Special tests can be performed on the Pap smear specimen to detect certain types (strains) of "high-risk" HPV that have a strong association with cervical cancer. However, just because this test is negative does not mean that a patient may not have been exposed to a low-risk strain of HPV.
Other things can cause cells to look abnormal, including irritation, some infections (such as a yeast infection), growths (such as polyps in the uterus), and changes in hormones that occur during pregnancy or menopause. Although these things may make cervical cells look abnormal, they are not related to cancer.
an HPV infection or abnormal cells can sometimes be missed (a 'false negative' result) abnormal cells can develop and turn into cancer in between screening tests. there is a small chance that a result says abnormal cells are found when the cervix is normal (a 'false positive' result)
A false-negative test result means you really do have an HPV infection, but the test indicates that you don't. This might cause a delay in appropriate follow-up tests or procedures.
A negative HPV test means you do not have an HPV type that is linked to cervical cancer. Your doctor may tell you that you can wait five years for your next screening test.
Approximately 5.5–11% of all cervical cancers are reported to be HPV-negative, which can be attributed to truly negative and false-negative results.
Cervical cancer not caused by HPV is called HPV-negative cervical cancer and accounts for roughly 5% of all cervical cancer cases. The statistic above comes from a 2021 review of HPV-negative cervical cancer. Human papillomavirus (HPV) is a sexually transmitted infection that includes low risk and high risk HPV types.
You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. It also spreads through close skin-to-skin touching during sex. A person with HPV can pass the infection to someone even when they have no signs or symptoms.
Cervical cell changes happen slowly. It can take many years for cells infected with HPV to develop into cervical cancer. We have great tools to prevent cervical cancer. Cervical cancer screening and HPV vaccination can prevent cervical cancer.
About 5% of all Pap tests will be abnormal, meaning that the sample contains atypical cervical cells. However, the majority of these cells are not cancerous or even precancerous. An abnormal Pap test result does not mean cancer, but it does require follow-up to rule out the possibility of cancer.
A false-positive HPV test result could mean your test shows you have HPV, but not the type of HPV that causes cancer. Some studies indicate HPV cotests – Pap smears that test the same cells for cervical and HPV – have more false-positive results than primary high-risk HPV tests.
Another possibility for a negative Pap test with a positive HPV test is that the focal area of cellular abnormality was sampled, but there were so few cells collected that the cells were not detected when screened by the computer and the cytotechnologist. This is called a false negative result.
There are actually lots of reasons your Pap smear may come back “abnormal.” You may have an infection or inflammation, growth or cysts, changes in your hormones (usually due to pregnancy or menopause), problems with your immune system related to diabetes, HIV, or autoimmune diseases.
Most abnormal Pap smear results are nothing to worry about
Most women will have at least one abnormal Pap smear result in their lifetime, with an overall average of 5% of all Pap tests coming back as “abnormal.” In most cases, the abnormal result is nothing to worry about, but it's important to follow up to make sure.
“I Received an Abnormal Pap Test. What's Next?” Your next step is usually a minor procedure called a colposcopy. This procedure is a visual examination of the cervix using a low-powered microscope used to find and then biopsy abnormal areas in your cervix that may lead to cervical cancer.
Those who said they were depressed or believed they had high levels of stress also still had an active HPV infection. HPV usually clears up on its own, but this study is really the first to indicate a link between stress and persistent HPV infection.
Research has found that it can take 10 to 20 years, or even longer, for HPV-infected cervical cells to develop into a cancerous tumor. Among women whose cervical cells are infected with high-risk HPV, several factors increase the chance that the infection will be long lasting and lead to precancerous cervical cells.
People can be infected with HPV without having sexual intercourse. The likelihood of exposure increases with the number of partners a person has, and HPV will often spread early in a relationship as the person is newly exposed to the virus.
Sex partners who have been together tend to share HPV, even when both partners do not show signs of HPV. Having HPV does not mean that a person or their partner is having sex outside the current relationship. There is no treatment to eliminate HPV itself. HPV is usually dealt with by your body's immune system.
Women Don't Need to Feel Ashamed About HPV
“Anyone who's ever had sex may have been exposed to HPV,” says Trimble, adding that she wishes she knew how to get rid of the unnecessary stigma associated with the disease. “Raising awareness can give you choices, and knowing you have choices is empowering.”
Low-risk HPV (lrHPV) – HPV 6 and HPV 11 cause approximately 90% of genital warts and are rarely associated with pre-cancer or cancer of the lower genital tract. Warts on other parts of the body, such as the hands, are caused by different types of HPV. Contact with these warts does not seem to cause genital HPV warts.
HPV and Cervical Cancer | Understanding HPV
These types of HPV are called high-risk HPV. Going forward, when we use the term HPV, unless we say otherwise we're talking about high-risk HPV. Two HPV types in particular are the worst. These two – HPV types 16 and 18 – are responsible for about 70% of all cervical cancers.
If your Pap test results are abnormal, your doctor may recommend a colposcopy. If you're told that you need a colposcopy, don't panic, says Coleman.