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1,2 This can lead to fewer false-positive results and unnecessary invasive procedures such as, colposcopy and biopsy.. Genital warts usually appear as a small bump or group of bumps in the genital area. Can being hpv positive only mean high risk hpv or can that include low risk also? From pediatrics to adult needs, preventive programs to complex care were here to support you on every step in your journey. This may be your experience when its time for your regular Pap smear: You have your test, wait for results and breathe a sigh of relief when your results show youre fine. AskMayoExpert. See Cervical Cancer Screening for information about when to get screened and what to expect during the tests. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Other types of cancers, including cancers of the anus, penis, vagina, vulva and back of the throat (oropharyngeal), have been linked to HPV infection. Just because you tested positive for HPV does not mean that you have or will develop cervical cancer. We do it in the office and you can go back to work the next day.. The best way to protect yourself from HPV-related cancers is to get the HPV vaccine. The HPV test is a screening test for cervical cancer, but the test doesn't tell you whether you have cancer. LABORATORY-BASED METHODS Traditional laboratory testing for vaginitis includes cell culture and Gram stain (also called Nugent scoring). Your doctor may ask you to come back for another Pap test in a few months. The risk for cancer increases if your body cannot fight off the virus for some reason, and it stays in your system. However, some adults age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their healthcare provider about their risk for new HPV infections and the possible benefits of vaccination. Click here for an email preview. Women ages 30 to 65 are advised to continue having a Pap test every three years, or every five years if they also get the HPV DNA test at the same time. If you havent received general anesthesia, your provider may inject a numbing medication into parts of your cervix. The high-risk HPV types detected by the assay include: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68. with Genotyping: The changes may be minor (low-grade) or serious (high-grade). Accessed Feb. 25, 2019. They don't detect HPV in men or any other cancer. CIN is the term used to describe abnormal cervical cells that were found on the surface of the cervix after a biopsy. This could be less than the actual number of people who get genital warts. . Often, we cannot detect when you were exposed to HPV, explains Dr. Sarraf. Avoid intercourse, douching, or using any vaginal medicines or spermicidal foams, creams or jellies for two days before the test. A Pap test result can be normal, unclear, abnormal, or unsatisfactory. Call your healthcare provider if you havent received your results after three weeks. Pap smears that combine screens for HPV and cervical cancers are called cotests. If the initial high-risk test is positive, then the residual specimen will be tested for HPV types 16 and 18,45; type 18 cannot be differentiated from type 45. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Those tests include: The test procedure is the same. Rarely, the infection may cause a noncancerous growth in the baby's voice box (larynx). Hi, i just found out that my test for HPV came back positive but my pap smear is normal..I am 41 and I have only had sex with my husband and that read more. Warts. The CDC recommends that all 11- and 12-year-olds receive two doses of HPV vaccine at least six months apart. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Your doctor may tell you that you can wait three years for your next screening test if you received a Pap test only. This means that if you had another strain of it, it would identify it as HPV, but wouldn't tell you which strain you had. Try to see a physician who specializes in this procedure. (*A primary HPV test is an HPV test that is done by itself for screening. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful. . Review/update the Although CIN 3 is not cancer, it may become cancer and spread to nearby normal tissue if not treated. Some strains cause genital warts in men and women. Center for Disease Control and Prevention. HPV and Pap testing. If you were given local anesthesia, the biopsy itself may feel like a cramp or slight pinch. The other HPV-related cancers are rare. http://www.aptimaforher.com/ It does look for all high risk HPV, but genotypes 16, 18 and 45, which are the types most associated with cervical cancer. All males and females ages 926 should get the HPV vaccine. You also can develop symptoms years after having sex with someone who has the infection. The virus can pass on through skin-to-skin vaginal,. For example, cell culture requires the inoculation of a vaginal swab sample on an appropriate culture media and a relatively long waiting . Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Sign up for Email: Get Your Free Resource Coping with Cancer. There isnt a medical treatment for HPV. Your immune system will attack the virus and it will likely be gone within two years. Accessed Oct. 6, 2021. this is the second time within 1 year with same result. Chromeexternal icon | Safariexternal icon | Edgeexternal icon | Firefoxexternal icon | IEexternal icon, CDC National Prevention Information Network (NPIN), American Sexual Health Association (ASHA)external icon. You may have some cramping, spotting or discharge for a few days after your procedure. Hpv is so common and routine. Cervical Cancer Screening for Individuals at Average Risk: 2020 Guideline Update from the American Cancer Society. Frequently asked questions. Doctors do not yet have a way to tell which cases of CIN 3 will become cancer and which will not. U.S. Food and Drug Administration. Centers for Disease Control and Prevention. Healthcare providers who specialize in gynecology or gynecologists. You may go back to your normal diet unless your healthcare provider tells you otherwise. In women, these strains can cause cancers of the cervix, vagina, vulva, andanus, as well ashead and neckcancers. CDC twenty four seven. Our doctors take time to listen to your concerns, from wellness programs to chronic care management. There are several available tests for HPV, some non-specific and some yielding data on which strains have been involved.Without knowing which type of To know the specific significance from the test you got, it would be best for you to ask the doctor ordering it. Your doctor will gently insert an instrument called a speculum into your vagina. Make a donation. Most HPV infections don't lead to cancer. In men, HPV is often undetected because men seldom have symptoms and men are not screened regularly for HPV. Accessed April 13, 2020. The most common treatment for high-grade cervical cell changes is conization, the removal of a cone-shaped piece of tissue from the cervix and cervical canal. The goal of treating high-grade cervical cell changes is to remove or destroy abnormal cervical cells that have a high chance of becoming cancer. However, CIN 2 can sometimes go away on its own. If you have questions about MD Andersons appointment process, our information page may be the best place to start. And an HPV test can keep you from spreading a virus to someone else. https://www.cancer.org/cancer/cancer-causes/infectious-agents/hpv/hpv-and-hpv-testing.html. This may help in identifying difficult-to-see flat lesions. The CDC recommends catch-up HPV vaccinations for all people through age 26 who aren't adequately vaccinated. Dr.sOrders. Be in a mutually monogamous relationship or have sex only with someone who only has sex with you. In rare cases, an abnormal Pap test can show that you may have cancer. Change the lives of cancer patients by giving your time and talent. "It sounds worse than it is," says Dr. Sarraf. What does this result mean? These infections are often transmitted sexually or through other skin-to-skin contact. Some strains cause genital warts in men and women. Results from your HPV test will come back as either positive or negative. Current guidelines recommend that women ages 21 to 29 have a Pap test every three years. Tasty, delicious cheese has a couple of health drawbacks: saturated fat and salt. Your doctor then places an instrument called a colposcope close to the vagina. 2,3. It can protect against diseases (including cancers) caused by HPV when given in the recommended age groups. What does it mean if i got a normal pap but a positive hpv testing? Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. There are more than 100 strains of the virus, most of them do not cause cancer. With any medical problem, the natural reaction is to ask, how did this happen? A negative HPV test means you do not have an HPV type thats linked to cervical cancer. HPV is a sexually transmitted infection (STI). An HPV test result can be positive or negative. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. In women, genital warts can also grow inside the vagina. These are Pap smears that only test for HPV. If your provider removed some cervical tissue for testing, you may want to rest a while after the procedure. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Being tested may also stop the virus from spreading. The HPV vaccine is safe and effective. You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. Administer your anesthesia. information highlighted below and resubmit the form. They help us to know which pages are the most and least popular and see how visitors move around the site. A primary HPV test is a Pap smear done just to screen for HPV. If you also received an HPV test, and the result is negative, your doctor may tell you that you can wait five years for your next screening test. You have severe pain in your lower abdomen or stomach. * About one in 100 sexually active adults in the U.S. has genital warts at any given time. It means that you do not have any precancerous cells or precancerous changes in your cervix but the hpv virus is present. Gently insert a speculum into your vagina. Your Pap test was abnormal, showing atypical squamous cells of undetermined significance (ASCUS). HPV stands for human papillomavirus. HPV and HPV testing. It is most effective when given at ages 1112. Gently insert a speculum into your vagina. However, he or she has probably already been exposed by you or someone else. The American College of Obstetricians and Gynecologists (ACOG) estimates that about 79 million Americans have been infected with HPV. Antioxidants like vitamin C, vitamin E, beta-carotene, and other carotenoids can pack a big health punch, acting as defenders of your DNA and reducing your risk of disease. Accessed Feb. 20, 2019. Vaccines can help protect against the strains of HPV most likely to cause genital warts or cervical cancer. A positive test result for HPV does require careful follow-up. All rights reserved. Just a couple quick questions before I transfer you. Doctor's Assistant: The OB/GYN Doctor can help. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. If you are pregnant or plan to become pregnant, your health care provider will talk with you about procedures that are recommended for you and the timing of these procedures. 