Evaluation and Management of Abnormal Pap Smear

Human papillomavirus (HPV) is a sexually transmitted virus that infects approximately 75% of the sexually active women in the United States. ‘Low risk’ strains cause genital warts. ‘High risk’ strains can lead to cervical changes that put us at risk for cervical cancer. We detect ‘high risk’ HPV on Pap smears, which is a test used to screen for pre-cancerous cells in the cervix. There are no symptoms of ‘high risk’ HPV and that is why Pap smear screening is so important. A diagnosis of ‘high risk’ HPV cannot reveal when a person has been exposed to HPV. Exposure could have been years ago or during the last sexual encounter. There is no way to know.

Men can also carry HPV. Men have no way of being tested. A carrier for HPV (male or female) may unknowingly pass it to a sexual partner. Like any virus, doctors have no way of making the human body get rid of HPV. Much like the common cold or herpes virus, medicines can only treat the symptoms. We do not treat ‘high risk’ HPV, we treat cervical changes that can result from the ‘high risk’ HPV. Most women with ‘high risk’ HPV do not develop cervix cancer. More than 50 million women are carriers for ‘high risk’ HPV in the United States.

We encourage women with ‘high risk’ HPV to get regular Pap smears, stop smoking, take a multivitamin daily and use condoms if not in a lifelong monogamous relationship. These actions can help your immune system keep HPV suppressed. It is common to test positive for ‘high risk’ HPV and never test positive again.

If you have recently had an abnormal Pap smear or have a history of abnormal Pap smear, there may be additional testing that is indicated. We will evaluate your Pap smear, make recommendations about further testing that is recommended, and then perform that additional testing. We will also make recommendations about follow up Pap smear testing. We will discuss and explain in detail the names of the recommend procedure(s) and what that procedure entails. Our goal with this is to make you feel as comfortable as possible and understand as completely as possible what is happening throughout this process. By receiving routine health care, being compliant with medical recommendations and knowing the facts, you are optimizing your health.