HPV and Abnormal Pap Smears
HPV and the Abnormal Pap
Abnormal Pap smears always make women anxious and make us wonder if we have cancer.
Over the past decade, a new anxiety provoking term has slipped into the GYN lexicon : human papilloma virus or HPV infection.
Studies show that around 90% of cervical cancer is caused by HPV infection. Most precancerous cervical changes are caused by HPV.
Currently experts recommend that HPV testing be part of the annual Pap exam in all women over the age of 30. Furthermore, they recommend HPV testing in women under 30 when the Pap smear is abnormal.
The upshot of this recommendation is to ensure adequate follow up for all women with HPV infection and abnormal cervical cells.
Here’s what you need to know about abnormal Paps.
Pap smears are classified as: negative, no endocervical cells present, inflammatory changes, atypical, low grade, high grade, and cancer.
If the Pap is read as having no appropriate cervical cells, you may be called back for a new exam. If a woman in such a case is menopausal or at low risk, re-sampling can often wait until her next pelvic exam in a year’s time.
A Pap smear report may show infection with bacteria or yeast or atrophy from low estrogen that occurs in menopause. These findings are easily manageable with medication.
The other interpretations of a Pap smear range from atypical changes, which may be caused by infection, medications or other causes to cancer. Aggressive treatments including colposcopy to obtain further cervical cells or more invasive procedures to remove precancerous or cancerous lesions may be undertaken.
HPV testing may be incorporated into Pap testing either as part of the initial smear - in women with histories of abnormal Paps or who are over 30 years of age, or as a followup to an abnormal Pap smear.
A negative HPV test result often means that the cell changes that were seen are not related to precancer.
If you test positive for HPV - even if your Pap is normal – do not be anxious. Most women with HPV infection do NOT get cervical cancer. And, many women do not realize that almost everyone will have HPV at some point. And in most cases, HPV will go away on its own. There is no treatment for HPV, but knowing the virus is present gives your doctor important information to help keep you healthy and cancer free.
Charlotte Grayson, M.D., is an internist in the Atlanta, Georgia, area. She is a 1995 graduate of Boston University School of Medicine. She completed her internal medicine residency in 1998 at the Medical University of South Carolina in Charleston. Previously, Dr. Grayson was Senior Medical Editor for a leading healthcare content company. She frequently speaks to the media about health, appearing on Fox News and CNN and contributing to TIME, Real Simple, Women’s Health, and WebMD magazines.