Q: My gynecologist says I have an infection with the human papilloma virus (HPV). Does this mean I have cervical cancer?
A: About 80 percent of women in the U.S. will have some kind of HPV infection in their lifetime. Most infections resolve without medical intervention and need only follow-up Pap tests every six months.
Although cervical cancer is caused by an infection with the HPV virus, not every infection turns into cancer. Better screening has resulted in cervical cancer rates declining more than 50 percent in the last 30 years. Most cases occur in women who have never been screened or have had inadequate screening.
There are two classes of HPV: one that might cause cancer (high-risk HPV) and one that will not (low-risk HPV). HPV infects the cells of the cervix, altering their appearance (dysplasia).
HPV infection is most common in teenagers and women in their early 20s. These women have an effective immune system that usually clears the virus in about eight months.
HPV infection in women older than 30 is more likely to persist. Other factors that can result in persistent infections are cigarette smoking and any illness that compromises the immune system.
Typically, it takes years for an HPV infection to develop into cervical cancer. The best way to prevent cervical cancer is to have regular Pap tests as recommended by your gynecologist.
Q: I thought I needed an annual Pap test, but my gynecologist says I don’t need one this year. Why not?
A: For years, women at low risk for cervical cancer have been over-screened. In fact, it is now recommended that Pap tests should not start before age 21. This is based on new studies that show less than .1 percent of teenagers are diagnosed with cervical cancer.
For women 21-29 with a normal Pap test, it is recommended the test be performed every three years. Beginning at age 30, healthcare providers should also test for the presence of the high-risk HPV virus. If the Pap test is normal and HPV is negative, then screenings can be performed every five years.
In women 65 and older with no history of recent abnormal Pap tests, screening can be stopped.
Your gynecologist will look at your Pap test history and determine your appropriate screening regimen. Regardless of whether or not you need a Pap test yearly, you should still have a breast exam and pelvic exam.
Joanne Price Williamson, M.D., is an obstetrician-gynecologist in practice at Memorial Health University Physicians-Provident OB/GYN Associates at Legacy Center in Okatie.