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Old 03-08-2009, 08:05 AM   #1
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Question Abnormal-Normal Smear Results and HPV...

Hi,

I went for my first smear test in Jan last year (aged 25) and the results came back saying that there were signs of cell changes, but it was the very minimal level listed and also it said something along the lines of 'signs of hpv sighted'. So I was a bit freaked out and made an appointment to go and see my GP about it, he said that in most cases its nothing to worry about and that this is very common in young women and it usually clears up by itself, but they recall you every 6 months just to check it doesnt develop any further, and if it does then they deal with it right away before it gets a chance to get even worse.

Then I asked about the hpv and he said again that this is very common, but he said that those results just mean that it has been there at some point or another and may not still be there now.

Anyways so a little later than 6 months (September) I went back for my repeat smear test and the results came back as clear, and it didnt mention any 'signs of hpv sighted'.

I have to go back again for my next 6 month check up next Monday but I was wondering what that means.. that it said signs of hpv sighted in the first smear but then nothing at all in the second one... even though the doctor said that it just means hpv has been there at some point in the past, well wouldnt it still be visible on my second smear as well?

Also if it IS there does that mean that I have a high risk type hpv and is it likely to come back and damage cells? I have to have repeated tests for 6 months for the first 3 years now I think and then once a year for 3 years after that provided everything stays clear but im worried if hpv is there then it could come back?

It's quite a confusing thing really, we dont seem to get told a lot about it, the focus seems to be on chlamydia and gonnorhoea but if hpv can cause cancer then why isnt there more information out there about it?

thanks for any advice!

 
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Old 03-08-2009, 11:10 AM   #2
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Re: Abnormal-Normal Smear Results and HPV...

Hi Laura, I know this can be so confusing. Let me see if I can shed a little light on things.

The pap is just a screening tool. It only samples tissue from the part of the cervix (exocervix) where the doctor samples. Doctors attempt scraping as much of the exocervix as they can, but they don't always scrape all of it. Then, not all of the sample is viewed at the lab (that's how I understand it).

Your doctors comments about young people clearing the virus is what I've heard and read. Rechecking every 6 months, for someone your age seems reasonable (give your results). From what I understand, they check every 6 months until they get 3 "clear" checks in a row, then they put you back at yearly exams.

I've read that low risk HPV can cause changes that can be detected on the pap (as can high risk HPV). CIN II or greater results (from what I've read) is caused by hrHPV, not low risk HPV.

To answer the question "why is there so little information" . . . well it could be because the discovery of HPVs connection with cervical cancer was detected only 33 years ago (in 1976). You know how slowly scientific information is discovered, then proven, then reproven. And that is before it is accepted by the medical profession, and that is before it is shared with the population at large, and THAT is before it is commonly known. I figure we are somewhere between the last two steps.

The HPV/dna test was approved by the FDA only 4 or 5 years ago. Doctors are just (in the last year or 2) beginning to offer it to women (over 30 years of age). Some doctors use it every time they do a pap, others only when they thing to ask.

Again, the information regarding HPV can be confusing. I think it is because of the difference between low risk and high risk HPV. I also think some of the terminology can have different meanings than what we think they mean.

The good news is that there are plenty of good sites to get information (Center for Disease Control and the National Cancer Institute). We can also discuss our worries and concerns with other women to gain support for the struggles we face. This wasn't available to women just one generation ago.

Anyway, I've rambled long enough.

Let us know how we can help!

 
Old 03-09-2009, 04:19 PM   #3
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Re: Abnormal-Normal Smear Results and HPV...

Hey,

Thanks for your reply! you know a lot more about this than I do!

So if my smear results were only very mild, (I think if i remember correctly there were 4 levels? Mild, CIN1, CIN2, CIN3??) so does that mean I most likely had a low risk HPV as apposed to a high risk HPV?

I guess regardless of whether its high risk or low risk its just important that you go to your follow ups and get checked anyways! Mine is next week and im a little nervous again incase the abnormalities come back, but fingers crossed it will be okay!

Thanks again

Laura

 
Old 03-09-2009, 06:31 PM   #4
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Re: Abnormal-Normal Smear Results and HPV...

