I am a 25 yo who just had a colposcopy and biopsy last week. My pap said CIN1 LSIL. I have a couple of questions.
At the colposcopy, I requested if I could be HPV tested. The MD told me no, and that there was no point. I believe that there is definitely a point to get HPV tested if they can figure out which strain of HPV is causing CIN1. My physician told me that they cannot, but I do not necessarily believe her or think she knows. Has anyone had an HPV test? When you get results, do they let you know if it's a low causing cancer subgroup or a high cancer causing subgroup?
Also, I would like to get pregnant someday. Is it better to try and get pregnant now while I am in the LSIL stage? Or wait until and hope it clears up. I am worried that it will progress, and that each procedure does decreases chance of carrying a baby to term.
Any thoughts appreciated.
Your doctor is partially right--there is no point, because the types of hpv that cause dysplasia (not just ASCUS) are almost always the high risk strains of hpv, and they will keep a close eye on you no matter which specific strain it is. (I know that is not what you wanted to hear: I'm in the same situation.) There IS an hpv test, in that you can determine which category the strain you have falls under: high, intermediate, or low risk. The low risk types cause warts (not cancer), the high or intermediate risk types (very significantly) do not cause warts or other visible changes, but can lead to cervical cancer if not properly treated.
Only the very specialized research labs can type which specific strain(s) you have. Most doctors do not have access to this and I imagine won't bother to try unless you REALLY push.
You could ask for testing to see which general category it falls under (hi/intermediate/lo), but it probably wouldn't make a difference, because again it's almost always the high risk types that cause dysplasia. In fact, my gyn-onco said "I never test for hpv if there is dysplasia, because dysplasia is ALWAYS (100% of the time) caused by hrhpv." He was quite adamant about this.
I know some women will say not all dysplasia is caused by hpv but imo the newest literature says otherwise. Sometimes hpv is even undetectable: many women have dysplasia picked up by pap, but it takes 1,2, sometimes 3 hpv tests to test positive for the hr type.
At your age, your body has a very good chance of fighting it off (regression) and clearing the hpv. I encourage you to do a search for natural methods of reversing dysplasia; there are quite a number of success stories on here (success in varying stages). Hope this helps.
As to your second question, I'm in the same situation (albeit a little older than you) and I'm trying like the DICKENS to get this to regress and clear naturally because I don't want to undergo any procedures, though I understand I may have to undergo leep in March if I am the same or worse. I also really want to be pregnant within the next few years, but have no one to do that with. Again, I encourage you to do all you can to build up your immune system so it can fight off the hpv; there are plenty of encouraging posts here. Regression rates are highest for 25-and-under women.
Thank you very much for the advice! That does clear some things up for me about the HPV test.
How often do people think that they should be rechecked with LSIL? My thoughts are every six months, but I think the MD mentioned a year. Also, if recheck of pap comes back with LSIL, will another colposcopy automatically be conducted?
What types of immune system therapies are people trying? I quit drinking alcohol and eat a cup of lentils a day for my daily recommended folic acid. Any other thoughts?
Assuming your colpo biopsies match the pap's showing of low-grade LSIL/CIN1, I think a follow up every 6 months is fine. Perhaps even 4 months, if you are like me (super-cautious, extra-paranoid!) and your gyn is on board with this (some are not, my first gyn was quite flippant and wouldn't even colpo me). Annually seems too long to wait with hrhpv, imo but chances are you wouldn't go wrong waiting a year. And because you are young, with the right lifestyle changes, in a year it will probably be gone. But, allow at least 3 months closer to 4 months for repap and colpo because any sooner and you may detect "abnormal" cells that are healing.
You said you quit drinking, but the smoking is even more important (not sure if you smoke).
Eat as many fruits and green veggies as you can, the darker the green the better.
I think a folic acid supplement (pill form) is a good idea right now. You caught this early, best chance of building your body up to eradicate it. Use the advanced search function and look up "natural methods" on this board. There are many success stories from Lagirl81, 88Shadow, just to name a few. I learned a lot from their posts and am seeing a naturopath in a few weeks to start my own regimen.
Thanks for the info! I appreciate it.
My colposcopy results came back.......they took 3 biopsies. Two of them were negative and the third one went into fragments and was not large enough to biopsy once it got to lab. (Unfortunately the colposcopist did not tell me about the third biopsy being screwed up. I thought it had been a false + pap test until my regular women's health doctor told me today that I do have LSIL and it is in the area where the 3rd biopsy was screwed up.) Grrr... Anyway, my women's health doctor gave me an HPV test today due to my persistence, and I will wait and see what that says.
All they will offer me is another pap smear in a year. I pushed 6 months and neither doctor would budge. So depending on the HPV test, I will try and figure out what next. I also am extra cautious as you are!!
I dont understand the whole HPV thing either. I was diagnosed with Carcinoma in situ and my hpv test was negetive. One dr. told me I dont have it and my gyno oncologist says I do and its a false negetive. Its very confusing and I think the dr.s really need to get in the same boat with the info on HPV.
I think if you are not happy with the care you are recieving from your dr. then you should find someone else.
Recent evidence surfacing to say virtually all cervical cancers point back to hpv. My gyn-onco axes the "virtually" part and says ALL/100%. I WISH I had known this before engaging in intercourse of ANY kind (protected or not). Many negative tests later turn positive upon retest. The Digene hybrid capture apparently has a significant rate of false negatives.
The other causative element is DES (anti-miscarriage drug that mothers in the 50s took), but that causes a very specific type of cervical cancer, clear cell carcinoma.
Well I got an HPV test two weeks ago and it came back negative. I figure this is a good sign. Just very confusing. This either means that I cleared the infection, the HPV test was a false negative, or I still have LSIL but not from HPV (which is very unlikely). What is the rate of false negatives for the HPV test? Too bad nothing is every for sure!!
FYI if anyone is interested, they are starting to look into approving gardisil for men. In the hospital I work at, we are going to automatically test men with anal cancer for HPV to start tracking the incidence. I think this is very good. It would be nice if men could have the opportunity to either get the HPV test or gardisil because they can get both head and neck cancer as well as anal cancer, and they can pass HR HPV along to us!!
Hey sweetsn0w, that is great news. Based on the negative test, you can expect regression of the CIN1 within 3 month (clearance precedes regression by 12 weeks). Or, you may have had metaplastic cells, which are common in young women and not a sign of dyplasia or dysplasia-precursor unless accompanied by hrhpv.
I suspect so-called "false negatives" are due to the body "clearing" the infection (whether you take that to mean eradication or dormancy/suppression).
Most likely what happened is your body was in the process of fighting off the infection when you had your pap, and remember, in most young women this is the case (most infections are "missed" by paps because they clear within a year).
What has your doctor said about hpv clearance? Does he vote for eradication or merely dormancy? There are two theories out there.
Hey Sweetsnow, my situation is kind of like yours, although I am 45 yo. My pap last May was Cin1, biopsy confirmed Cin1. Follow up PAP in Sept still said Cin 1. They also did an HPV test for high risk strains in Sept and that came back negative. So it's puzzling to me as well what is causing the Cin1, although I guess it could be a low-risk HPV strain which they did not test for low risk. My follow up PAP is at the end of Jan so will see if the Cin1 has cleared or what..