I am 42 and I have never had an abnormal Pap smear until now which showed Atypical Squamous Cells of Undetermined Significance.  The HPV test that was done with the pap is negative.  All I got on the patient portal was repeat in 1 year with no other explanation. I’m highly concerned. I have had genital warts in the past and I know that is a type of HPV. I have always had Pap smears done every year due to having warts and being concerned.  Can a high risk type of HPV be causing this but the HPV test be negative?  What are the chances of this being the start of cancer?  If I repeat the tests in 1 year as recommended, can it come back as cancer then?  I have had multiple std tests done over the past year as well and nothing has come back positive except for this Pap smear. 

Welcome back to the Forum.  I'm sorry that you continue to worry.  Given the information you provided earlier, I'm not surprised that that the HPV test done on your ASCUS positive specimen was negative.  In some studies over half of Atypical Squamous Cells of Undetermined Significance (ASCUS) is not HPV related.  ASCUS can arise from inflammation, hormonal changes and in some cases is just a transient problem.  I would suggest that you speak with your doctor rather than dealing with the patient portal which will provide non-specific generalizations.  HPV can occur after apparent resolution but after going as long as you have without a positive test it would be rather unusual. ---

I do want to add that the comments on the abnormal pap that I just had says inflammation. Does that even mean anything?  I’m just very confused on all of this.  What are the chances this is Hpv related but the Hpv part is just not showing up?  Is this a possibility?  Why do doctors wait a whole year to repeat the tests in a situation like this?  

Inflammation is a non-specific  term which has many causes.  ---

This is the response I got from the nurse practitioner when I asked about my situation. ASCUS requires more testing but is almost always a sign of an HPV infection.  She said that a negative test result does not rule out HPV. She advised me to follow up in 1 year as recommended which I will do. None of this is promising to me and very confusing. I explained my concerns to her and it was just like I am a number and she didn’t have much time to answer any of my questions. I will be looking for another doctor to help me with further testing when the time comes. Thank you for your help and advice. 

The nurse practitioner you spoke with has overstated things.  All too often health practitioners fail to acknowledge what they do not know and do not take the time to listen to and hear their patients.  I'm sorry that this was the case.  I agree with your plans to seek another doctor. At the same time, you should consider contacting the DOCTOR that the NP works with and state that you believe you were misinformed, as much as a service to future patients and to address your own lingering concerns.  ---