Abnormal Pap With Negative HPV

Last Reviewed: December 11, 2017

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:

Christina S. Chu, MD, oncologic gynecologist, responds:

Most cases of dysplasia of the cervix are associated with the HPV virus. Other risk factors, such as cigarette smoking, are also associated with cervical dysplasia and cancer. 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 young women, mild dysplasia is cured by the body's immune system within 2 years. You should continue with your colposcopy and follow-up as frequently as your provider directs.

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