Berman - Figure 10 - Risk of Persistent HPV

What about the risk of persistent HPV?

The purpose of co-testing is to find those women who are truly at risk. Women with persistent HPV as evidenced by a positive HPV test. These are women who need to be followed. This is not a false positive.
The Pap is not a perfect test. The Pap is a screening test, and not a diagnosis. A negative Pap does not mean that disease is absent on that woman’s cervix, but the finding of a positive HPV test means she has the risk factor, a necessary factor for cancer to develop.
If she remains persistently positive on her one year follow up after an initial Pap-negative/ HPV-positive result, we will look at her cervix colposcopically and determine if she has disease. If she does not, these are women who must be followed, because the fact is that there is a risk of CIN 3+.
Facts
- 20% - 30% of women with persistent HPV will develop significant precancerous changes.
- Untreated CIN3 has a 30% chance of becoming invasive cancer over 30 years. Approximately 1% of treated CIN3 will
become invasive.
- We may find women with existing disease and be able to treat as a preventative strategy. We may find those women
that don’t have disease yet but have the potential for developing disease over time.

References

[94] Saslow D, Solomon D, et al “American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology Screening Guidelines for the Prevention and Early Detection of Cervical Cancer, Journal of Lower Genital Tract Disease, 2012;6;(3):175-204.