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Hemorrhoids and Anal Pap Smears; do they interfere which each other? If I have a normal Pap smear, am I HPV-free?
Dec 29, 2002

Do the presence of hemmorhoids make the results of an anal pap smear turn out abnormal?

Also, if a first anal pap smear comes out normal, and there is no sexual activity since then, are future anal pap smears required? Does a normal result indicate that one is HPV-free in that bodily region?

Thank you.

Response from Dr. Dezube

These are three excellent questions

1) Do hemorrhoids interfere with the Anal Pap test-- probably not. However, if the hemorrhoids are inflammed, then inflammation can indeed affect the Pap test. Although hemorrhoids will not cause a PAP test to read cancer, it may prevent a Pap smear from being read as completely normal. When I have a patient with inflammed hemorrhoids, I tend not to perform a Pap test until the inflammation subsides.

2) Because of sampling error, one negative PAP smear is reassuring, but may miss some abnormal cells. I usually recommend two negative Pap smears, one year apart, before I tell a patient that we can let down our guard a bit. After two negative Pap smears, in the absence of receptive anal sex, the frequency of the Pap smears can be spaced out. Please note that condoms are NOT completely protective of HPV infection, so that even if a patient has receptive anal sex (i.e. he's a bottome) with condoms, he is not completely protected from HPV and therefore anal Pap smears are recommended.

3) A normal PAP smear does NOT mean a patient is HPV-free. I am sorry to say that it is indeed possible to harbor an HPV infection even with negative Pap smears. That said, it is more likely that you are HPV infected if the Pap smear is abnormal


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