Abnormal Pap After Cone Biopsy

Last Modified: March 1, 2009


Dear OncoLink "Ask The Experts,"

I was diagnosed with CIN-3 after a cold cone knife biopsy for an abnormal Pap smear. I have heard that Pap smears after cone biopsy can be inaccurate and asked my physician to also test for HPV. Does this sound like a good idea?


Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:

I usually recommend having a Pap 6 months after the cone biopsy. As long as the Pap is "adequate", meaning it captured both squamous and glandular cells on the specimen, then it is as accurate as any Pap.

As for HPV testing, anyone who has cervical intraepithelial neoplasia (CIN1 or higher) already has a 95% or more chance of having a positive test for high-risk strains of HPV, so I don't find it useful in this situation. I usually only check HPV in patients with ASCUS (atypical squamous cells of undetermined significance) on Pap.