How HPV Causes Cervical Cancer and Abnormal Pap Smears

Human papillomavirus, or HPV, is so common that one out of every two sexually active adults has been infected with one or more of the approximately 100 types of HPV, only 30 of which are transmitted sexually.



(ISTOCKPHOTO)


Human papillomavirus, or HPV, is so common that one out of every two sexually active adults has been infected with one or more of the approximately 100 types of HPV, only 30 of which are transmitted sexually. Most of these are benign, but some can cause genital warts, while others can cause cervical cancer—a disease that can be halted in its very early stages by a gentle, painless scraping of the cervix known as a Pap smear, generally recommended annually.


What is an abnormal Pap test?
A Pap test, or Pap smear, is part of a womans routine physical exam. It is the best way to prevent cervical cancer, because it can find cells on your cervix that could turn into cancer. The cervix is the lower part of the uterus that opens into the vagina.

When your doctor says that your Pap test was "abnormal," it means that the test found some cells on your cervix that do not look normal. It does not mean that you have cancer. In fact, the chances that you have cancer are very small.

What causes an abnormal Pap test?
Most of the time, abnormal cell changes on the cervix are caused by certain types of human papillomavirus, or HPV. HPV is a sexually transmitted disease. Usually these cell changes go away on their own. But certain types of HPV have been linked to cervical cancer. Thats why its important for women to have regular Pap tests. It takes many years for cell changes in the cervix to turn into cancer.

Sometimes cell changes in the cervix are due to other types of infection, such as infections caused by bacteria or yeast. These types of cell changes can be treated. In women who have been through menopause, a Pap test may find cell changes that are just the result of getting older.

What increases your risk for an abnormal Pap test?
High-risk sex raises your chances of getting HPV and having an abnormal Pap test. High-risk sex includes having sex without condoms and having more than one sex partner (or having a sex partner who has other partners).

HPV can stay in your body for many years without your knowing it. So even if you now have just one partner and practice safe sex, you could still have an abnormal Pap test if you were exposed to HPV in the past.

Smoking or having an impaired immune system also may raise your chances of having cell changes in your cervix.

Do abnormal cell changes cause symptoms?
The cell changes themselves don't cause symptoms. HPV, which causes most abnormal Pap tests, usually doesn't cause symptoms either. This is why regular Pap tests are so important.

If a different sexually transmitted disease or infection is the cause of your abnormal Pap test, you may have symptoms, including:

  • A discharge from the vagina that isn't normal for you, such as a change in the amount, color, odor, or texture.

  • Pain, burning, or itching in your pelvic or genital area when you urinate or have sex.

  • Sores, lumps, blisters, rashes, or warts on or around your genitals.


What will you need to do if you have an abnormal Pap test?

You will need more tests to find out if you have an infection or to find out how severe the cell changes are. These tests may include:

  • Colposcopy, a test to look at the vagina and cervix through a lighted magnifying tool.

  • An HPV test. Like a Pap test, an HPV test is done on a sample of cells taken from the cervix.

  • Another Pap test in 4 to 6 months.

  • A colposcopy is usually done before any treatment is given. During a colposcopy, the doctor also takes a small sample of tissue from the cervix so that it can be looked at under a microscope. This is called a biopsy.

  • Treatment, if any, will depend on whether your abnormal cell changes are mild, moderate, or severe. In moderate to severe cases, you may have treatment to destroy or remove the abnormal cells.




Last Updated:
January 12, 2007

Author:
Shannon Erstad, MBA/MPH


Medical Review:
Joy Melnikow, MD, MPH - Family Medicine

Barbara S. Apgar, MD, MS - Family Medicine, Women's Health

Ross Berkowitz, MD - Obstetrics and Gynecology


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Last Updated: October 16, 2008

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