What’s Pap-pening? What You Should Know About HPV and Abnormal Pap Tests
My patients have told me that they don’t like when I call them on the phone. It’s not that they don’t like me, but rather they have learned to expect that normal results will come electronically or from my medical assistant. Abnormal results, however, will come directly from me. “I’m calling to tell you that your Pap came back abnormal.” “My what?” “Your Papanicolaou test.” “My Papanico-what?” Let’s break things down from the basics to the details.
- The Pap test looks for pre-cancerous cells on the cervix. These cells are graded by level from normal, to slightly abnormal, to significantly abnormal, to cancer. You can rest assured that if your doctor calls saying you have an abnormal pap, you don’t have cancer. Otherwise he or she would have said, “You have cancer.” Pap testing can be done from as frequently as every 6 months, to as infrequently as every 2-3 years in some cases. You and your doctor can discuss how often your pap should be done.
- The Pap is a screening test that randomly collects a sample of cells from the cervix. If abnormal cells are detected, often a more targeted test is indicated to determine if the Pap accurately represents the cells of your cervix. That targeted test is called a colposcopy.
- HPV, or Human Papilloma Virus, is the virus that causes precancerous changes on the cervix. It is also the virus that causes genital warts, though different strains are responsible for warts. HPV is tested as an adjunct to certain Pap results, and is routinely tested over the age of 30.
- If you test positive for HPV, you will never know when, where and from whom you contracted it. Men aren’t tested for it. Imagine that your Pap is like that T-Rex in Jurassic Park, the first movie. It only saw the people if they moved. Similarly, the Pap will only detect HPV if it is “moving”, or replicating. HPV could have been present for years even with normal testing, but if it was dormant in a small quantity, it may not have been detected.
HPV does not necessarily stay forever. It is a virus that your body can, in theory, fight off and destroy. Staying healthy and eliminating or minimizing exposure can help your body to have the immune strength to fight this virus. I stated that you cannot know a partner status, but condom use can at least decrease potential exposure.
There is an FDA approved vaccine for HPV. It protects against the 9 most common strains of HPV. This is especially important to administer BEFORE exposure, meaning girls and boys should ideally get the vaccine before the onset of sexual activity. Getting the vaccine does not mean you can skip paps (#sorrynotsorry) and you should still see the gyne at least annually.
Rarely does someone get cervical cancer if they follow the screening guidelines and recommendations from their doctor. Even if you get that call about an abnormal pap, if you do your part and follow up for testing as recommended, you can avoid devastating results and stay safe.