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Wednesday, June 10, 2015

New Types of HPV Tests and Why to Have Them

The high risk kind of human papillomavirus (HPV) are associated with 90-100% of cervical cancers and over 90% of anal cancers. We know that testing the anal region may be as important as testing the cervix and the vagina, but who and when to test is a very complex subject, and this post won't cover everything you will need to gab with your own gyno about.  Guidelines can be found in many organizations on line, such as the US Preventative Task Force, or the ASCCP. a question that comes up frequently is what about the "field effect" (the urethra, the clitoris, the anus, as well as the cervix and vagina and vulva) of the disease? Do you need actual pap tests of areas other than the cervix? USPT guidelines do recommend anal pap tests for HIV men who have sex with men, and for HIV women with prior cervical caner. The anal pap smears often will not get cells (about 13% of the time accordin to Dr Lamme et al in Obstetrics and Gynecology), so it may have to be repeated.  How about HPV tests of these areas? Almost two thirds of women will have a positive HPV test of this area if they have cervical HPV disease, but exactly what to do if that test is positive. HPV tests may be more sensitive in screening for disease that has spread from it's initial place, but we do not know this yet, much work needs to be done. Women will ask if they have not ever had anal sex is it possible to get anal HPV disease, and the answer is that yes, it seems to be possible because the disease affects the epithelium (surface) tissues of the entire area, and probably can be passed by touching. When we do studies and pap test the cervix and the anal region about half the patients who do test positive for anal HPV and cervical HPV will have disease with the same time of HPV type in both places according to the March 2011 issue of the Female Patient . It is not clear who should yet have this pap smear test of the anal area, and a new journal article points out how common anal infection is in women with cervical disease. Their study showed that those at risk of developing cervical cancer, women with high-grade cervical dysplasia may have an elevated risk of anal cancer," lead author Jacqueline Lammé, MD, from the Department of Obstetrics Gynecology, Naval Medical Center, San Diego, California, and colleagues write in an article published in the August issue of Obstetrics &; Gynecology. Women with persistent rectal , like itching might benefit, by a test for anal pap or anal HPV as well as some other tests, but generally we think of HPV is a disease without symptoms.While itching may be a simple hemorrhoid or irritation it is important to see your gyno to be evaluated.

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