Screening & Detection Insights
Welcome to a comprehensive exploration of HPV testing, its implications, and potential outcomes. Human Papillomavirus (HPV) is a prevalent infection with significant health ramifications, making screening a critical aspect of preventive healthcare.
Based on your individual risk of developing severe cervical cell changes that could become cervical cancer, you may be advised to
- return for a repeat HPV test or HPV/Pap cotest in 1 or 3 years
- have a colposcopy and biopsy
- receive treatment
There are various screening techniques available, highlighting their effectiveness and importance in identifying HPV infections and related abnormalities. Understanding the screening process is key to maintaining optimal health and preventing the progression of potential complications.
HPV TEST / PAP SMEAR
The test is similar but they search for a different outcome:
The HPV test looks for the virus (human papillomavirus) that can cause these types of cellular changes in the cervix.
The Pap test (or Pap smear) looks for precancers, which are changes in the cells of the cervix that could become cancer if not treated properly.
HPV/Pap cotest: uses combine both to check for both high risk HPV and cervical cell changes. If your doctor finds that you have a type of HPV that can lead to cancer, they may suggest you get Pap tests more often to watch for signs of abnormal cell changes in the genital area.
HPV test results
HPV test results show whether high-risk HPV types were found in cervical cells. An HPV test will come back as a negative test result or a positive test result.
- Negative HPV test result:
High-risk HPV was not found. You should have the next test in 5 years. You may need to come back sooner if you had abnormal results in the past.
- Positive HPV test result:
High-risk HPV was found. Your healthcare provider will recommend follow-up steps you need to take, based on your specific test result.
| Result | What it means |
|---|---|
| HPV found (HPV positive), but no abnormal cell changes | You’ll be invited for screening in 1 year and again 1 year later if you still have HPV. If you still have HPV after 2 years, you’ll be asked to have a colposcopy. |
| HPV found (HPV positive) and abnormal cell changes | You’ll be asked to have a colposcopy. |
What does it mean if you have a positive HPV test after years of negative tests?
Sometimes, after several negative HPV tests, a woman may have a positive HPV test result. This is not necessarily a sign of a new HPV infection. Sometimes an HPV infection can become active again after many years.
Pap test results
Pap test results show whether cervical cells are normal or abnormal. A Pap test may also come back as unsatisfactory.
Normal or negative Pap test results: No abnormal cervical cells were found.
Abnormal or positive Pap test results: Some of the cells of the cervix look different from the normal cells. Abnormal Pap test results include
- Atypical squamous cells of undetermined significance (ASC-US): It means that some cells don’t look completely normal, but it’s not clear if the changes are caused by HPV infection.
- Atypical glandular cells (AGC): Some glandular cells were found that do not look normal.
- Low-grade squamous intraepithelial lesions (LSIL): There are low-grade changes that are usually caused by an HPV infection.
- Atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H): Some abnormal squamous cells were found that may be a high-grade squamous intraepithelial lesion (HSIL), although it’s not certain.
- High-grade squamous intraepithelial lesions (HSIL): There are moderately or severely abnormal cervical cells that could become cancer in the future if not treated.
- Adenocarcinoma in situ (AIS): An advanced lesion (area of abnormal growth) was found in the glandular tissue of the cervix. AIS lesions may be referred to as precancer and may become cancer (cervical adenocarcinoma) if not treated.
- Cervical cancer cells (squamous cell carcinoma or adenocarcinoma): Cancer cells were found; this finding is very rare for people who have been screened at regular intervals.
Follow-up tests
Keep in mind that most people with abnormal cervical screening test results do not have cancer. However, if you have an abnormal test result, it’s important to get the follow-up care that your health care provider recommends.
State of dormacy
Human Papillomavirus (HPV) can sometimes enter a state of dormancy in the human body. When HPV is in a dormant state, it means that the virus is present but not actively causing any symptoms or abnormalities. The virus can exist in a latent or inactive form, and during this period, it may not be detectable through routine tests. Key points about HPV dormancy include:
Asymptomatic Carrier State:
- Many people who contract HPV may never experience any symptoms, and the virus can remain dormant in their bodies.
- An individual may be an asymptomatic carrier, meaning they carry the virus but do not develop visible warts or other HPV-related conditions.
Reactivation:
- HPV can be reactivated, leading to the recurrence of symptoms or the development of new ones.
