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Anal Pap Smear Results
Sep 22, 2000

I had anal warts about 20 years ago. I got infected with HIV in 1999. I just got the results from my anal Pap smear test. It showed atypical cells. The nurse who gave me the results really wasn't able to tell me what this means. She said the test is too new. All she could suggest is to repeat the procedure in six months and see if the result is the same. She does not know if there is a doctor in my city who does follow up on this type of test. Should I be worried?

Anchorage AK

Response from Dr. Stryker

Anal warts are caused by the human papilloma virus (HPV), and there is some concern that a history of anal warts may predispose to anal cancer. The use of the anal PAP smear is being investigated as a screening tool to pick up early cases. However, the appropriate role and interpretation of this test is still unclear, and it is not in widespread use. However, since you have already had the test, and there were some abnormal cells, it makes sense to follow up on the result.

In general, you need the advice of a proctologist or colorectal specialist, and there should be one in your area. Bring a written copy of the PAP report to the doctor for review. He or she may recommend a biopsy of the area; this would give a much better indication of whether the atypical cells represent anything of concern. This consultation should be your next step, and further screening for your particular case can be discussed after you know what this PAP result means. Good Luck! RAS

Rick Stryker, M.D., M.P.H.



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