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pap smear - abnormal but no HPV

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Old 02-26-2009, 05:04 PM   #1
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letpetit HB User
pap smear - abnormal but no HPV

i just had a pap smear and my first abnormal reslult. my doctor wants me to test again in 6 months but said that i don't have HPV which she said is really good. i also have to get a pelvic ultrasound done now because she felt some fullness on the one side and wanted to make sure. she said the two issues are not related but i'm really worried.... what could this be caused by? i just am getting over a flu virus and i my period just ended when i got the exam and she said that could cause it (just coming off a period). i hope i don't have cancer!

Last edited by letpetit; 02-26-2009 at 05:08 PM.

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Old 02-26-2009, 05:57 PM   #2
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Re: pap smear - abnormal but no HPV

If you had even a chance of cancer my dear they would have sent you for wayyyyyy more tests to determine that fact rather than telling you to wait 4 months . IF you feel in your heart that there may be that chance I urge you to ask to be either re tested by the same doctor or seek a second opinion for some peace of mind!.

Please do yourself a big,big favor and DO NOT read anything regarding cervical cancer that you do not need to. Some good reading for you would be to Google the word "cervical dysplacia",and its suitable treatment etc. That might bring some knowledge for you that will explain what is going on with your abnormal paps .

Heres something to get you started:
Cervical dysplasia is a term used to describe the appearance of abnormal cells on the surface of the cervix, the lowest part of the uterus. These changes in cervical tissue are classified as mild, moderate, or severe. While dysplasia itself does not cause health problems, it is considered to be a precancerous condition. Left untreated, dysplasia sometimes progresses to an early form of cancer known as cervical carcinoma in situ, and eventually to invasive cervical cancer.

It can take 10 years or longer for cervical dysplasia to develop into cancer. Dysplasia can be detected from a Pap smear, the single most important step that a woman can take to prevent cervical cancer.

Mild dysplasia is the most common form, and up to 70% of these cases regress on their own (i.e., the cervical tissue returns to normal without treatment). Moderate and severe dysplasia are less likely to self-resolve and have a higher rate of progression to cancer. The greater the abnormality, the higher the risk for developing cervical cancer.

Cervical dysplasia does not cause symptoms; therefore, regular screening and early diagnosis are important. Detecting and treating dysplasia early is essential to prevent cancer. For this reason, most physicians quickly remove suspicious cervical lesions and require frequent Pap smears to monitor for recurrences.

Incidence and Prevalence
Every year, between 250,000 and 1 million women in the United States are diagnosed with cervical dysplasia. While it can occur at any age, the peak incidence is in women between the ages of 25 to 35. Most dysplasia cases can be cured with proper treatment and follow-up. Without treatment, 30% to 50% may progress to invasive cancer.

Risk Factors

Risk factors increase the frequency of occurrence. Several risk factors have been linked to dysplasia including multiple sexual partners, early onset of sexual activity, cigarette smoking, and sexually transmitted diseases, especially human papillomavirus (HPV) and HIV infection.

HPV Infection
Eighty to ninety percent of women with cervical dysplasia have an HPV infection. Human papillomavirus (HPV) is a group of more than 80 different viral strains. About one-third are sexually transmitted, and some types cause genital warts. HPV infects about 25 million people in the United States, and most of the viral strains are harmless.

However, the NIH Consensus Conference on Cancer of the Cervix and the World Health Organization (WHO) have concluded that several strains of HPV cause cervical cancer. The strains found most frequently in precancerous lesions and in cervical cancer are types 16 and 18. Other strains with high malignant potential include 31, 33, 35, 39, 45, 51, 52, 56, 58, and 68, and together, they account for almost 90% of cancerous lesions and dysplasia in HPV infections.

Most HPV infections resolve within 6 months and many women develop immunity. HPV often does not cause symptoms. One study found that nearly one-half of the women infected with HPV had no symptoms and a person may not even know that they are infected. Untreated HPV can result in recurrent and persistent cervical dysplasia and many experts believe that HPV is the main cause for changes in cervical cells that result in dysplasia.



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Old 02-26-2009, 06:14 PM   #3
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Re: pap smear - abnormal but no HPV

Hi- I just want to let you know I was just diagnosed this week with severe cervical dysplasia and I have tested negative for HPV twice (actually 3 times including once several years ago). I had never had an abnormal pap in my life until late last year. My doctor, as soon as I had the abnormal pap, recommended a re-pap within a month (I ended up waiting until January to go in though). That pap too came back abnormal, so they did a procedure called a colposcopy where they look at your cervix and possibly take a sample for biopsy. When they did the biopsy they thought I had maybe mild dysplasia... but then I got the call saying it is CIN III, the most severe form without being actual invasive cancer. And again, I don't have HPV, so it's very unusual. Anyway, I am not trying to scare you but I think it wouldn't hurt for you to request a follow up sooner than 4 months... just to be safe. Odds are it's nothing to worry about but I would keep a close eye on it just in case.

Old 02-26-2009, 06:30 PM   #4
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letpetit HB User
Re: pap smear - abnormal but no HPV

well actually i don't know why you both say 4 months but it's 6 months she's having me wait to get the pap again. she said not to worry and that it's a very good thing i don't have HPV. but i have to go in for a pelvic ultrasound next week because she felt fullness on the one side and wanted to make sure it was ok so maybe i would know more after that? she said the two weren't related.

Last edited by letpetit; 02-26-2009 at 06:30 PM.

Old 02-26-2009, 08:35 PM   #5
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Re: pap smear - abnormal but no HPV

The swelling could be from many different things: endometriosis, andyomyosis, cysts, bowel problems, etc. The ultrasound will help determine a possible cause.

The rechecking with the pap in 4-6 months is fairly standard if the doctor suspects mild dysplasia. Is your doctor running a separate HPV/dna test? I believe the most commonly used one is by Digene (company name).

It is possible to have cervical dysplasia and not have HPV, though it is usually found, later, that there is/was HPV infection.

I suggest that if/when your doctor performs a colposcopy for you to request an ECC (endocervical curettage) at that time. It checks the cells that are further up in the cervix which cannot be sampled during a pap or colpo.

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