In most cases women are surprised and dismayed when their Pap test returns as anything other than normal, and questions abound. Here are just a few of the most common concerns women have regarding HPV and abnormal Pap smears.
“My practitioner found an abnormal Pap, positive for ‘high-risk HPV,’ and this has me very worried. She sent me to another doctor for a colposcopy, but that doctor found nothing. Then he sent me back to the nurse practitioner for follow-up Pap smears. Now what?”
This series of events sound appropriate. Clinicians do not always have the skills for colposcopy. So sometimes you need a specialist for an advanced testing procedure. The colposcopy findings are reassuring, however. In your case, either the Pap smear was a bit of a false alarm (which is not uncommon), or your body is doing a good job of taking care of the HPV virus. It is important for you to continue the follow-up process as directed by your healthcare practitioners, to verify that the cellular changes remain resolved over time. Nutrition and self-care measures to shore up your immune system are likewise important to promote continued healing.
“I’ve had genital warts and was told they were caused by HPV. So does this mean I will get cervical cancer? I have never had an abnormal Pap test.”
The strains of HPV associated with genital warts are not generally or exclusively high-risk strains associated with cervical cancer. However, a practitioner cannot know for certain how many strains of the virus you have possibly been exposed to, nor the strains to which you may be exposed in the future. So good health and prevention is key. Some research supports the premise that the topical wart treatment known as Aldara (imiquimod) triggers an effective immune response. This may be one of the most ideal treatment measures we currently have for warts. And it may also confer an element of protection from the high-risk HPV strains.
“How did I get the HPV virus and an abnormal Pap test? — I practice safe sex with condom use every time!”
HPV virus can be anywhere within the genital region, and condoms cover only a portion of the penis. So in most cases, there is extensive genital contact beyond the condom, and the virus can be transmitted very easily. Safe sex is still important to prevent transmission of other STD’s. But an open, honest discussion regarding both party’s sexual history and STD’s prior to having sex is a wise measure.
“My Pap was ‘normal,’ but it also said ‘HPV is detected,’ and to make a follow-up appointment in six months. Is that at all possible? All the information I’ve researched would have it seem that an abnormal Pap is significant if HPV is detected. My ob/gyn also told me that my husband and I can ‘resume our normal lives.’ This is puzzling, because wouldn’t that mean that we were playing ‘ping pong’ with the virus and compromising our immune systems if the virus is even present?”
The result you received is a very common finding. Your doctor may use newly available viral technology to detect the HPV virus itself, separate from evaluating the health or quality of the tissue cells sampled. So even if they see no abnormality in the cells on the sample, they can detect the virus.
Different practitioners may follow slightly different follow-up algorithms with this finding. It depends on whether they adhere to guidelines developed by the American College of Obstetricians and Gynecologists (ACOG), the American Society for Colposcopy and Cervical Pathology (ASCCP), or Planned Parenthood.
But in most cases this virus will clear. Your practitioner will then just want to watch you a little more closely than usual, generally by retesting in six months. This is to ensure that the cervical cells indeed stay normal and that the virus hopefully becomes dormant. Dormant means it becomes undetectable, due to the response of your healthy immune system.