0 A Pap test result can be normal, unclear, abnormal, or unsatisfactory. Our experts say, the most important thing to know if you have HPV is that the risk of cancer is very small, but should be taken seriously. If genital warts aren't visible, you'll need one or more of the following tests: Vinegar (acetic acid) solution test. In Women, HPV can also cause abnormal cell growth on the cervix and cervical cancer. Providers may use local or general anesthesia during your biopsy. https://www.acog.org/Patients/FAQs/Abnormal-Cervical-Cancer-Screening-Test-Results. HPV tests are not recommended to screen men, adolescents, or women under the age of 30 years. If you have HPV, theres a very good chance it wont be a long-term problem for you.. Choosing your cheese carefully can mean you dont have to cut out this simple pleasure. Because HPV lives on your skin, condoms don't fully protect you from it. If a Pap test finds abnormal cells on your cervix, your doctor can monitor or treat them so they don't turn into something more serious. And theres no approved HPV screening test for men. There are several types of cervical biopsies. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. To learn more, please visit our. Accessed Feb. 25, 2019. New Here: Just had surgery for mouth and neck (lymph) cancer, Mayo Clinic Minute: Don't skip your child's HPV vaccine, Science Saturday: Uncovering disparities in local communities -- the case of the HPV vaccine, Mayo Clinic Comprehensive Cancer Center joins national call to get HPV vaccinations back on track. Human papillomavirus infections: Epidemiology and disease associations. Youre more than a set of symptoms. For early detection of premalignant dysplasia, evidences are coming out on the usefulness of HPV E6/E7 mRNA test as a potential tool compared with cytology and HPV DNA testing. (https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21628), (https://www.cancer.gov/types/cervical/pap-hpv-testing-fact-sheet), (https://www.merckmanuals.com/home/women-s-health-issues/diagnosis-of-gynecologic-disorders/tests-for-gynecologic-disorders). Sexually transmitted HPV types fall into two groups, low risk and high risk. Sometimes the speculum feels cold when it's first inserted. what steps does he need to take? The good news is that the majority of HPV resolves on its own over the course of a year. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6514435/). an OB/GYN who practices at the Virginia Womens Center West End office. As with any screening test, an HPV test carries the risk of false-positive or false-negative results. During your Pap smear, your provider will: During your colposcopy, your provider will: During your cervical biopsy, your provider will: Pap smears and colposcopies typically dont cause any post-procedure discomfort or problems. They can spread through direct contact with a wart. More than 4,000 women die from cervical cancereven with screening and treatment. Taking into account shortage of compiled data on this field, the aim of this systematic review . The Aptima HPV assay targets E6/E7 mRNA and identifies high-risk HPV infections that are present and active. The American Cancer Society recommends primary HPV tests for anyone between the ages 25 to 65 who has a cervix. 12 HPVs (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59) are defined by . A positive HPV test result is a warning sign for cervical cancer. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. HPV test results show whether you have a high-risk type of HPV infection. Most women don't think about their cervix until they have to get a Pap smear. Background Genital infection with certain types of Human papillomavirus (HPV) is a major cause of cervical cancer globally. Cervical cancer screening tests: Techniques for cervical cytology and human papillomavirus testing. The HPV test looks for the virus ( human papillomavirus) that can cause cell changes on the cervix. at the National Institutes of Health, An official website of the United States government, HPV and Pap Test Results: Next Steps after an Abnormal Cervical Cancer Screening Test, HPV test results: What positive and negative results on a screening test mean, Pap test results: What normal, abnormal, and unsatisfactory screening test results mean, Follow-up tests and procedures after an abnormal Pap test (Pap smear) or HPV test, Treatment for high-grade cervical cell changes, updated ASCCP risk-based management consensus guidelines, Pregnancy and Treatment for High-Grade Cervical Cell Changes, Understanding Cervical Changes: A Health Guide, U.S. Department of Health and Human Services, previous treatments for precancerous cervical cell changes, personal health factors, such as your age, return for a repeat HPV test or HPV/Pap cotest in 1 or 3 years. Mayo Clinic does not endorse companies or products. HPV is a group of more than 200 related viruses, some of which are spread through vaginal, anal, or oral sex. Checks your cervix for abnormal cells that could turn into cervical cancer. Pap test results show whether cervical cells are normal or abnormal. If you are portuguese or brazilian or hispanic, this probably refers to the classification used to code categorize pap smear results. There are many different types of HPV. It could be related to life changes like pregnancy, menopause, or an infection. Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings. Genital warts are a common sexually transmitted infection. