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Cancer: Cervical & Ovarian Message Board

Cancer: Cervical & Ovarian Board Index


I am wondering -- how can you dispute the solid facts, and basically state that the HPV test is not an important weapon against fighting cervical cancer? It's proven to be far more accurate than the Pap test -- and has already saved many women from going through procedures that are not necessary. Additionally, I ask you again to re-read my initial post -- or any of my posts in these forums. I have stressed nothing but the utmost importance of getting regular Pap tests, and following up on any abnormal Pap result. Because of the high margin of error with Pap tests -- the HPV test is another weapon in our arsenal to catch this disease before it becomes an invasive cancer.[/QUOTE]

Michelle, I am not reading that Kim is disputing the importance of the hpv test. What I am reading is that if someone tests negative on an hpv test, this does NOT mean that person is not experiencing some kind of cell changes or cervical cancer. There are several instances that I know of women receiving a negative hpv test and they HAVE cervical cancer. You're right, the hpv test does typically capture whether the virus is present or not, but it, like any other test is not one hundred percent fool proof. Just because you test negative for hpv does not mean you are in the clear, particularly if you have a pap that comes back showing high grade changes OR you have a visible tumor on your cervix.

Yes, the hpv test is very important and can be an effective tool to further reduce the number of cases of cervical cell issues and catch abnormalities before they become invasive. But isn't it more effective if your pap is reading ascus - atypical or low grade versus a high grade result? Certainly if you are recieving a high grade pap result, it MUST be followed up on regardless of whether you test positive for hpv or not. And in 75% of the cases of a high grade result, that is what will show up on biopsy (I believe I read that somewhere once, but don't have the article or the time to go and search for it). Standard of care is that if there is a high grade result, it must be followed up on, AND they strive for correlation between cytology and biopsy. Thus, if you have a high grade cytology and yet they cannot find anything during the colpo, that is also a red flag for further investigation. I do believe the asccp guidelines state this, but again, I have not reviewed them today (I've reviewed them many, many times though).

Bottom line for me is this. I think the test is most useful when you are seeing an atypical result, a positive hpv test will encourage docs to explore further to ensure there is nothing sinister going on. Honestly, if you are getting a high grade pap result, I really don't think it matters one way or the other if you test positive for hpv or not. It really doesn't. Because you still have to explore the high grade result. Now, if you have an ascus/atypical smear and you test negative for hpv, then I think probably it makes a doc comfortable recommending "come back in 6 months". But I'm not a doc, so I can't say for sure.

The unfortunate fact is, that despite regular pap screening and even regular hpv testing, there will still be women who do not fit the statistics. There will still be a woman who tests normal for years on her paps, and if she is testing normal, they are NOT going to repeat an hpv test every smear, are they? I mean, in a utopian world, sure...but cost limitations will play a role. There will still be women who develop cervical cancer without ever having an abnormal pap test or positive hpv test. It won't be many women, for sure, but there will be women who do! Surely you can agree with that?

I think this is what Kim is trying to get at, if I may give my opinion on what I am reading in her post. Maybe I'm wrong? I don't know. But I thought I'd throw it out there anyway.

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