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Old 12-03-2009, 06:37 PM   #2
Pickle Eyes
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Re: newbie with LSIL- lots of questions!

Hi SerendipiSis, I'm glad you've gone for your pap. HPV and its negative effects to the cervix is very confusing. There are so many if/then situations, so many strains of HPV, etc. Add to that the fact that you are not in the USA (where many of us are) and the fact that not every country has the same guidelines for following up on a "bad pap."

I assume you are over 30. I also assume you've been pretty consistent in getting your paps, annually.

Not every doctor runs the HPV test. Some doctors just assume if there is cellular change to the cervix that HPV is involved. Greater than 99% of cervical dysplasia (CIN I/mild dysplasia or higher) is caused by high risk HPV. In the USA, many doctors are now offering the HPV/dna test to women over 30 when they perform the pap. The two tests together dramatically increase the reliability of the pap; together the accuracy rate is greater than 98%.

The cellular changes (I don't think) don't necessarily mean there is an active infection (again, I'm not sure). A positive result on an HPV/dna test *does* mean there is an active HPV infection. That is important to know. This is why I think it is so important to have the HPV test.

When it comes down to who might have infected you and/or how long the dysplasia has been present there are several things to consider. When was the last time (that you know) that your ex was sexually unfaithful? My bet is that he exposed you to the strain(s) of HPV which results in your LSIL. I don't know how long it takes for cellular damage to become detectable by a pap. The pap, by the way, is only a screening tool. It is possible it was one of your more recent sexual partners. Like you've read, there is almost no way to know for sure.

Can second hand smoke cause a problem? I'd think yes. I've read that second hand smoke is as bad or worse than smoking. Smoking definitely negatively impacts the health of the cervix and increases the speed at which irregular cells grow (ie cancer). Smoking deprives the body of oxygen; cancer is anaerobic - it thrives in an oxygen depleted body.

I don't know if waiting 6 months is appropriate for a woman over 30. I'd think not, but I don't know what the current recommendations from the major medical associations are. I know in a woman under 30, that waiting 6 months and retesting is typical. Women under 30 are more likely to be able to reverse the negative impact of HPV on the cervix.

I think it is a good idea to do a few things: get a copy of your pathology reports and maybe your doctor's notes on your visits; ask to have the HPV/dna test run; if/when you are sent for a colposcopy (in lieu of waiting 6 months for a re-pap) ask for an ECC (endocervical curettage).

Are you able to get a second opinion or have your doctor perform an HPV/dna test? If so, I strongly suggest you do that OR ask for your doctor to go ahead and do a colposcopy (and ECC) and HPV/dna test.

I hope that helps!