- Factors such as a weakened immune system, stress, or other health conditions may contribute to the reactivation of the virus.
Persistent Infections:
- In some cases, HPV infections persist over an extended period without causing noticeable symptoms or complications.
- Persistent infections with high-risk HPV types are associated with an increased risk of developing cervical and other cancers.
Screening and Detection:
- Dormant HPV infections may not be easily detectable through routine screening methods.
- Screening methods, such as Pap smears and HPV DNA tests, are designed to identify active infections or cellular changes that may indicate a risk of developing cervical cancer.
Is citology and pap smear the same?
Yes, in the context of HPV (Human Papillomavirus) and cervical cancer screening, “cytology” and “Pap smear” are often used interchangeably, though there are subtle differences.
Cytology:
- Cytology refers to the study of cells. In the context of cervical cancer screening, cytology involves examining cells collected from the cervix to detect any abnormalities.
- Cytology is a broader term that encompasses various methods of studying cells, and it can be used for different types of cytological examinations, not limited to cervical cells.
Pap Smear:
- A Pap smear, or Papanicolaou smear, is a specific type of cytological examination used for cervical cancer screening.
- During a Pap smear, cells are collected from the cervix and then examined under a microscope to identify any abnormal changes in the cervical cells that could be indicative of HPV infection or precancerous conditions.
COLPOSCOPY
During this procedure, a lighted instrument called a colposcope magnifies the cervix, bringing abnormal cells into view. Then they are removed to test them in a lab for signs of precancer or cancer (biopsy).
Biopsy findings
Biopsy samples are checked by a pathologist for CIN.CIN is the term used to describe abnormal cervical cells that were found on the surface of the cervix after a biopsy.
CIN is graded on a scale of 1 to 3, based on how abnormal the cells look under a microscope and how much of the cervical tissue is affected. LSIL changes seen on a Pap test are generally CIN 1. HSIL changes seen on a Pap test can be CIN 2, CIN2/3, or CIN 3.
- CIN 1 changes are mild, or low grade. They usually go away on their own and do not require treatment.
- CIN 2 changes are moderate and are typically treated by removing the abnormal cells. However, CIN 2 can sometimes go away on its own. CIN 2 must be treated if it progresses to CIN 3 or does not go away in 1 to 2 years.
- CIN 3 changes are severely abnormal. Although CIN 3 is not cancer, it may become cancer and spread to nearby normal tissue if not treated.
Colposcopy view
Is VIA and colposcopy the same?
No, VIA (Visual Inspection with Acetic Acid) and colposcopy are not the same procedures, but they are related in the context of HPV (Human Papillomavirus) and cervical cancer screening.
VIA (Visual Inspection with Acetic Acid):
- VIA is a simple and low-cost screening method for detecting cervical abnormalities, including those caused by HPV.
- During VIA, a healthcare provider applies acetic acid (vinegar) to the cervix, and visual changes in the cervical tissue are observed.
- The acetic acid causes abnormal cells to temporarily turn white, making them more visible.
Colposcopy:
- Colposcopy is a more advanced and detailed examination compared to VIA.
- It involves using a colposcope, which is a magnifying instrument, to closely examine the cervix and vaginal tissues.
- Colposcopy is often performed if there are abnormal results from a Pap smear or other screening tests, including VIA.
Find more information about your results here
Most HPV infections (90%) clear up on their own within 2 years.
There is no treatment for the virus itself. However, there are treatments for the health problems that HPV can cause.
From negative results offering peace of mind to positive results prompting further investigation, each outcome plays a crucial role in managing and maintaining reproductive health.
By comprehending the lifecycle of HPV and its potential consequences, you can take proactive steps towards prevention and early management.
Implications for Women:
- For women, a positive result may lead to additional screenings, such as colposcopy, to examine cervical cells more closely.
- Abnormal cell changes can be monitored and treated to prevent the progression to cancer.
Implications for Men:
- HPV can affect men as well, causing genital warts or, in some cases, leading to cancers such as penile or anal cancer.
- Beaware of the importance of regular health check-ups for men.
No test for other cancers
There aren’t any approved tests for identifying HPV on the vulva, vagina, penis, scrotum, rectum or anus. HPV-related cancers on these body parts are much less common than cervical cancer. There’s no similar test for the strains of HPV that cause cancer in men, except for anal cancer.
