How Many Paps and Where To Have Them

HPV probably never goes away. So if you have had paps that wax and wane: they are good, they are bad: don't get out the frying pan and chase anyone out the door. It's probably a reactivation of prior disease. Disease which we thought our immune system could resolve, probably just goes into latency. And if a woman has HPV disease she may have a 'field effect' meaning that the entire area: your vagina, your vulva, your urethra, and your anorectal areas may all be affected.  There has been an increase in anal cancers in the US. Mostly these are individuals that are already immunodeficient, and on medication. So regular anal pap testing can be done. If your pap is abnormal then you need an anoscopy(microscopic look at the anal area) exam.  So after offering cervical paps since the 1950s, we added the Halo Breast pap a few years ago, now an anal pap. We want to be more aggressive once we do a pap and go on to the colposcopy to see what the lesion really is. However in pregnancy, the newest guideline is to manage early abnormal pap tests (ASCUS, LGSIL) expectantly, as the pregnant state actually gives most women a bit of an immune boost.


  1. Thanks for you post. Good Housekeeping magazine actually published an article a few months about about Pap testing and HPV testing for cervical cancer prevention

  2. The article you mention is a great summary! But women also need to know that if they've had the Quiagen test vs the Cervista HPV test there may be different strains tested for. In fact other tests are still under development that may test for even more strains. For more information on that and other clinical trials try,
    What I try to remind women is that that there is a lot of pap information out there, and nothing beats having that talk with your own gyno about your individual case! Thanks,


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