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Pap Test Results Often Confuse Women and Their Physicians

For more on cervical cancer and other health conditions, go to WebMD's Women's Health: Common Conditions board moderated by Jane Harrison-Hohner, RN, RNP. continued...

HPV is a sexually transmitted disease that has been rapidly increasing in the last 20 years. For many years gynecologists have known that HPV is associated with cervical cancer. Recent studies suggest that some strains of the virus are more likely to cause invasive cervical cancer than other strains of the virus, says Waxman.

For women with atypical cells, an HPV test can detect more than 90% of the cases that will progress to invasive cancer says Waxman. But he says that even HPV testing is not a simple matter because "most HPV infections are cleared, meaning that the virus does not go on to promote cancer." He says that most HPV infections last for "an average of eight months and young women are very likely to clear the infection." Waxman defines young woman as "younger than 30."

So if a young woman has atypical cells and tests positive for HPV, Waxman says he is likely to take a watchful waiting approach with her but if an older woman has the same clinical findings and has not recently changed sexual partners, he will "do a cone biopsy." A cone biopsy involves removing a small sample of tissue from the cervix.

In addition to HPV testing, some gynecologists are now using liquid-based testing methods such as ThinPrep for Pap tests.

Traditionally the doctor scraped some cells from the surface of the cervix and placed the cells on a slide. The slide was then sent to a lab for analysis. The liquid-based tests "just involve putting the cells in liquid and sending that container off to the lab," says Waxman.

Fans of the liquid-based tests say the tests permit better visualization of the cervical cells.

Waxman says the liquid tests cost more and the HPV test adds even more cost. "Consider it this way: start with a traditional Pap and the charge is $35, add a liquid Pap and that's another $50 and the HPV adds another $50," he says. The result is that the cost for cervical cancer screening is likely to increase, he says.

But even with a higher price tag, cervical cancer screening is still a bargain when you consider the life it can save, says Waxman.


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