YOU SHOULD KNOW

To Partners for Women’s Health Patients age 30 and older having a PAP smear performed:

HPV is the virus that causes the precancerous and cancerous changes of the cervix and vagina that PAP smears identify. The presence of HPV always precedes the development of cervical precancer and cancer. In other words, the presence of HPV always precedes significantly abnormal PAP smears. About 80% of women that have ever had sexual intercourse have been infected with this virus at sometime in the past. About 85% of women who been infected by the virus completely clear the virus from their body over a period of 18 to 24 months. However, 15% of the 80% of women who have ever had sexual intercourse will carry the virus on an ongoing basis.

If you have precancerous changes currently, then you are considered to be carrying the HPV virus and therefore do not need an additional test for HPV at this time.

If your PAP smear returns “Atypical” or “ASCUS”, then testing for HPV can help your provider determine whether to pursue further evaluation or not. In this case, a negative HPV test means the risk of precancerous changes is so low that routine annual PAP smear testing is sufficient. Alternatively, if the HPV test is positive, there is a 15% chance that you already have a precancerous change that should be identified and treated. Your provider would then recommend a test called a colposcopy. All Partners for Women’s Health providers recommend that an HPV test be done if your PAP smear result is “ASCUS” and your HPV carrier status is unknown.

If your PAP smear returns “Normal” then testing for the HPV will determine whether or not you are currently at higher risk for the future development of cervical precancer changes and cervical cancer.

Women who have a normal PAP smear and a negative HPV test who have not had a potential new exposure to HPV (eg. same sexual partner in a monogamous relationship) will be considered for having future PAP smear at a three year interval. That decision would be made with your provider on an annual basis at the time of your annual check-up.

Women who have a normal PAP smear and a positive HPV test must continue to have yearly PAP smears. Additionally, your PAP smear will have been double checked by a pathologist (physician) before being reported as normal.

PAP smears being interpreted without the benefit of HPV testing have a false negative rate of about 15%. Repetitive false negative PAP smears can result in a missed opportunity to prevent cervical cancer which can be lethal. By combining an HPV test with a PAP smear, the risk of a false negative PAP smear is reduced to about 5%. Because of this fact, all providers at Partners for Women’s Health recommend that you have the HPV test done if your PAP is normal and your HPV carrier status is unknown.

However, HPV testing is expensive. The test is done in two steps. The first step looks for the presence of many HPV types, most of which are harmless. If this first step is negative, then the test is negative and the charge is $140.00. If the first step is positive, then a second step looking for high risk HPV types is performed. The charge for the second step is $435.00.

Even if your insurance will cover the expense related to your PAP smear, it may not cover the expense related to HPV testing. Partners for Women’s Health providers are not able to determine in advance whether your insurance will cover all or part or none of the expense related to HPV testing as the test is actually performed and billed for by Seacoast Pathology. Seacoast Pathology will hold you personally responsible for all charges related to HPV testing not covered by your insurance carrier.