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Risk factors for HPV infection include: It's difficult to prevent HPV infections that cause common warts. Being in a mutually monogamous sexual relationship, Using a latex condom, which can reduce your risk of. Genital warts and cancers result from different types of HPV. If you are between 30 and 65 years old, you may choose to get a Pap test only, an HPV test only, or both tests together. These cookies may also be used for advertising purposes by these third parties. You may be asked to undress completely or only from the waist down. Unsatisfactory Pap test results: The lab sample may not have had enough cells, or the cells may have been clumped together or hidden by blood or mucus. 20th ed. HPV is the most common STI. What these updated guidelines mean is that, in addition to your current Pap, HPV, or cotest screening result, your health care provider will consider additional factors when recommending follow-up care, including, Based on your individual risk of developing severe cervical cell changes that could become cervical cancer, you may be advised to. Theyll send your tissue to a lab for analysis. Some people, after consulting with their health care provider, may decide to have a colposcopy with biopsy every 6 months. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. A Pap test may also come back as unsatisfactory. Cookies used to make website functionality more relevant to you. Some types of HPV infection cause warts, and some can cause different types of cancer. The human papillomavirus (HPV) test detects the presence of human papillomavirus, a virus that can lead to the development of genital warts, abnormal cervical cells or cervical cancer. I know hpv dna can spontaneously revert to normal but if i've tested positive for hpv dna does that mean it will never clear? HPV test results show whether high-risk HPV types were found in cervical cells. When patients get that positive result back, they often dont know what to do with it, says Sara Sarraf, MD. Tell your healthcare provider if youre pregnant or may be pregnant. Youll probably spend some time in a recovery room so providers can monitor your blood pressure, pulse and breathing. Cervical cancer screening (Pap test). Centers for Disease Control and Prevention. I just found out that my test for HPV came back positive but. Approximately 150 different strains of HPV have been identified. This is good news. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. You may want to wear a sanitary napkin until the spotting or discharge stops. However, since an HPV test often is done at the same time as a Pap test, you can take these measures to make both tests as accurate as possible: An HPV test is usually done at the same time as a Pap test a test that collects cells from your cervix to check for abnormalities or the presence of cancer. Youre bleeding. HPV vaccination in this age range provides less benefit. Want to use this content on your website or other digital platform? These all mean the same thingthat your cervical cells look like they could be abnormal. But, if given before someone is infected, the vaccine can prevent most cases of cervical cancer. Abnormal Pap test results: An abnormal test result may also be called a positive test result. However, HPV infections often clear on their own within a year or two. They may apply a weak solution of acetic acid to your cervix. Your doctor may likely recommend the HPV test if: The HPV test is available only to women; no HPV test yet exists to detect the virus in men. Advertising revenue supports our not-for-profit mission. Our syndication services page shows you how. Fontham, ETH, Wolf, AMD, Church, TR, et al. If youre sexually active, recommend steps you can take to protect your partner(s). The HPV mRNA E6/E7 test uses the Aptima HPV mRNA method, which is shown to be more specific than an HPV DNA test. But when HPV does not go away, it can cause health problems like genital warts and cancer. If your initial HPV test is positive and follow-up tests, such as colposcopies, are negative, your provider may recommend you have another Pap smear to test for HPV. National Cancer Institute does that mean i have all 14 of them? All rights reserved. Office on Womens Health. Every year, about 19,400 women and 12,100 men experience cancers caused by HPV. They may place a pressure dressing on your cervix. Its important to remember that you can get HPV even if youve only had one sexual partner and that you can transmit HPV through oral sex, direct genital skin contact and other sexual encounters (not just intercourse). The virus lives on your skin and is spread during intimate genital contact. Trismus (lock jaw) after Head & Neck cancer treatment: What helps? Research has shown that receiving the vaccine at a young age isn't linked to an earlier start of sexual activity. Accessed Feb. 20, 2019. This can be a sign of a more serious problem up inside the uterus, so your healthcare provider will likely ask you to come back for a colposcopy. The U.S. Food and Drug Administration recently approved the use of Gardasil 9 for males and females ages 9 to 45. Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. These cookies may also be used for advertising purposes by these third parties. Tell your provider about regular medications you take that may affect how your body reacts during the procedure. Knowing whether you have a type of HPV that puts you at high risk of cervical cancer means that you and your doctor can better decide on the next steps in your health care. No special preparation is necessary before you have an HPV test. Policy. This content does not have an English version. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event. I tested positive for HPV Aptima [c], (02) and HPV Genotype 16 (02) Ask an Expert. 