Many of us know that the HPV infection is the biggest risk factor for cervical cancer, and that a pap smear is the foremost diagnostic tool for detecting cervical cancer or pre-cancer. So what is the connection between an abnormal pap smear and HPV?
A pap smear is a process where tissue from the outer part of the cervix is removed using a speculum and then examined under a microscope. Many abnormalities, including infections such as HPV and pre-cancerous changes can be detected by virtue of a pap smear. So the connection between an abnormal pap smear and HPV is that the former can often help to identify the latter.
What is an abnormal pap smear?
When abnormality is detected in a pap smear, the abnormality is usually mild, classified according to the Bethesda System (a system for reporting vaginal and cervical diagnoses) as atypical squamous cells of undetermined significance (ASC-US).
These are mild abnormalities, many of which require no treatment and will resolve on their own. However clinicians cannot predict with abnormalities will resolve on their own and which will need treatment to prevent complications.
However it has been seen that when HPV testing was performed following such an abnormal pap smear result, it offered useful guidance as to which cases needed treatment and which did not.
So here the connection between an abnormal pap smear and HPV becomes quite clear: HPV testing offers more clarity about the nature of the abnormality detected and also about the sort of treatment that is needed if any. This is why many clinicians believe that an HPV test should be the next logical step after an abnormal pap smear.
What women should know about an abnormal pap smear and HPV
HPV is not just one virus but a group of about one hundred different viruses. Out of these about 40 are sexually transmitted infections and it is only some types of HPV that are implicated in cases of cervical cancer.
Many cases of HPV are sub-clinical; that is to say that the infection may be latent and may not have any symptoms such as genital warts and so on. The discovery of sub-clinical HPV may actually be the result of an abnormal pap smear.
The important thing to know about an abnormal pap smear and HPV is that just because a woman is detected with HPV, this doesn’t mean that she will develop cervical cancer. in fact a vast majority of women who have the infection will not get the cancer. The connection is that HPV increase cervical cancer risk rather than the actually cause the cancer.
The reason that the connection exists between an abnormal pap test and HPV, is this: many women may have HPV and not even know they have it, because it can be completely asymptomatic. However when the infection remains in the body, it causes certain changes in the cervix, and these changes are what a pap smear will detect.
So in other words, both an abnormal pap smear and HPV are warning signs that things may go wrong from here on, and that a woman needs to take care and perhaps undergo further testing in the interests of her health and wellbeing.