If you have worries about HPV, you are not alone. Every year, millions of young women get the stomach-dropping notification that human papillomavirus was detected on a routine Pap.
Recently, I got this question from a reader:
I am 31 years old and I just got e-mail from my OB-GYN saying I have HPV on my Pap. They said not to worry and that I should just have a repeat Pap in a year. Not to worry? A year? Doesn't HPV cause cancer? What can I do to get rid of it?
It has been estimated that at least 80% of sexually active women and men will be exposed to HPV in their lifetime. Some say the numbers are closer to 100%. HPV is responsible not only for cervical cancer but also for vulvar, vaginal, anal and oral cancers.
This all sounds terrifying, but the reality is that your HPV will most likely cause no problems — and the advice you were given was correct.
HPV on your Pap is upsetting, but not serious.
Most Pap tests check not only for the presence of the HPV virus, but also inspect individual cervical cells to make sure they look healthy. HPV on your Pap simply means that the virus was detected. If your cervical cells look normal, there's no damage done other than having a viral guest you would rather not have.
If HPV continues to hang out, as opposed to clearing out or becoming latent — which means it's there, but it's inactive and undetectable — there is a potential for problems down the road. In other words, it is the persistence of HPV — defined as consecutively positive HPV results at least 12 months apart — rather than the presence of HPV that is concerning.
Over time — and we are talking years, not months — HPV can impact normal cell growth patterns. If untreated, those abnormal cells can progress to pre-cancer (dysplasia) and, in some cases, cancer. Since no abnormal cells are present now, it is perfectly reasonable to repeat your Pap in one year because ...
HPV almost always goes away and the likelihood of progressing to cancer is very, very small.
Cervical HPV is almost always a transient infection, which means it is cleared by a healthy immune system without treatment. Some 90% of first-time HPV results will revert to a negative result within six to 12 months. More important, less than 1% of all women infected with HPV go on to get cervical cancer.
The most likely HPV infections to progress to cancer are in women who smoke, have a compromised immune system (due to conditions such as HIV/AIDS), or simply don't follow-up on recommended testing.
HPV will not impact your ability to have a healthy pregnancy.
The cervix, which is located at the top of the vagina, is the opening to the uterus. It lets menstrual blood out and sperm in. The cervix is a thick-walled tubular structure about 3-4 inches long; it shortens and thins out in labor to allow the baby to exit the uterus. A healthy cervix is critical to getting and staying pregnant, but even if there is persistent HPV that causes pre-cancerous cells and requires treatment down the road, it is extremely rare that the treatment compromises the function of the cervix.
In addition, HPV does not enter the uterus, so there is no possibility of infecting the baby during a pregnancy.
Note: There is a very rare possibility of the baby getting HPV in the mouth and throat during delivery, but this is unlikely.
Action steps to protect your cervix:
- If you smoke, stop. Breakdown products of cigarette smoke are concentrated in cervical mucus, where they promote the growth of abnormal cells, pre-cancer, and over time, cancer.
- If you haven't had the HPV vaccine, it's not too late to get it. It will not make your HPV go away, but it will prevent you from getting infected with other sub-types. Gardasil 9 is the newest version of the vaccine; it protects against the seven viral types that are most associated with cervical and other genital cancers, and the two types of HPV that are most likely to cause genital warts. A vaccine to make HPV go away is in development, so stay tuned.
- Be sure to follow up with your next Pap and HPV test. In developing countries, where Pap tests are not done, cervical cancer is still the leading cause of death among women aged 35 to 45. In the U.S., the rate has been extremely low since the 1960s, when routine Pap tests were introduced.
If you keep up with your recommended testing, nothing bad will happen. It's the women who ignore follow-up testing that get into trouble down the road.
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Dr. Lauren Streicher is a clinical professor of obstetrics and gynecology at the Feinberg School of Medicine at Northwestern University and medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause. Dr. Streicher is a regular contributor to TODAY.