Hello everyone. I’ve been HPV+ for the last three smears (three positive smears over three years). I had a colposcopy last year and there was inflammation but no cell changes. I was referred back to one smear every three years which has left me feeling uneasy. I haven’t had any abnormal bleeding or bad symptoms (apart from 40-43 day cycles) so I don’t have reason to push for a smear this year. I am thinking of going private as I don’t trust the NHS guidance. What would you do?
Hi Lonrah. Personally I wouldn’t. But I would ask questions about the inflammation and what it means. Other than that I would take your results as a good sign and try to get on with things and forget about it for a while. They would not put you back onto 3-yearly smears if they were concerned about your colposcopy results. Clearing HPV within 2 years is only an average. It can take longer for some and some women can have persistent HPV and it never causes any cell changes. Having HPV does not mean you will definitely go on to develop changes and those changes if they happen, for the most part, happen slowly. If you are still HPV positive in 3 years you will be monitored annually again so if anything has changed, it will be picked up. Just make sure that if anything changes during that time for you, you see your GP, given your HPV status.
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Thank you. That does help!!
Hi Lonrah,
I would double check that, as I believe NHS guidance wouldnt put you back to 3 yearly routine recall if your latest result was HPV+ AND the one before it was also positive, irrespective of the colposcopy outcome. Unless something in the guidance has changed over the past year…
Up to this point my colposcopies always indicate that everything is normal, but as my smears show HPV+ each time i’m still on 1 year recall.
https://www.gov.uk/government/publications/cervical-screening-care-pathway/cervical-screening-care-pathway
So anyone who tests positive for HPV the FIRST time and has a normal colposcopy result IS put back on 3 year recall, but anyone who has a SECOND CONSECUTIVE hrHPV positive result and normal colposcopy should be recalled for smear in 12 months.
If it were me i would chase up with your practice, but ask the receptionist to put you through to the practice nurse to discuss!
As for going private, ive had the same considerations myself but havent done so yet. The NHS waiting is painful - smear results can take 8 weeks, then waiting for colposcopy appointment letter, then waiting for actual appointment, then results…
The main information you need is “do you still have high risk HPV after 12 months?” because you probably only need a smear if thats true. You can get an HPV test at high street chemists now, so i also considered getting one of those then going for private colposcopy if its positive (which is what the NHS do anyway it just takes forever) which would be so much quicker. If the HPV test is negative then NHS guidance is 3 year recall is fine (if youve no symptoms or concerns).
Im not a healthcare worker though, i can only go off my own experience and what Ive read 
Hope it helps though!
Hi Autumn thank you for taking the time to reply. I did chase that with the screening service to make sense of why I was put back on 3 yearly tests and they said the following:
You have indicated in your email that “colposcopy only showed inflammation”. Therefore no abnormal colposcopic changes to your cervix were detected at this time, hence the statement from my colleague “Individuals who have an adequate and normal colposcopic examination are at low risk of developing cervical cancer. These individuals are returned to community-based 3 year recall.”
“We understand that a return to routine recall can be confusing following a HPV positive test, but we would want to try and reassure you that this action forms part of the colposcopy management guidelines following intensive research into patient outcomes, prior to the implementation of primary HPV testing into the cervical screening programme.“
So yeah it’s a bit confusing. I will probably seek out a private smear test later this year (would be due in July). I’m not 100% convinced with the guidance either but admittedly I don’t have any other symptoms to cause concern.
Hi,
Yes its really confusing isnt it?!
We do have to put our trust in the healthcare professionals and the science behind it all.
It doesnt help that even their own guidance is conflicting - if you look at the document on thus page l, number 8, Flowcharts… https://www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management the cervical cytology (smear) guidance says one thing, but the colposcopy decisions for someone with +ve hpv and no abnormality, says another thing. So no wonder we a get different answers!
Im in the same boat, having tested hrHPV positive since 2016, so i know its a persistent case. I’m content enough with annual smears but there is just no way i could be relaxed enough to go 3 yearly! I would definitely go private if i get that advice this time around (my next annual smear is due in about 6 weeks, so we’ll see!). Hopefully the hpv will have cleared and it will no longer be a worry.
Edit- i should add here though that my smears do also show ‘abnormal’ cells sometimes, though colposcopy lady always says everything looks entirely normal. So in my case, its not just the hpv alone and maybe that does make a difference? After my first colposcopy, i got a letter saying i was discharged to routine recall, but then i got a letter at 1 year. It was as if the cytology screening service and the colposcopy service were not joined up at all.
Hi Autumn
Yes I know what you mean it feels a bit contradictory! I think it’s because I’ve never had abnormal cells. I will pursue a private exam next year at the latest as I’m not convinced by the guidance either. I think as I don’t have any extra symptoms I couldn’t push for another nhs screening so I will give myself peace of mind.
In the UK if you test HPV positive (the NHS only test for high risk strains) with no abnormal cells, you are recalled to smear in a year’s time. The same again if you are HPV positive for the 2nd time. If, at your 3rd smear recall you are still HPV positive with no abnormal cells, you are referred to colposcopy. This is to examine your cervix more thoroughly and to make sure nothing has been missed.
If you have no prior history of abnormalities (even if you have HPV) and there are none found at colposcopy, you are put back on routine 3 or 5-yearly screening depending on the area you live in and your age.
If abnormalities are found at any stage you will be referred straight to colposcopy and any decisions made from then on will depend on what is found and will take into consideration any prior history of abnormalities.
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Personally I would go private for the piece of mind, and you’re health is more important above all else! but before spending the money to go private double check with your GP if they will do a yearly test for you, sometimes doctors will do it to put the patients mind at ease if they are particularly worried (you may just need to nudge them a bit!)
