Her last Pap smear was around 3-4 years ago and was clear.

Due to these symptoms, the doctor has arranged a smear test this week to rule out cancer/Hpv.

We have been together for 15 years and been faithful during that time.

I had a one night stand at age 19, 3.5 years before getting together with my wife.

- Is it possible I picked up Hpv from this encounter and was still able to pass it in after 3.5 years?

- Could it have been missed/undetectable during Pap smears for the last 15 years?

- Is it possible that since the last Pap smear, the Hpv has become ‘active’ and progressed to cancer?

- What is the usual timeline for Hpv to advance to cancer? When I check online it says 10-20 years, but is that 10-20 years of an active, detectable Hpv infection?

Thank you

You don't say what symptoms your wife has. However, the large majority of cervical cancers cause no symptoms at all; usually cancer is not suspected until a Pap smear is abnormal or there is obvious cancerous tumor seen during pelvic exam. When symptoms are present, the most common is abnormal vaginal bleeding -- but there are many more common causes than cervical cancer. A normal pap 3-4 years ago makes cervical cancer unlikely, mainly for exactly the reason you state yourself:  it generally takes 10-20 years, and rarely less than 5 years to develop overt cervical cancer with symptoms. Did her doctor really indicate cervical cancer is likely? Or maybe just indicate it's one [unlikely?] possibility? Of course your wife should follow the doctor's advice, but I wouldn't be very worried at this point.

Could you have genital HPV, or a past infection? Sure: 90% of all people acquire HPV, assuming an average sex life. Could you have been infected during the exposure on your mind all those years ago? Conceivably yes, but if you've had other sex partners, there's no way to know which was the source. And if your wife had other sex partners before you became a monogamous couples, those events are just as likely (perhaps a lot more likely) source(s) of HPV.

Of course we're experts in STDs, not cervical cancer or its diagnosis. But I will be surprised if it turns out your wife has cervical cancer or an HPV-related cause of her symptoms. I'll be interested to know the outcome after your wife has had her exam and Pap smear. In the meantime I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

As far as I am aware, the doctor/nurse didn’t specify Hpv or cancer, just booked a pap in response to my wife’s symptoms. Possibly just to rules things out as you say.

Could I just check:

Is it possible/likely to still have an active Hpv infection after 3 years for a man? Would it normally clear by that time?

I also keep reading about a dormancy period - how does that work? Would the Hpv be detectable during the usual 10-20 years leading up to cancer?

As you can probably tell, this is preying on my mind a little..

Thanks again

"Active HPV infection":  Most HPV infections in males are cleared by the immune system -- at least to a point where the virus is not detectable with testing -- within 3 years.

Dormancy:  Many (perhaps most) HPV infections are permanent, i.e. HPV DNA persists in tissues for life. Most of the time, it is undetectable, but it can reactivate at any time. However, there is uncertainty among the experts about how often this happens. Some believe it's always permanent, whereas others believe most infections are cleared entirely by the immune system. There is no way to know for any particular patient.

At this point, I suggest you put HPV aside entirely. Most likely your wife's gyn exam will include a normal Pap smear and no evidence of an active HPV infection. I'll be happy to comment further if you'd like to let me know the results after she has been examined, but before then this is nothing more than speculation and I won't have any further comments until then.

The results were clear, negative for Hpv.

Thank you for your help.