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HPV/pap

My wife was diagnosed with genital warts 1 year ago.  They cleared after about 1 month of treatment and have not returned.  After her annual pap smear last week she received a call saying she had an abnormal pap smear positive for hpv and needs to return.    Last year when she was diagnosed with genital warts we both freaked out.  6 months later it was pretty clear that we freaked out over a minor and temporary health condition.  I'm trying to keep that in mind this time and have been telling her that 6 months or 2 years from now we will probably feel the same way about this.  Is that a good way to look at it?


1) It is our understanding that different strains result in warts and abnormal pap smears.   Is it common for a woman to experience warts one year and then the next year have an abnormal pap and is it still safe to assume the strain that caused warts is cleared?

2)  If this is a different strain of hpv and neither of us has been unfaithful, she probably had it last year when she had her pap, but due to cervical cell changes occurring slowly it just hadn't shown up yet?  Similarly it is likely that without treatment they will slowly return to normal, never to return?  

3)  My wife read that she needs to inform her dentist of this as there is an increased risk of oral cancer.  From reading this site I've come to conclusion that there is a minute chance of oral cancer.  Should she tell her dentist?

4)  My wife is going back to her doctor for follow up in a few weeks and is worried they are going to tell her she already has cervical cancer since by her calculation she had the warts for about 12 months prior to her diagnosis last year so she has had hpv now or at least 24 months.  Since most hpv infections clear by 24 months she thinks that means she has a high risk case.  Cancer is still a rare outcome, correct?

Thank you for your help.


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300980 tn?1194929400
MEDICAL PROFESSIONAL
I agree. Your risk for penile cancer is tiny.  EWH
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Avatar universal
Thank you for your help. My wife is stressing some over it and I think this will help her relax. She is actually 29 so we were surprised that they did an hpv test. My wife did not request one. She was told the changes were cause by hpv by the woman who called to schedule her follow up so I'm not sure exactly what was said.  Maybe they just assumed hpv?  She will clarify at her follow up.  I forgot my wife's last concern. She is worried I will get penile cancer. This is even more uncommon than cervical cancer correct?  I told her I thought I was more likely to be killing myself by eating junk food resulting in a heart attack than by having sex with her. Would you agree?

Thanks again for all your help. This site is a tremendous source of help and information.
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
Welcome to the Forum.  I'll try to help.  This issues surrounding PAP smears and HPV are complicated and evolving.  Further, unfortunately many health care providers are not well informed on these rapidly evolving topics.  I'll try to help and address your questions but I'll also forewarn you that the time/space available on this site is limited so that we have time to address as many questions as possible.  It also appears that you have already done some research on the topic.  If it hasn't already been part of your research, I'd suggest taking a look at the information at the American Sexual Health Association (ASHA) web site.  It is often quite helpful.  

Second, I'll congratulate you on your approach.  It appears that you and your wife have taken a mature approach to the facts that HPV infections, whether manifest as warts or abnormal PAPs are incredibly common and that having warts or HPV detected on PAP smears should not disrupt a relationship.  

Finally, I'll presume that your wife is over 30 since unless there are other abnormalities, HPV testing for PAP smears is not suggested until women are over 30.  The infection is SO common in women under 30 that there are few reasons for testing for HPV before a woman is 30 years old.

With this as background, let's go to your questions:

1) It is our understanding that different strains result in warts and abnormal pap smears.   Is it common for a woman to experience warts one year and then the next year have an abnormal pap and is it still safe to assume the strain that caused warts is cleared?

The HPV types that cause warts (mostly types 6 and 11) can also be present on PAP smears.    Other types which rarely cause warts (most commonly 16 and 18 but there are many other types as well) however are far more common on PAP smears.  Her doctor will need to explain which types are present and suggest next steps.  The important distinction is that these types almost never go on to the sorts of problems that can sometimes lead to cancer.  

2)  If this is a different strain of hpv and neither of us has been unfaithful, she probably had it last year when she had her pap, but due to cervical cell changes occurring slowly it just hadn't shown up yet?  Similarly it is likely that without treatment they will slowly return to normal, never to return?  

Correct on both counts.  HPV may not be detected until years after acquisition and typically do resolve over time without consequence.

3)  My wife read that she needs to inform her dentist of this as there is an increased risk of oral cancer.  From reading this site I've come to conclusion that there is a minute chance of oral cancer.  Should she tell her dentist?

I would disagree with this statement, It is an overstatement.  Oral HPV is far less common than genital infection and its consequences are unknown.  Most dentists would not know what to do with the information and might well make incorrect conclusions if told.

4)  My wife is going back to her doctor for follow up in a few weeks and is worried they are going to tell her she already has cervical cancer since by her calculation she had the warts for about 12 months prior to her diagnosis last year so she has had hpv now or at least 24 months.  Since most hpv infections clear by 24 months she thinks that means she has a high risk case.  Cancer is still a rare outcome, correct?

Yes, cancer typically takes years and years to develop.  the PAP smear is a wonderful test which allows early detection of slowly developing abnormalities so that, IF NEEDBE, interventions can be taken before cancer develops. Cancer is a very rare outcome.  She should not worry.

I hope my comments are helpful.  EWH
Helpful - 0

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