Abnormal Pap Test Results and HPV

Abnormal Pap Test Results and HPV

What is a Pap test?

The Pap test or Pap smear is a test to screen for cancer of the cervix (the neck of the uterus). It involves a vaginal examination to look at the cervix and brushing the surface to collect cells. The cells are then placed on a microscope slide, stained and examined by a pathologist who will then report whether the cells are normal or abnormal.

Why is it important to have a Pap test?

A Pap test detects changes on the cervix years before cancer of the cervix develops and therefore makes it possible to prevent cervical cancer. The test should be repeated periodically and your doctor will be able to tell you how often you should have this test done because every woman has a different risk for developing cervical cancer. Pap tests should begin at age 21.

What causes Abnormal Pap test results?

Pap test results can be abnormal if you have an infection on the cervix with Human Papilloma Virus (HPV). This virus is very commonly present and as many as 75-90 percent of all women who have had sexual intercourse are likely to have been exposed to this virus. This risk increases with more number of sexual partners in a woman’s lifetime. In most women, immunity will develop and they will not get abnormal Pap smear or develop genital warts.
Even among women who have Pap smear showing infection with HPV, it either resolves on its own over time or after treatment. Cervical cancer most commonly occurs in women who have not had Pap smear screening as recommended by their doctor or those who fail to return for treatment of abnormal Pap smear.

Can I test to see if I have HPV?

Yes. A test similar to Pap test can be performed to look for certain types of HPV that can cause cervical cancer. However, the test is only recommended for women 30 years or older as part of routine screening or women 21 or older for follow up of abnormal test results in special circumstances. This is because HPV is very common in women under the age of 30 years and most women under age 30 who test positive for HPV do not develop any health problem.

How can I prevent infection with HPV?

Some HPV infection can be prevented by vaccine, especially when the vaccination is completed before a woman or man has sexual intercourse for the first time. HPV vaccine is recommended for all boys and girls.
For additional information on prevention of HPV infection please see the Centers for Disease Control.

What happens when I have Abnormal Pap test?

The management of abnormal Pap smear is based on the type of abnormality, your age, and your risk for developing cervical cancer. A majority of abnormal pap smear falls into a mild category and resolves over 1- 2 years without treatment. It is recommended that the condition be followed closely by repeating pap smear tests every 6 months or so until it clears. Abnormal pap smear often prompts a gynecologist to recommend a procedure called colposcopy to look at the cervix closely and make sure there are no areas that are in the severe category that requires treatment.

What is colposcopy?

Colposcopy is a procedure done in the doctor’s office where the cervix is inspected using a bright light and magnification. A dilute solution of vinegar is applied to the cervix to highlight the abnormal areas. The doctor can then decide whether to take a sample of the cervix from the abnormal area. The sample can then be evaluated by a pathologist to tell us how abnormal the cervix is and whether one can just watch the condition over time.

What is dysplasia?

Dysplasia of the cervix is a condition that describes changes on the lining of the cervix. It is usually due to HPV infection. It is often classified as mild, moderate or severe. Mild dysplasia usually resolves on its own. Severe dysplasia needs treatment that involves removing the abnormal areas on the cervix to prevent cervical cancer.

The Pap test and the HPV test can help detect early pre-cancerous changes on the cervix. These tests do not check for uterine or ovarian cancer. Pap test does not test for sexually transmitted infections or pregnancy.