About a month ago I had a Pap smear that came back abnormal, and was told I have hpv. My dr then did a colposcopy two weeks ago. I got a call today saying that it came back normal. What does this mean? Do I still have hpv? Do I just have low risk hpv? I have never experienced warts.
Hello, Welcome to Icliniq. There is a difference between all the tests you underwent. To make it clear for you I will explain one at a time. 1) Pap smear - it's a test used to screen if a women can be harbouring cancerous or precancerous cells over the mouth of the uterus ( i.e. CERVIX) , so basically a screening test for cervical cancer and it's pre cancerous changes. And as it is just a screening tests, it can not always diagnose if you have any foci of cancer over the cervix. it just give characteristics of the cells which were studied on the smears. So unless they are overtly cancerous looking, we always try to rule that out by doing other tests, So next comes the HPV ( Human Papilloma Virus) testing. 2) HPV testing - It's a test to detect the causative agent of the cervical cancer, that is human Papilloma Virus, it's spread through sexual contact. Based on their genomic sequence, they can be categorised into various types. So warts are caused by the low risk type that is 6 & 11. where as there some 12 high risk types which can cause cervical cancer, so these are detected in the HPV testing ( Depending on your test done - as various tests have different sensitivity & specificity). Of these high risk majority are caused by Type 16 & 18. So once a women starts her sexual activity, almost 70- 80% women may have HPV infection but it gets cleared over 1-2years, so that is why we do not test it for women less than 30yrs ( I see you haven't mentioned your age).So as the HPV is a virus and it coming positive indicates higher risk of having precancerous changes or may be risk of cervical cancer in future, we need to see if any changes have already happened to substantiate the previous tests. So then comes the role of colposcopy. 3) Colposcopy - it's basically a test to visualise the cervix under huge magnification and to see for any deviation from normal, and to look for any changes over the cervix which can hint on being abnormal or precancerous, so that from that particular abnormal sites biopsies canbe taken and subjected to histopathological examination ( where a pathologist sees the tissue under microscope to look for any cancerous cell). So as your colposcopy finding are normal, your gynaec may call you repeat testing after 6-12months for repeat cytology & HPV testing. If the Repeat screening are negative twice then you can just follow the screening protocols routinely as other women. Please share the reports of your HPV & Pap smear so that I can go through & guide you through in case you any further doubts.  Hope the information helps you. Have a nice day.