A pap smear is a test that is performed on women, usually during a yearly pelvic examination by a gynecologist. The procedure involves scraping cells from the cervix to test for cervical cancer or precancerous conditions. When a pap smear comes back with an abnormal result, it means that conditions may indicate a sign of cancer or pre-cancer, according to the Mayo Foundation for Medical Education and Research. If the abnormal cell changes demonstrated in the pap smear result from one of the high-risk HPV strains, the likelihood that the abnormal cells are precancerous increases.
Testing for High Risk HPV
If a pap smear shows abnormal cell changes, some doctors will test for human papillomavirus. The HPV virus has hundreds of strains, but many of these strains clear up on their own. There are two strains that are high risk: numbers 16 and 18. These high-risk strains are the cause of approximately 70 percent of all cervical cancers. If an abnormal pap smear is accompanied by one of these high risk strains of HPV, it is an indication that further testing should be done to determine whether the cell changes observed in the pap were pre-cancerous or caused by a more benign condition, the Mayo Foundation reports.
Testing
HPV can be tested for when a woman receives her annual examination at the gynecologist using the same cell scrapings that are used for the pap smear. If a women tests positive for HPV and also has an abnormal pap result, further testing can be done through the use of a colposcopy. This procedure involves using a lens to closely examine the cervix. The doctor will then conduct a vinegar solution test. This test involves applying a solution of vinegar to the cervical area. All areas affected by HPV will turn white. This is the most common test; however, a doctor may also use an HPV DNA test to determine the strain of HPV that is causing the abnormal cell growth, according to the Mayo Foundation.
Treatment
Based on the results of the pap test and HPV testing procedures, your gynecologist will decide the best form of treatment. Even in high-risk HPV cases, not all cases turn into cancer. In fact, there are some situations where even high-risk HPV has disappeared on its own. However, high-risk HPV must be monitored closely and carefully.
When you first have an abnormal pap test combined with a positive result on an HPV test, the doctor will normally perform the colposcopy. During the colposcopy the doctor may take a sample of cells from the cervical wall where the worst infection seems to be. The lab will analyze the sample to determine if the cells are cancer or pre-cancerous. Pre-cancerous cells will be removed using surgery, laser surgery, cryotherapy or electrocautery. After removal, you must make sure to come back for yearly pelvic examinations to monitor the condition and ensure it does not develop into cervical cancer.
HPV and Cancer
If the results of the sample cells taken indicate cervical cancer, usually the woman will need to have a hysterectomy. Cancer is determined by the depth of the cancerous cells into the cervical wall. If the cancer has been detected early, then only a partial hysterectomy is necessary. The partial hysterectomy removes the cervix, the top of the vagina, and the uterus. The ovaries are left, unless the cancerous cells have spread to one or both. If the cancer has spread to the ovaries, then a complete hysterectomy must be performed. It is important to note here that even after a partial or complete hysterectomy the woman is not free of the HPV virus. The chances of the virus creating cancer again are very low, but the virus can still go on living in the cells of the vagina. This is the reason that many women are still recommended to have a Pap test performed normally even after a hysterectomy, according to the Everyday Health website.
Prevention/Solution
High-risk HPV is considered a sexually transmitted disease. Therefore, the best prevention of HPV is abstinence. If you have sexual relations, then you should take precautions by using a condom, making sure the relationship is monogamous, and limiting sexual partners if the relationship is not monogamous. Another means of prevention for HPV is the use of a new immunization recommended for 11- to 13-year-old girls called Gardasil. This immunization is quickly becoming the No. 1 combatant of the HPV strains that cause cervical cancer. Most pediatricians will recommend this immunization to all females of the age mentioned. No immunization is readily available for males, the Mayo Foundation reports.
Tags: cervical cancer, Mayo Foundation, abnormal cell, cell changes, abnormal cell changes