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Women's Health

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The New HPV Test You Should Ask Your Doctor About

OK, but what if a yearly Pap makes you feel safer?

Trouble is, each time you're tested, you run the risk of an abnormal finding. And though there's a strong chance that any aberrant cells would be cleared by your body before your next test two or three years later, now the doctor has to "do something," which might include removing those cells. You're subject to needless procedures, not to mention a lot of anxiety about the possibility of cancer — all for a disease that likely would never have developed.

If you have an HPV test and a Pap and both are normal, what next?

You're "free," so to speak, for three years. "Even if a 40-something woman went out and got a new infection the very next day, she would be effectively setting the clock back to zero; her risk of cervical cancer wouldn't rise significantly until she was in her 60s," says Mark Schiffman, M.P.H., M.D., senior investigator at the National Cancer Institute. In other words, a double "all-clear" may finally give a woman — and her doctor — the peace of mind to break the Pap-every-year habit.

What if your Pap is fine, but your HPV test is positive?

First, it doesn't mean that you definitely have cancer or will get cancer. But what's next depends on whom you ask. Some experts recommend, if possible, following up with the more specific HPV 16/18 test, approved last year, to check if the two most worrisome forms of the virus are present (this test is not yet widely available). If that test is positive, your doctor will almost certainly advise a colposcopy, a procedure in which the cervix is viewed directly through a tube-like microscope and, if necessary, tissue samples are removed. But most experts advise retesting in a year and, if those tests are positive, then doing a colposcopy, says Karen Smith-McCune, M.D., associate professor of obstetrics and gynecology at the University of California, San Francisco Helen Diller Family Comprehensive Cancer Center. However, not all women are comfortable with this wait-and-see approach. "I am getting a lot of self-referrals from women who are really frightened because they tested positive for HPV and don't want to wait even a few weeks for additional test results," says Dr. Smith-McCune.

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