For 50 years pap smears have been done during the annual gynecologic visits to screen for cervical cancer. This practice has reduced the occurrence of cervical cancer by 75%. A new screening tool has been added to our pap smear test which is called Human Papilloma Virus Testing (HPV). HPV is a skin virus and more then 100 types have been identified. Thirty of these types affect the genital skin and almost 15 have the potential to cause cancer. HPV types have been classified as low-risk or high-risk depending upon the cancer potential.
HPV testing is performed whenever the pap smear results are slightly uncertain. In the past mildly abnormal results were handled by simply re-testing. Since cervical cancer takes a long time to develop this was satisfactory. However now with HPV testing we can take mildly abnormal results and determine the risk that a patient might have to develop cancer in the future.
HPV is a sexually transmitted disease and is usually cleared by the immune system in 8-24 months after contact. Though condoms help prevent transmission of the virus it is found in genital tissue which makes condoms not foolproof. The virus also can be passed between homosexual partners. HPV is usually not visible to a woman and is only found by the pap smear. Low risk types of HPV can cause lesions of genital warts which do not have cancer potential and can be easily treated.
If a woman has a pap smear which showed atypical cells of undetermined significance, this is where HPV testing can be most beneficial. If a woman is positive for the virus or if the pap smear is more abnormal, further evaluation is advised by a procedure called colposcopy. During colposcopy the cervix is examined under magnification and biopsy is taken if needed.
The addition of HPV testing to our armamentarium allows us to more perfectly categorize patients according to the need for further follow up or not. Of course, the first step is to have regular pap smear testing. You should speak with your medical provider about these issues if you have other questions.