[Question #583] Quick follow up on question 421

42 months ago
Hi Doctor Hansfield. I think this will be a quick question to answer and not take up too much time. 
 I stated in my last question that my wife had an abnormal pap. They called it precancerous cells. She had one treatment where I believe they did some form of freezing. We were under the impression that it was almost certainly from hpv 16 but in your response you stated that the chances would be under 10%  of it being hpv16. Would you mind clarifying a bit for us? Thank you.  Oh, by the way the treatment was many years ago and she has been fine ever since. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
Welcome back to the forum.

I didn't re-read my previous reply in detail, but I doubt I said that the chance any particular abnormal pap smear has under 10% chance of being due to HPV16. Certainly I didn't mean to imply that either in my previous reply or in any other statements. On the other hand, I have no idea why you and your wife thought HPV6 was the cause of her abnormal pap smear, unless she had an HPV test that showed HPV16. But usually the HPV testing with paps simply reports high or low risk. HPV16 is among several high risk types. In any case, it makes no difference in either her health or yours going forward. Aside from following her doctors' advice if follow-up exams or pap smears are recommended, you and she need not give this another thought.

I hope this has helped. But let me know if anything isn't clear.

Best wishes--  HHH, MD

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42 months ago
Thank you for the response. I just reread question 421. You say that an abnormal pap resulting from hpv 16 is probably under10%. I may be misunderstood. Definitely not trying to argue. Just trying to get a better understanding. My wife's current doc is not very knowledgable. She told us that the hpv that causes warts is the one that causes cancer which we know is incorrect. 
There was no hpv test when my wife was treated.  We only recently discovered it was caused from hpv. We thought that all abnormal paps were caused by type 16 or 18. 
Thanks again for the help. I apologize for our ignorance. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
OK, now I understand. Yes, knowing nothing more than "abnormal pap", I would still guess that around 10% are due to HPV16; maybe as high as 20%, but it is definitely not true that "all abnormal paps" (or even a majority) are due to HPV 16 or 18. The low risk (wart causing) HPV types also cause abnormal paps, as do the 15-20 reasonably common high risk types. In the absence of HPV testing at the time of your wife's abnormal pap, there's simply no way to know at this time. As for "We only recently discovered it was caused from hpv", no apology is necessary!  But in fact, HPV is by far the main cause of abnormal paps. In other words, "abnormal pap" is almost synonymous with abnormal pap. This was known in past years, although in the pre-HPV testing days, many if not most doctors deemphasized the HPV relationship in advising many of their patients.


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42 months ago
Thank you again. I'm satisfied with the answers and will end this with this last request. Could u guess at the number of different strains of hpv that could cause abnormal paps and the needed procedure my wife underwent. 
Please keep up the good work!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
There are over 100 HPV types that cause genital infections and are sexually transmitted. Most, maybe all, can cause abnormal pap smears that would be treated with freezing or other methods to destroy the abnormal cells.


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42 months ago
Thank you Doctor.  I'm done. Very informative!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
Glad to have helped. Best wishes.---