Abnormal Pap With Negative HPV

Author: OncoLink Team
Content Contributor: Christina Chu, MD
Last Reviewed: August 12, 2019

Question:

Dear OncoLink "Ask The Experts,"

My recent pap results said I have precancerous lesions with mild dysplasia. I have read that HPV causes low-grade squamous intraepithelial lesions in 85% of cases. My test came back negative for HPV, so what else could have caused this?

Answer:

Most cases of dysplasia of the cervix are associated with the HPV virus. Sometimes they can be caused by infection. In some instances, we do not know the cause of the dysplasia. You should be aware that the Pap test is NOT a direct test for the HPV virus. Special tests can be performed on the Pap smear specimen to detect certain types (strains) of "high-risk" HPV that have a strong association with cervical cancer. However, just because this test is negative does not mean that a patient may not have been exposed to a low-risk strain of HPV. Note that there are over 100 types or strains of HPV and the tests cannot test for all of these.

In general, the chances of mild dysplasia going on to become true cervical cancer are very low. In 70-80% of women under 30, mild dysplasia is cured by the body's immune system within 2 years. However, it is important to follow up to be sure the HPV is cleared and the pap results return to normal. You should continue with your colposcopy and follow-up as frequently as your provider directs.

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