Should I Pay for a Pap Smear After Testing Positive for HPV?

Is it necessary to pay out of pocket for a Pap smear if HPV is positive?

Hello, doctor.
I am currently 31 years old, unmarried, and have no history of pregnancy.
After my last sexual intercourse on January 25, I underwent an HPV test at Taipei Medical University Hospital on January 27, which returned positive for high-risk HPV (method: diene HC2 high-risk HPV DNA test) with RLU/cutoff: 133.53 and HC2 HPV_RLU: 38593, type: 51+.
My last Pap smear was done in August of last year and showed normal results with no cancer cells.
The physician at Taipei Medical University Hospital advised me to have another HPV and Pap smear test in August this year for follow-up.
However, I recently learned that my boyfriend has been diagnosed with stage 1 penile cancer.
He mentioned that there was a small bump on the side of his penis shaft, and after a biopsy, it came back positive for an HPV 51 lesion.
I was very surprised because I know that HPV takes a long time to cause cancer.
This has made me very worried.
Should I consider paying for a Pap smear or any other tests soon, or should I just wait until August to do both the HPV and Pap smear tests? Thank you very much, doctor, for alleviating our concerns and providing guidance.

Aj, 30~39 year old female. Ask Date: 2016/04/17

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the Pap smear was done in August of last year, and it showed no cancer cells.
You can follow your doctor's instructions, and it would be better to have another Pap smear done recently.
Wishing you good health.

Reply Date: 2016/04/17

More Info

When it comes to managing your health after testing positive for HPV, particularly in the context of your boyfriend's recent diagnosis of penile cancer, it's understandable to feel concerned and seek clarity on the next steps.
Firstly, regarding your question about whether you should pay for a Pap smear after testing positive for HPV, the answer is nuanced. The Pap smear is a critical screening tool for cervical cancer and can detect precancerous changes in cervical cells. Since you had a normal Pap smear in August of the previous year, and your HPV test results indicate a high-risk type (HPV 51), it is advisable to follow your doctor's recommendation for regular monitoring. The fact that your last Pap smear was normal is reassuring, but given your positive HPV result, additional monitoring is prudent.

Your doctor has suggested waiting until August for your next Pap smear and HPV test, which is a common practice. However, considering the recent developments regarding your boyfriend's health, it may be beneficial for you to have a follow-up Pap smear sooner than the scheduled date. This is particularly relevant since HPV can have varying effects on individuals, and your boyfriend's diagnosis may heighten your risk factors or concerns.
In general, HPV can remain dormant for years before leading to any significant health issues, including cancer. However, the presence of high-risk HPV types, especially in the context of a partner with HPV-related cancer, warrants closer observation. If you feel anxious about waiting until August, you could consider discussing the option of a Pap smear with your healthcare provider sooner. They may agree that an earlier test is warranted given your circumstances.

Additionally, it’s important to understand the implications of your HPV status. While HPV is a common virus, the high-risk types can lead to cervical cancer over time. Regular Pap smears and HPV testing are essential for early detection and management. If any abnormalities are found in your future Pap smears, your healthcare provider may recommend further diagnostic procedures, such as a colposcopy or biopsy, to assess the cervical tissue more closely.

Regarding the HPV vaccine, if you have not yet received the nine-valent vaccine (Gardasil 9), it is worth discussing with your healthcare provider. The nine-valent vaccine protects against several strains of HPV, including those that are most commonly associated with cervical cancer and other HPV-related diseases. Even if you have already received the quadrivalent vaccine, getting the nine-valent vaccine can provide additional protection against more HPV types.

In summary, while it is generally acceptable to wait for your scheduled Pap smear in August, given the recent developments in your boyfriend's health, it may be wise to consider an earlier appointment for peace of mind and thorough monitoring. Regular screenings are crucial for early detection and effective management of any potential health issues related to HPV. Always feel empowered to discuss your concerns with your healthcare provider, as they can offer personalized advice based on your health history and current situation.

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