Normal Pap Smear

Normal Pap Smear: Could I Still Have HPV?

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The regular Pap test can be a dread for many women. The situation is uncomfortable, and the fear of an abnormal result can be anxiety-provoking.

What’s more, the results of a Pap smear can often be confusing.

Here, we have provided a breakdown to help you better understand your Pap results and how we can use testing to better prevent complications like cervical cancer.

What Is a Pap and HPV Test?

The HPV and Pap Smear Tests are the primary ways for women to test for HPV and signs of abnormal cells.

Pap test involves taking a sample of cells from your cervix to assess for any abnormalities. It is usually combined with a pelvic exam and sometimes an HPV test, which screens for the presence of HPV viruses in your cell tissues.

What Do Your Pap Results Mean?

The test results from a Pap smear can go one of three ways: NORMAL, UNCLEAR, ABNORMAL.

  • Normal: a normal Pap test suggests no abnormal cellular changes on the surface of the cervix. Pap testing will be recommended every three years.
  • Unclear: an unclear test indicates some mild abnormality and usually warrants a repeat Pap test. Mild abnormality could be due to a vaginal or sexually transmitted infection, changes in hormones, such as those seen in pregnancy or menopause, with certain medications, or poor test collection.
  • Abnormal: an abnormal pap test means that cervical cell changes were found. This does not mean that you are positive for cervical cancer but further investigation is needed.

Can You Have a Normal Pap Smear But Be Positive for HPV?

Because the Pap test and HPV test for two different things, abnormal cellular changes and the presence of HPV in your cells, it is possible for your Pap test to come back normal, but you screen positive for HPV.

This results likely means you have HPV, but the virus remains in a state of low activity and has not caused significant abnormal changes to your cervix.

HPV is typically cleared by activation of the adaptive immune system, which releases immune molecules called T-cells into the circulation to suppress viral replication. Over time, a healthy immune system should prevent HPV from further proliferating into your cervical epithelial cells and render the virus in a latent state.

A normal Pap test could therefore indicate that your immune system is actively suppressing cell proliferation, but the virus is still active.

Errors In Pap Testing

A normal Pap test could also mean the swab may not have caught the areas of abnormality on your cervix. While Pap testing is a great tool, it isn’t always perfect.

Studies find that abnormal findings increase when conventional Pap smears are replaced by liquid-based cytology (LBC). However, because most HPV infections resolve over time and cytology exams lead to costly follow-up investigations with repeat Pap smear and biopsies, HPV reflex testing is being used to identify high-risk strains.

HPV Reflex Testing

Pap and HPV testing are usually done in combination to evaluate whether the strain of HPV that is infecting a host, has a high risk of developing into cancer.

HPV reflex testing can help identify the particular HPV strain that is causing the infection.

We know that high-risk HPV types 16, 18, 31, 33, 35, 45, 52, and 58 account for about 88% of all cervical cancers worldwide. Detection of these strains within an individual can help prioritize preventative measures and screening to monitoring changes and cell development.

By performing more specific screening we can ensure that individuals at high-risk are getting proper follow ups and avoiding undue stress to minor cases that are unlikely to progress into cervical cancer.

It should be noted that HPV reflex screening is not typically included in screening guidelines but is offered as a commercial test to better screen for a patient’s risk.

What Can You Do?

If you have received a result of a normal Pap test but remain positive for HPV, it is still important for you to take steps to support your immune system and keep watch on the situation.

We recommend:

  • Eating a diet rich in plants and high in micronutrients.
  • Supplementing with herbal formulas, like Papillex, and medicinal mushrooms to support your immune system.
  • Developing techniques to reduce daily stressors and manage overwhelm.
  • Limiting the consumption of alcohol and avoiding smoking.
  • Getting daily exercise and movement into your day.

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