I have been told my smear has shown high-risk HPV, should I be worried about?
Positive test results can be upsetting. HPV stands for Human Papilloma Virus since it is a mouthful, I’ll use HPV in my discussion.
HPV is often associated with genital warts, precancerous changes in the cervix as well as cancer of the cervix. The short answer to your question is that high-risk HPV strains are the culprits behind the bulk of cervical cancer cases. However, one time positive HPV test result does not necessarily mean that you will develop cancer. For many women, the body will fight off high-risk HPV within one to two years.
It is also good to know that in the eventuality that it does begin to develop into precancer to sinister changes, it can take anywhere from one to three decades. So, even with high-risk HPV, there is enough data to support optimism. Also, knowing a little bit more about HPV, HPV tests and risk factors can help one understand it and take further steps to address it.
A quick note about cervical smear and HPV tests:
A cervical smear checks the cervix for abnormal cells that could turn into cervical
cancer, whereas, HPV test checks the cervix for HPV that could cause abnormal
cells and lead to cervical cancer.
We live in a tinder culture and casual relationships are becoming more common
than committed ones. HPV is one of the most common sexually transmitted
infection. The lifetime risk of HPV infection in women who are sexually active is
75%. If the person had only one sexual partner in her lifetime, the chance of
encountering HPV is about 20%. The way one can look at this is, if a person has
had several sexual relations in her lifetime, then, most likely that person has
encountered HPV. In most cases, HPV infection of the genital tract occurs about
5 years after the first sexual intercourse. Most women clear their HPV infection
within 12 to 24 months. This is particularly true for women in their 20’s.
There are more than one hundred different types of HPV, out of these, there are
about a dozen that is grouped as high risk, meaning they are associated with
changes in the cervical cells and with developing cancer and few as low risk.
Among these, HPV 16 and 18 are the most common and they have been blamed
for 70% of cervical cancers.
HPV 16 is by far the most significant HPV to cause persistence of infection and
progression from normal to high-grade lesions in cervix and minority to turn into
Because there is a strong association between high-risk HPV infection and
cervical cancer, high-risk HPV testing is considered as an alternative for cytology
based cervical screening.
A woman with a positive HPV test has an increased risk of precancerous changes
(cervical intra-epithelial neoplasia-CIN) even though her cytology may be
There is evidence to suggest that, detection of viral gene expression (HPVmRNA)
constitute a more specific approach for differentiating clinically significant
infection in women who are HPV-DNA positive.
HPV oncogene expression (Positive HPV-mRNA) and evidence of its deregulation
can be monitored through direct detection of viral mRNA transcripts
Low risk HPV usually cause genital warts and some call them as distant cousins
of high risk HPV.
Life cycle of HPV
When one is exposed to HPV, one of three things may happen:
1. Individual’s immune system may clear it
2. Can cause lesion or and may persist without causing cellular change
3. Can cause changes at the cell level that can eventually one day progress
Infection with 14 high risk HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68) is
associated with almost all cases of pre-cancer and cancer changes of cervix.
High risk HPV testing guides patient management by identifying patients at
elevated risk for CIN-2 or higher. But, importantly, it also reassures patients
who are negative for high risk HPV of their extremely low cancer risk.
High risk HPV molecular DNA tests work by detecting viral genomic DNA in cells
from the cervix. However, because the presence of high risk HPV in the female
genital tract is common and often transient in nature and most cervical HPV
infections resolve without becoming cancerous.Virtually all cases of cervical
cancer are caused by HPV, and just two HPV types, 16 and 18, are responsible for
about 70% of all cases.
Few frequently asked questions include following:
When and how the test for HPV is done?
The HPV test is done just like a cervical smear and can be done at the
same time as the smear test. The HPV test is directed towards high risk
types most likely to cause cervical cancer.
Why shouldn’t women less than 30years old get an HPV test?
Since HPV is very common, many women younger than 30 will have HPV.
But, these infections are more likely to go away in younger women. A
young woman might need to have an HPV test if she has a cervical smear
which is not normal and show changes in her cervix. In this case, HPV test
would be part of her follow up, here age does not matter.
If I am over 30, should I be tested for HPV, when I get my smear test?
Having both HPV testing and cervical smear is now known to be the best
way to be tested starting at age 30.
What will happen if I have a positive HPV test?
Don’t be scared, just make sure you get a second HPV test in one year. It
may be worthwhile to look for whether the same virus type has gone
away or not. One positive HPV test is very common. Keep in mind that
those infected with HPV, 50% of them, fortunately, clear the virus within 8
months and 90% of them within 2 years. If the infection does not go
away, it will grow very slowly, so waiting one year to repeat the test is
For more information and to schedule preventative
care appointment contact me at
Tel : 07940072311