Pap Smear and HPV Test Results: Your Questions Answered

Pap smear & HPV testing

Hello Dr.
Lin: I received the results of my Pap smear and HPV test conducted on December 15.
The HPV result is negative, while the Pap smear indicates a grade of (2) with inflammation.
I would like to know if the inflammation indicated in the Pap smear could affect the HPV test results.
Is the risk of cancer due to inflammation significantly high? When I picked up the report, the doctor mentioned that there was only a slight inflammation and did not advise me to undergo treatment before repeating the Pap smear.
Should I consider repeating the Pap smear and HPV test? If so, how long should I wait before doing so? I might be a bit anxious, and I feel that clinics may be somewhat negligent, but I don't want to let my family know, so I can only choose a general clinic.
Should I consider switching to another clinic? Which is more professional, a large hospital or a clinic? Could you recommend a specialized clinic or hospital in Taipei? There is a new thin-layer Pap test available; is it necessary to pay out of pocket for that? Is its accuracy higher? Additionally, I would like to ask about the gynecology clinic I visited; they did not perform a transvaginal ultrasound, only a standard abdominal ultrasound.
Can a standard abdominal ultrasound detect abnormalities or tumors in the uterus or ovaries? I am unsure if a transvaginal ultrasound is necessary to identify symptoms, so I am currently considering whether I need to find a gynecology clinic that offers transvaginal ultrasound for a repeat examination.
I apologize for asking so many questions...
Thank you for your help!

An An, 20~29 year old female. Ask Date: 2006/12/27

Dr. Lin Zhaopei reply Obstetrics and Gynecology

1.
A Pap smear showing inflammation will not affect the results of the HPV test.
2.
If you want to receive the vaccine, you can have another test done at least 3 months prior.
3.
There is no need to change clinics.
4.
The new thin-layer Pap smear costs approximately 1500 NTD out-of-pocket, and its increased accuracy may be worth considering.
5.
A full bladder is necessary for an accurate assessment of the uterus and ovaries.

Reply Date: 2006/12/27

More Info

Understanding your Pap smear and HPV test results can be quite overwhelming, especially when you receive mixed results. Let's break down your questions and concerns regarding your recent tests.

1. Impact of Inflammation on HPV Results: Your Pap smear indicated a score of 2, which typically suggests some inflammation. Inflammation itself does not directly affect the accuracy of HPV testing. However, it can sometimes lead to atypical cells being detected, which may complicate the interpretation of results. The presence of inflammation does not inherently increase the risk of HPV or cervical cancer, but it is essential to monitor any changes in your cervical health.

2. Cancer Risk Associated with Inflammation: While chronic inflammation can be a risk factor for various health issues, including cancer, a mild inflammatory response, as indicated in your results, is not usually a cause for alarm. The link between inflammation and cancer is more significant in cases of persistent inflammation over time, often associated with other risk factors such as smoking or long-term HPV infection.

3. Need for Follow-Up Testing: Since your HPV test came back negative, and the inflammation noted in your Pap smear is described as minor, your doctor may not see an immediate need for retesting. However, if you have concerns or if symptoms persist, it is reasonable to discuss the possibility of a follow-up Pap smear and HPV test. Generally, if everything remains stable, a follow-up in one to three years is standard, depending on your age and health history.

4. Choosing a Healthcare Provider: Your comfort and trust in your healthcare provider are crucial. If you feel that your current clinic is not providing the thoroughness you need, it may be worth seeking a second opinion or finding a facility that specializes in gynecological care. Larger hospitals often have more resources and specialists, but many private clinics also offer excellent care. Look for clinics with good reviews or recommendations from trusted sources.

5. ThinPrep Pap Smear: The new ThinPrep or liquid-based Pap smear tests are designed to improve the accuracy of cervical cancer screening. They can provide a clearer sample for testing and may detect abnormalities more effectively than traditional methods. If you are considering this option, discussing it with your healthcare provider can help you weigh the benefits against the costs.

6. Ultrasound Types: Regarding your concerns about ultrasound, both abdominal and transvaginal ultrasounds have their uses. Transvaginal ultrasounds are generally more sensitive for detecting abnormalities in the uterus and ovaries, especially in early pregnancy or when assessing pelvic pain. If your current provider only offers abdominal ultrasounds and you have specific concerns, seeking a facility that provides transvaginal ultrasounds may be beneficial.

In summary, while your current results indicate a mild inflammatory response and a negative HPV test, it is essential to maintain regular check-ups and communicate openly with your healthcare provider about your concerns. If you feel uncertain about the care you are receiving, seeking a second opinion or a more specialized facility can provide peace of mind and ensure that you are receiving the best possible care for your reproductive health.

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