HPV positive

[concernedhubby882]

My wife recently had a pap smear and it tested HPV positive. She has over the last 15 years had annual tests performed and all were negative. We are in a very committed marriage and we are the only sexual partners either of us have ever had. Obviously this news has concerned my wife and myself. My question is, how frequently does HPV show up from non-sexual contact. And what are the other modes of transmission? Also, is it likely she had a false positive test. The doctor wants to perform a scope procedure and biopsy and we are both wondering if the biopsy is necessary for what might have been a false positive test.  Thoughts?

[Hollyv]

It would be unusual if your Dr. even mentioned or acknowledged the chance of false positives. Some of the risk factors for cervical cancer are sex at an early age (before 18), multiple sexual partners, smoking, other STD’s, a weakened immune system and HPV. You might want to ask the Dr. what the risk is for your wife for cervical cancer and why the rush to do a colposcopy and not just a repeat Pap in 6-12 months (except for the reason that she can charge more). Good Dr.’s use a patient’s history combined with testing to determine further diagnostic procedures. A colposcopy is an invasive procedure and only should be done by an experienced colposcopist and they would not even know if they needed to biopsy until after they took a look because a good colposcopist uses a visual to decide if they need to biopsy (some take biopsies just to make sure but that also increases cost). And there was very little info in your post and you did not say if she has had children or is still planning to have children or will have any more. And if you don’t get a satisfactory response from the Dr., one that understands your concern then you also have an option of getting a second opinion—get all your records and lab results and take them with you to see another OB/Gyn.

[concernedhubby882]

Thanks for the response. Yes, my wife and I started dating early in high school, both devoted Christians, and out sexual relationship extends no further than the two of us. Which is why the phone call from the doctors office to my wife saying she had an STD did not sit well. All she heard was "STD", "biopsy", and "cancer" on the phone. No mention of false positives, no mention of other means of transmission, nothing. They scheduled the biopsy for her, but we decided she needs to speak with her doctor about these results first.

[Hollyv]

If you are the only sexual partners each other has ever had then her risk for HPV would be almost zero. I presume she had a mildly abnormal Pap and tested HPV positive. Neither the Pap nor the HPV test is 100% accurate and there are false positives. The options that you usually have with a mildly abnormal is to do a reflex test off of the original specimen for an HPV test, to repeat a Pap in 6 months or to have a colposcopy done. Many Dr.’s don’t give the patient an option and do the HPV test. I would have her discuss this with her Dr. and if it were me, I would have a repeat Pap in 6-12 months before I had a colposcopy with or without biopsy. Even if she had HPV, which would appear unusual in your case most HPV infections clear within a number of months. She should have her Pap 10-20 days after the 1st day of her last period and she should not have sex 48 hours before or use lubricants, suppositories or tampons 24 hours before either. Both the Pap and the HPV test are “screening tests” to help the Dr. determine if there is a risk for cancer (cervical cancer is very rare in the US) then the colposcopy is done to see if there are any cell changes. There are 4-5 million mildly abnormal Paps a year and a study in 2007 indicated that 95% of the colposcopies were unnecessary. There are approx 11,000 cases of cervical cancer diagnosed a year in the US and most are in women that have never had a Pap or not had one in 5 years.