Pap failure???

Does anyone know and/or have any statistics for how often a pap smear does not catch cervical cancer? I'm searing for info online, but coming up essentially empty-handed (except for a law firm that specializes in such cases! )

The reason I ask is because I had seven years* of perfectly normal pap smears--including one two weeks before my >4 cm cancerous tumor was discovered!--and I'm just wondering how often this happens to women and if the pap should be trusted as much as it is.

What's really super scary to me is that had I not started two weeks of heavy bleeding/passing clots two days after my last pap smear, my gyn would not have had any reason to explore further and would have totally missed the tumor!

*Seven years ago cancerous cells were detected and, supposedly, eradicated with a cone biopsy. After five years out, I was considered completely cured.

I've had 15 years of normal paps and had a punch biopsy that came back as adenocarcinoma in situ. Had a pap done moments before the biopsy. Had an endocervical curttage a couple days later that came back with CIN 2 as well.

From what my Gyn and Gyn Onc told me is that paps are pretty reliable at picking up cervical changes and glandular changes are missed more than squamous. This being due to the fact they are higher up in the cervical canal.

I was pretty shocked by this info as I have felt lead to belief that paps are extremely reliable. But like many medical tests, they are good indicators and not 100%. <sigh>

If you do find anything, please share!

Mine wasn't picked up on a pap either. From what I've gathered over the years most CC is caught by symptoms such as bleeding after intercourse. I just started to have irregular bleeding. Up until my cancer diagnosis I had had routine paps that all came back clean, not even an odd cell.

I was told that paps can miss cancerous cells because the gyne scrapes just a small area. If its not the area near the cancer...it can come back clean.

I remember a new type of pap test that came out a few years back. I didn't get the specifics but it was something like a liquid test/wash that would pick up more cells than the scraping does. Does that sound familiar to anyone? At that point I had already been dx and just didn't care what they were coming out with because mine had already been missed.

Vega, I think you are talking about the Thin Prep PAP test, but it has been out for several years. It's the type of PAP smear I have received, and it still missed my cancer. And, I just found a JAMA article that was published on 10/28/09 that said traditional pap smears work as well as thinprep. I can't link to the article because I don't have a JAMA account - but I found the article here - http://www.massdevice.com/news/jama-...tive-pap-smear

Anyway, ccd, you sound like I did when I was first diagnosed. I don't understand how they could have missed my tumor. I'd been to my OBGYN 6 times since 2007 because something wasn't right. I've pondered how I could have so many false negatives. I gave up on focusing on why this wasn't caught sooner for me but it is in the back of my mind. I had initially pondered a malpractice suit, but I wouldn't know whether to sue my OBGYN or the laboratory that misread my slides. False negatives are more common on slides from what I found. Here's one website with some helpful information - http://www.ehealthmd.com/library/pap..._accurate.html. Also, you might want to check out the National Cervical Cancer Coalition's website - http://www.nccc-online.org/. They have information on the PAP test as well.

The Thin Prep pap missed mine too. All of my paps were fine, until my tumor was over 5cm! Even then, the pap showed a CIN3 but no cancer! Since then, I've never cared what a pap showed. I never even inquire about pap results. As far as I'm concerned, they're useless for me.

Vega is right, they only swab a small area, so it is possible to get the all clear when there are cells actually growing on the cervix or in the vagina. I am an example as to how aggressive and fast cancer can become in only a few weeks time. My persistent vaginal tumor went from VERY SMALL to covering my entire cervix, vagina, penetrating the cul da sac and pushing into the rectum and found on the mucousa. All in just 3 weeks time. Cancer is unpredictable and the doctors could never have predicted how quickly this spot would grow. It is possible to go from not noticable to 4 cm in a short period of time. My vaginal tumor was accidentally seen because I squirmed on an exam and it was hiding behind the cervix. Only reason I went for a follow up was because the pap came back HSIL and they though it was my cervix. Long story short I now live with a colostomy and urostomy and waiting patiently on my new vagina. But I'm not upset or mad. Would not serve a purpose, it won't change anything.

Just want to add that 21 years ago I also had the conization and then cryosurgery for cells on my cervix and 5 yrs later "cured". But nearly 20 yrs later I was diagnosed with vaginal cancer and it is believed to be related to those issues all those years ago and the cervical cells ended up on my vagina. But because so many years have passed it is diagnosed as primary vaginal cancer and the proceedures really did cure my cervix of the cells as in the beginning of this journey in 2007 my cervix was very healthy up until this summer when the vaginal cancer spread.

	Quote:
Originally Posted by Ialwaysworry Just want to add that 21 years ago I also had the conization and then cryosurgery for cells on my cervix and 5 yrs later "cured". But nearly 20 yrs later I was diagnosed with vaginal cancer and it is believed to be related to those issues all those years ago and the cervical cells ended up on my vagina.

Does anyone think it is possible for cervical cells to still be present after a hyst. My last pap came back ASCUS and under the statement of adequacy(?) it says endocervical/transformation zone component present.
This after having 3 paps normal post surgery...and all normal prior to surgery.

	Quote:
Originally Posted by ccd39275 Does anyone know and/or have any statistics for how often a pap smear does not catch cervical cancer? I'm searing for info online, but coming up essentially empty-handed (except for a law firm that specializes in such cases! )

I did search the net (Dutch pages) and found a site where was stated that 90% of the smears are correct and in 10% of the cases they aren't. I have had a similar situation where my pap-smears were okay while I did have cancer (and I also had adenocarcinoma).

The site referred to an article in The Lancet (English) of 1989! I also read some good news that a new kind of test is being developed that is supposed to be more reliable. If you google on QMSP cervical cancer you will find a link to obgyn.net
(http://www.obgyn.net/newsheadlines/w...0040817-40.asp)

I think it is possible Pattieo. I think that is why women are supposed to continue with PAPs after having a hysterectomy, and even if the cervix is taken. Guess we just need to stay on top of this. From what I've understood is that trying to keep a healthy/strong immune system is good at fighting these cells.