I keep hearing about the new HPV vaccine, but it isn't going to do me any good: I just found out that my last Pap Smear was abnormal, so I'm not eligible to be vaccinated. What does an abnormal Pap smear really mean? Am I going to get cervical cancer? - Unhappy Pappy on JPA
First, pat yourself on the back. Continuing to get regular pap smears is the absolutely best way to protect yourself from cervical cancer. Before the advent of this screening test, cervical cancer killed more women in this country than any other malignancy. Thanks to the Pap smear, cervical cancer is now responsible for a tiny minority of cancer deaths in America. Unfortunately, this disease continues to be a tremendous problem in developing countries that lack screening programs.
How do pap smears prevent cancer? A Pap smear is a sample of cells from the surface of your cervix. Doctors examine these cells for signs of infection with certain types of Human Papilloma Virus (HPV), the bug implicated in the vast majority of cervical cancers. This is the same virus that causes warts, which can show up anywhere from the palms to the penis.
It's important to note that the types of HPV that cause common warts like the ones on hands and feet are totally distinct from those that cause genital warts. Similarly, the viral types associated with genital warts are different from those that cause cervical carcinoma. However, like the genital wart-associated HPV strains, the strains causing cervical cancer are transmitted through sexual contact. HPV is thus technically a sexually transmitted infection.
Because of the staggering prevalence of this infection (at least 75 percent of men and women of reproductive age are thought to be infected at some point in their lives), many physicians view it as indication of sexual activity, rather than a traditional STD. Increased numbers of sexual partners, younger age of first sexual experience and smoking can all increase the risk of infection. Although practicing safe sex reduces risk, this is not entirely protective as virus can be shed by surrounding genital skin cells not covered by condoms.
So you have HPV: now what? The presence of HPV-infected cells in your Pap Smear does not mean you have cancer; it does mean that there are changes occurring on the surface of your cervix that could lead to cancer. The next step will be to determine the extent of these changes.
To find this out, your doctor will get a magnified, up-close-and-personal view of your cervix with a culposcope. She will also take a small sample of tissue for further examination. If the tissue shows "mild" cellular changes, you will be monitored with more frequent pap smears to look for more worrisome changes. Ninety percent of these mild changes will either regress on their own or never get worse. If cell changes are considered "moderate" or "severe," treatment is recommended.
Treatment options include Loop Electrosurgical Excision Procedure, or LEEP, as well as laser and cryotherapy treatments. These approaches are tremendously successful, resulting in a cure for the vast majority of women with a single treatment.
With the development of the HPV vaccine, in the future, far fewer women will have to experience what you're going through. However, the vaccine does not cover all cancer-causing strains of HPV, so even vaccinated women should keep up the regular screening. Remember, a Pappy cervix is a happy cervix!
Anne Mills is a Cavalier Daily Health & Sexuality columnist. She can be reached at anne@cavalierdaily.com or through the Sex & Balances submission page at cavalierdaily.com/sex.asp. This column is used for educational purposes only and is not meant to substitute advice from your doctor.
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