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HPV: Would you recommend OraRisk HPV DNA test? Anal pap smear?
Jan 24, 2011

Hi Dr. Bob,

I know this is not related to HIV, but you're really the only doctor I trust when it comes to any STD-related topics. I'm HIV negative luckily despite past experiences of unprotected oral and anal sex. I no longer practice unprotected sex. However I'm concerned about HPV infection and its potential to cause anal and oral cancer. The fact that I've been sexually active and had anal warts in the past pretty much guaranteed that I've been infected with HPV both in anal and oral region. For anal cancer concern, would you recommend anal pap smear? And for oral cancer concern, would you recommend the new OraRisk HPV saliva test? My primary physician (and GI specialist) does not recommend both, citing lack of concrete evidence of clinical benefits from both anal pap smear and the new saliva DNA test. In fact they think the tests could do more harm than good, since they are not 100% accurate and are prone to false positives. What do you recommend? I'm so torn. On the one hand I don't want to be paranoid, yet I also don't want to be passive and "wait" for cancer symptoms to show up. I heard both anal and oral cancer are relatively "easy" cancers with high cure rate if caught early, but the problem is that they're usually caught very late in the stages. Please help, I'm really concerned and don't know what would be the right thing to do!

Response from Dr. Frascino

Hello,

I agree with your GI specialist. There is nothing to do clinically at this time, assuming your anal warts have been effectively treated. The tests you mention are used to diagnose HPV. You already know you have it. The tests do not diagnose cancer. Routine follow-up by physical examination is all that is warranted.

Dr. Bob



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