| Re: High Risk HPV
Good questions.
I'm sure you know this, but the pap is only a screening test, it isn't diagnostic. Abnormal paps can be caused by a variety of things: infections, recent trauma (aka intercourse), HPV, etc.
Low risk HPV can cause genital warts. High risk HPV can cause cancer, in worst case scenarios. HPV is the most common STD (because it requires intimate skin-to-skin contact to be transmitted). It is possible to be exposed to HPV (low or high) at one's first sexual experience (doesn't have to be intercourse). It is also possible to have more than one strain (there are more than 30, some are low risk and some are high risk) of HPV at one time.
A High risk HPV infection, if left untreated can lead to cancer. Fortunately, pap tests screen for abnormal cells. If a pap comes back abnormal the doctor has several options depending on the woman's age, her medical history, her sexual history, the extent of the dysplasia, etc.
One option, if the woman is younger than 30, is to wait and recheck. Rechecking might be "next year" or it might be in 3, 4 or 6 months. If the rechecks continue to show abnormality, then the doctor might order a colposcopy to take a closer look. The colpo is very similar to a pap, except the doctor swabs the cervix with a slightly acidic solution and looks at the cervix for abnormal cells. If there are abnormalities, the doctor might take a biopsy right then (called a pinch or punch biopsy). The doctor then applies a solution to stop the bleeding (Monsel's solution). That solution causes a slighly unpleasant, but normal, discharge.
If the woman is older than 30, then the doctor might not wait to recheck. The doctor might go ahead and order the colpo right away.
If the woman is older than 30, during the colpo, the doctor might perform an ECC. The ECC checks the cervical canal which cannot been seen or biopsied during a pap or colpo.
The HPV test itself has only been available (in the USA) for doctors to use for about 8 years. Prior to that, if a woman had dysplasia, the doctor assumed it was caused by HPV. There are several different ways the HPV test can be run. Sometimes an HPV test is run on the same tissued that was used for the pap's biopsy. Other times (and this is what my doctor did) the doctor will take a separate sample at the same time as my pap and send both samples off to pathology. So, HPV tests are not automatic. Many doctors are now running the separate HPV test along with the pap for women over 30.
My pap was good, but my HPV test came back as positive for high risk HPV. Because I had a long (25+ year) history of good paps, she immediately sent me for a colpo where my outer cervix looked good, but she did an ECC. The ECC detected the abnormal cells and thus began my "Mr. Toad's Wild Ride" year.
Anyway, you can ask your doctor(s)' office(s) if they can get copies of your pathology reports for you. They are very informative. The report will tell you what tests were run (thin prep or slide prep, etc), what tissue was taken, what the results were, and what the pathologist's recommendations were.
Wow. I got longwinded. I hope I haven't overexplained things. :blushing:
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