LVSI/PNI, restaged to 2A1 (2A1 on new FIGO)
  • Apr/May 17: 6 chemo, 25 external radio, 2 brachy
  • May 20:  NED.  Side effects notably hypotonic bladder since hysterectomy - ongoing ISC, unilateral lymphoedema lower abdo/groin/leg/ankle/foot
55

Hi Jazza

Thank you for your reply; I'm glad you agree with me about raising the screening age. Yes, the self sampling news was all over the press yesterday and is definitely a cause for celebration as a great step forward. Well done to Jo's Trust for their part in this. I wasn't aware of how high the rates were for women in their 70s. I will have a read of the Danish study. Thank you for sending the link.

A x

Abnormal smear hpv & severe high grade dyskaryosis lletz Sept 2019 polyp & nabothian cyst. Results hpv & mild cell changes polyp innocent Repeat colposcopy Dec 2019 test of cure January 2020 no high risk HPV present , colposcopy June because of discrepancy between initial smear & lletz- June 2020 colposcopy  all clear; next smear in 3 yrs August 2020 post menopausal bleed; TV scan; bleed hrt related & found small ovarian cyst said will check in 4 months; Letter from hospital saying no longer needed 4 month check as cyst under 2cm & contact them if I develop pain (if cyst bursts?)