A PAP smear is required on most patients after age 21. The purpose of a PAP smear is to determine your risk for cervical cancer. The cause of cervical cancer is HPV (Human Papilloma Virus) which is sexually transmitted. This test is obtained along with the PAP smear on all patients over 30. The HPV test helps us determine your level of cervical cancer risk.
If we call to inform you of the presence of HPV and the PAP smears cells are normal, do not be alarmed.
HPV is very common. Approximately 70% of sexually active persons get HPV at some time in their life although most are never aware of it. Some types of HPV cause genital warts, while others can cause cervical cancer. The vaccine Gardisil® is offered to our patients between the ages of 13 and 29 to help protect against acquiring the virus. The vast majority of patients with HPV do not develop cancer or even pre-cancer because the body’s immune system clears the HPV infection. HPV can lead to cancer or, more commonly, pre-cancer in patients who fail to clear the virus.
Partners in a long term relationship tend to share HPV. The partner is usually unaware because he has no symptoms. High risk HPV types that lead to cancer in women rarely cause visible warts or other symptoms in men. Detection of high risk HPV does not mean your partner is engaging in sexual activity with someone else. HPV can be present for years before it is detected, and no method can determine when it was acquired.
If your PAP smear shows abnormal cells as well as HPV, you will require an in-office procedure called a colposcopy. During this procedure, a speculum is placed in the vagina and the cervix is visualized with a camera which magnifies the cells. A vinegar type solution is placed on the surface of the cervix to aid in visualization of abnormal areas. The solution may sting a little when applied. If a suspicious area is seen a biopsy is obtained. Do not panic , the cervix does not have the same nerve endings as your skin. You may feel a pinch but most women feel minimal to no discomfort. We recommend Ibuprofen 800 mg or 4 Advil, one hour prior to the procedure. This is to minimize cramping which can occur towards the end of the procedure when cells are obtained from inside the cervical canal. After the biopsy, a chemical is applied to control bleeding. This may appear as a yellow-brown discharge for a couple of days. You should refrain from intercourse or tampons for one week if a biopsy is obtained.
The results from the colposcopy take 2 weeks. If you do not hear from the office in 2 weeks, you should call to check on the results.