(Published January 2009)

Counseling Tips

Lack of Information About HPV

Data from a national survey show that only 40% of women had ever heard of human papillomavirus or HPV.¹
Of these, less than half were aware that HPV causes cervical cancer.

HPV is sexually transmitted.
HPV is very common.
Most women with HPV will not get cervical cancer.
HPV infection usually clears by itself.
HPV tests are used to detect the virus that causes cell changes and cancer of the cervix.
Pap tests are used to detect cell changes and precancer that are caused by HPV.
Most women who test positive for HPV do not have precancer or cervical cancer on further evaluation.
However, some women with HPV infection that doesn’t clear quickly will develop cervical cell changes.
A positive Pap test result likely indicates a woman has cell changes caused by HPV.
A positive Pap test result usually means that a woman will need additional testing to make sure she doesn’t have serious cell changes or cancer.
If a woman is found on additional testing to have serious cell changes or cancer, effective treatment is available.
HPV types that are not covered by the vaccine cause 30% of cervical cancers.²
Because 30% of cervical cancers are associated with HPV types that are not covered by the vaccine, women will continue to need cervical cancer screening even if they are vaccinated.

HPV is very common. Almost 8 out of 10 women will get HPV at some point in their lives.
There is no way of knowing how long HPV has been present or who transmitted the virus.
Having HPV is not a sign of infidelity or promiscuity.
Most women who have HPV do not develop abnormal cells or cancer.
Women who have HPV in their cells a long time are at greater risk for developing abnormal cells or cancer.
If you have a positive HPV test result, your health care provider will want to examine your cervix more closely or more frequently than usual.

The positive HPV test is an indicator that closer follow-up is warranted.
It’s a good sign that the Pap test result is negative, but diligent follow-up is important.
Follow-up means that you should come back in 12 months for a Pap and HPV test.
If HPV is still present at follow-up, colposcopy will be recommended even if the Pap result is still negative.³

Proactively dispel the myths that abound about HPV. Ask your patient what she knows about the virus and provide accurate information as needed.
Provide information about HPV relevant to the clinical situation, then ask your patient if she has any questions. Tell her how to contact you if she has questions after she leaves your office.
To minimize patient anxiety, be sure to clarify that a positive HPV DNA test result is not a cancer diagnosis. Explain that because of the high prevalence of HPV infection and the relatively small risk of cancer, many patients will have positive test results but never develop cervical cancer.
Clearly communicate about any necessary follow-up, including the timing, any procedures or testing that will be done, and the approximate length of the follow-up appointment.

Tiro JA, Meissner HI, Kobrin S, Chollette. What do women in the U.S. know about human papillomavirus and cervical cancer? Cancer Epidemiol Biomarkers Prev. 2007;16:288-94.
Centers for Disease Control and Prevention. Human Papillomavirus: HPV Information for Clinicians. November 2006.
Wright TC Jr, Massad LS, Dunton CJ, Spitzer M, Wilkinson EJ, Solomon D. 2006 Consensus Guidelines for the Management of Women with Abnormal Cervical Cancer Screening Tests. Am J Obstet Gynecol. 2007;197(4):346-55.