There are 2 different systems for "grading" atypical paps. I forget their names, and I don't feel like looking them up (I'm lazy, I know).

CIN I = mild dysplasia
CIN II - moderate dysplasia
CIN III = severe dysplasia

Then there is either carcinoma in situ (squamous cell cancer cells "in place") or adenocarcinoma in situ (glandular/columnar cell cancer cells "in place"). Some people call this the highest level of precancer, others call it cancer Stage 0.

Some CIN I can be caused by things other than HPV. From what I've read (from a member here) that CIN II and above is most likely HPV related.

You are right, once a woman has been diagnosed with any of the CIN/or levels of dysplasia, it is essential that she keep regular on follow up paps, forever. We all know it is important for all women, but I'd say it is particularly true for women who have been told they are high risk HPV positive and/or have a diagnosis of CINanything.

I hope that helps!

 
Old 03-10-2009, 04:20 PM   #5
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Re: Abnormal-Normal Smear Results and HPV...

Yep, definitely good sense! We have a celebrity over here (UK) who has recently been diagnosed with terminal cervical cancer and shes only 27, (from what I read she had previously had 3 operations to burn away pre cancerous cells and the last time she was diagnosed with them she was scared to have the op again and hoped they would go away on their own, whether thats true or not I dont know, but its such a tragic scenario and the rates of young women now going for smears who had previously avoided them has risen a great deal. It's quite sad that it takes a rare situation like that to get people to go and get checked but people have said she can be proud that shes raised awareness of the issue and kind of put it more into the public eye.

Thanks again!Laura

 
Old 03-10-2009, 04:52 PM   #6
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Re: Abnormal-Normal Smear Results and HPV...

Hello. I've been going through your exact issue for over 2 years. I had an mild abnormal pap and tested positive for HPV. The first time, they said they were going to watch it, and to come back in 6 months. They also started me on the 3-series of the vaccination Gardasil. I went back in 3 months and they decided to do a copol; which is a biopsy of the cervix to look at the cells more closely. The cells were never bad enough to do surgery so I continued to go back, even every 3 months to be checked. After 1.5 years, it finally got better and my last visit (about 2 weeks ago) was totally normal. I have one more test in June and if everything is still normal I'm getting released. The doc advised me that a high folic acid diet helps, I wasn't good with that so I bought Folic Acid vitamins and took one daily. Not sure if that's what cured it, but it can't hurt to try! Make sure you keep up with the tests and be hopeful that it goes away on its own.

 
Old 09-19-2009, 02:08 AM   #7
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Re: Abnormal-Normal Smear Results and HPV...

Last month my pap came back and the gyne said i have hpv level 1. she scheduled a biopsy. During the procedure, she said i have a very large transformation zone and that the hpv was in multiple parts of the cervix and she couldn't biopsy all of it. She also took some cells from the tunnel. i just got a voicemail from her saying that it is actually level 2 abnormal changes, . no disease in the tunnel. but precancerous level 2 lesions, with treatment options of: freezing - conservative, LEEP procedure - outpatient, shave tip of cervix, slight increase fertility and miscarraige. Since it's the weekend, and i can't get in touch with her I started to do my own research. needless to say, i can't stop crying and i'm petrified. i want to do everything i can and fight fight fight to get rid of this thing. i've been with my boyfriend for over a year and had a normal pap right before i met him. my concern is that since the transformation zone is large that cutting that out will be very difficult/ineffectual/painful/affect fertility. i've had multiple symptoms that came up in the first visit with the doc that i wonder if there is any relationship (don't naturally lubricate during sex - when that was never a prob before, pain in the area of my bladder, frequent urination, occasional pain from sex). Additionally, I got on the pill just as I met my boyfriend. And apparently I also just got told after having an ultrasound down there that i have two uterine fibroids, one is about 4 cm long and is on the top outside part of my uterus - probably pushing against my bladder and explaining the aforementioned symptoms. I also have lower back pain (could be from being top heavy) and leg pain and stiffness in foot (which i just read is associate w cervical cancer). I wonder if it's all related. And short of taking my vitamins, i'm terrified. Terrified. And so sad about this. I'm only 31 years old!

 
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