Pap Smears and HPV: Frequently Asked Questions & Abnormal Results

What is a Pap Smear?

A Pap smear is a screening test for the Human Papilloma Virus (HPV) and is sometimes done during a pelvic exam. Cervical cancer is known to be caused by certain types of the HPV virus. The Pap test collects cells from the surface of the cervix, which is the opening to the uterus. These cells are then examined under a microscope to see if abnormalities are caused by HPV or if the HPV virus itself is present.

What is HPV?

HPV is technically a sexually transmitted infection that can cause changes in cells which may lead to cervical cancer. In the U.S. about 80% of women will have HPV during their lifetime, although very few go on to develop cervical cancer. The cancer growth rate is very slow and can take up to 10 to 15 years before cancer cells are present. Most women contract HPV when they are younger due to cervix structure. For most, the infection lasts just a short time before the body’s immune system clears it away; but for a few the infection persists. This can lead to abnormalities in the cells of the cervix. If a person has had two or more sexual partners in their lifetime, they have probably been exposed to HPV.

Are there different types of HPV?

There are many different types of HPV, but we’re going to focus on four types. HPV Types 6 and 11 are considered “low risk” and can cause warts. This type of HPV is a skin virus and is caused from skin to skin contact. Condoms will not prevent this type of HPV. HPV Types 16 and 18 are considered “high risk” and are the main virus types that can lead to cellular changes in the cervix. If left untreated these high-risk HPV viruses can, potentially, cause cancer.

Will the vaccine prevent HPV?

The HPV vaccine Gardasil-9© is designed to prevent HPV infections from 9 different strains of HPV: Types 6, 11, 16 18, 31, 33, 45, 52 and 58. If you are interested in the Gardasil-9© vaccine, talk to your healthcare provider.

What will happen if my Pap result is abnormal or I have a positive HPV test?

Depending on the type of abnormality or the type of HPV present, you will be instructed by your doctor to come back to the office for a follow-up appointment. That appointment may be for a repeat Pap smear or it may be for a test called Colposcopy. Regardless of the type of follow-up you have you should be aware of a few things:

1. 1. If you are pregnant, rest assured that the Colposcopy is a safe procedure, however we would prefer to do it during your second or third trimester.
   2. If you are not pregnant, continue your current form of birth control. If you’re not using birth control, you should start using condoms and schedule your Colposcopy appointment out about two weeks. You will likely receive a pregnancy test in the office before your Colposcopy is performed.
   3. Do not use any douche, vaginal creams, or have intercourse in the 48 hours before your Colposcopy. We don’t want anything to obscure the doctor’s view of your cervix during the test.
   4. During the Colposcopy your doctor will apply a solution of acetic acid (vinegar) to your cervix and inspect the area with a special microscope. It will feel very much like a pelvic exam. If there are any areas that look concerning a biopsy (a small pinch of tissue) will be removed from that area and sent to the lab for further testing.
   5. You will be scheduled for one more appointment with your doctor in about 2 weeks to review the results of any biopsies or tissue samples taken during the Colposcopy.

The goal of Pap smear testing is to identify problems early before they become cancerous. Although a Pap test may not be needed every year, women should still see their provider on an annual basis for a Preventive or “Well Woman” exam. At that time your healthcare provider will review your history and unique risk factors and make a recommendation as to how frequently you should have Pap testing.