Medical questions & health advice by board certified doctors
"Did the HPV come back and do I have cervical cancer?"
In May 2011 my PAP smear came back abnormal. I went to have the colposcopy and when the results came back, it turned out that the lesion was benign. I had a follow up PAP 6 months later and though everything was fine, I still had HPV. Six months later in June of 2012 I had another PAP, which was normal and the HPV test came back negative. Now, I've just had another follow up PAP and it the results were abnormal and the LSIL has returned (or a new one has appeared). I have two questions, the first is; Does this mean that the HPV came back? And the second is; Because this is my second abnormal PAP (although now in a row) does it mean I have cervical cancer?
I recommend that you speak with your OB/GYN to discuss your concerns. Human Papilloma Virus, or HPV is a sexually transmitted virus that is associated with mucosal cancers. There are multiple different sub-types of the virus, and the different sub-types are considered 'high risk' depending on their location. For instance, HPV sub types 16 and 18 are considered the high risk sub-types for cervical cancer. In head and neck cancers (such as tonsil cancer, or base of tongue cancer) HPV subtype 16 can also play a role indicating that the virus causes an abnormality that can potentially lead to cancer formation within mucosal (the cells that line inner organs) lining. That doesn't mean that every person that is infected with the HPV virus will develop cancer, as it is estimated in some studies that up to 25% of people in the United States are infected with HPV, and not all of them develop a cancer. Once infected with the virus, it is never completely eradicated form the body. Rather it can lie dormant for a time before becoming reactivated and causing dysplasia. Dysplasia is a pathologic descriptive term used to stratify the appearance of abnormalities of mucosal cells as visualized by pathologists. It is a continuum of abnormality that can ultimately lead to cancer formation, and as such is considered a risk factor for cancer formation. An abnormal 'Pap' means that there is dysplasia seen on the path analysis, but does not necessarily mean that it is a cancer. Again, I recommend that you talk to your OB/GYN to discuss your questions. They will be able to give you more person-specific answers as they are familiar with your personal history.
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