69 0 obj <>/Encrypt 31 0 R/Filter/FlateDecode/ID[<36B52B89F8693243A3678EAE43FEB70C>]/Index[30 77]/Info 29 0 R/Length 157/Prev 235201/Root 32 0 R/Size 107/Type/XRef/W[1 3 1]>>stream Health problems related to HPV include genital warts and cervical cancer. Checks your cervix for the virus (HPV) that can cause abnormal cells and cervical cancer. Its also a very common and complicated virus. The ACS recommends the primary HPV test* as the preferred test for cervical cancer screening for people 25-65 years of age. Tell your provider if you have any pain during the tests. Some HPV infections that result in oral or upper respiratory lesions are contracted through oral sex. She is board certified in obstetrics and gynecology and certified in pediatric and adolescent gynecology. An abnormal cytology test or a positive HPV test can cause short-term anxiety, stress, fear, and confusion, possibly decreasing the patient's ability to absorb and retain information and acting as a barrier to follow-up care ( 1258 - 1261 ). HPV tests detect potential cervical cancer. However, if you have an abnormal test result, its important to get the follow-up care that your health care provider recommends. Human papillomavirus (HPV) vaccination: What everyone should know. Normal Pap test results: No abnormal cervical cells were found. Genital warts:Prior to HPV vaccines, genital warts caused by HPV affected roughly 340,000 to 360,000 people yearly. You may have bleeding from the biopsy. HPV is so common that almost every sexually active person will get HPV at some point if they dont get vaccinated. Flat warts are smaller and smoother than other warts. You can do several things to lower your chances of getting HPV. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. The reality is that approximately 80% of sexually active people will come in contact with HPV at some point in their lives. Ask your provider about steps you should take if your biopsy requires general anesthesia. Dont panic and dont ignore it, says Lois Ramondetta, M.D., professor of Gynecologic Oncology and Reproductive Medicine. American Academy of Dermatology. If you have questions about HPV, or if youd like to get the HPV vaccine,call 804.288.4084 to schedule an appointment with Dr. Sarraf or another VWC provider. If you dont have HPV, you can receive a vaccination that protects against HPV. Human papillomavirus (HPV) is the most common sexually transmitted virus, with doctors diagnosing roughly 13 million new cases every year. The Aptima HPV test (Gen-Probe) detects E6/E7 mRNA of 14 oncogenic types. The doctor or nurse will use a speculum and a microscope with a light to look at your cervix. Removing the pre-cancerous lesions means removing cancer. Normal pap but hpv hr positive. Providers evaluate STI and HPV tests differently, so you wont know you have HPV unless your provider tests for HPV specifically. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. For these, please consult a doctor (virtually or in person). You may feel some discomfort during your Pap smear or colposcopy, but the tests shouldnt hurt. Cervical changes that lead to cancer usually take several years often 10 years or more to develop. That's because testing positive does not indicate HPV persistence. Medical Questions. You will be subject to the destination website's privacy policy when you follow the link. A healthcare provider can usually diagnose warts by looking at the genital area. Routine screening is not recommended or available for them. What is HPV Aptima Positive mean? It has a bright light and a magnifying lens and allows your doctor to look closely at your vagina and cervix for abnormal areas. Human papillomavirus (HPV) vaccination. https://www.cdc.gov/vaccines/vpd/hpv/public/index.html. CIN 2 must be treated if it progresses to CIN 3 or does not go away in 1 to 2 years. HPV is a sexually transmitted infection (STI). One of the most common abnormal findings is something called atypical squamous cells of undetermined significance, or ASCUS. Cleveland Clinics Ob/Gyn & Womens Health Institute is committed to providing world-class care for women of all ages. But there are vaccines that can stop these health problems from happening. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Accessed March 4, 2019. An HPV test can be done using the same sample from the Pap test or by collecting a second sample from the cervical canal. There is no way to know who will develop cancer or other health problems from HPV. Cancer Center. What does it mean if you have a positive HPV test after years of negative tests? Read More This website uses cookies so that we can provide you with the best user experience possible. If you arent regularly tested for HPV, ask your healthcare provider to add the test to your regular screening tests. Accessed April 13, 2020. If you know you have HPV, you can make lifestyle changes to protect others from getting HPV. Mayo Clinic is a not-for-profit organization. Limitations Alternatively, consider using the STD facts brochuresor ordering materials through CDC-INFO on Demand (please note: stock is limited). This does not mean you have cervical cancer now. We make it easy to message your doctor, connect to on-demand virtual care, receive appointment reminders, refill prescriptions, and more. If your doctor detects severely abnormal cells, they may recommend removing them using a loop electrosurgical excision procedure (LEEP). information and will only use or disclose that information as set forth in our notice of Most of those cases are cervical cancer. Pap and HPV Tests. Healthcare providers use HPV screening tests to find and remove these pre-cancerous lesions.

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