Can You Have Negative Hpv And Abnormal Pap

Summary: A pap smear test is an important diagnostic tool that helps identify abnormal changes in the cervix. A negative test result for HPV does not always signify a normal pap smear. In some cases, women may show abnormal cells on a pap smear despite testing negative for HPV. This article explores this scenario and what it means for women.

1. Understanding Pap Smears and Abnormal Results

A Pap smear is a screening tool used to check for precancerous or cancerous changes in the cervix. During the test, a healthcare provider collects cells from the cervix and sends them to a laboratory for analysis.

Abnormal cells found during a Pap test could indicate a range of changes. It could signify a minor cellular change or a high-grade lesion. While Pap tests may not provide a definitive diagnosis, they can catch harmful cellular changes early so that appropriate treatment can be given.

Testing negative for HPV is not a guarantee that the Pap smear will be normal. Some abnormal cells found on a Pap test may not be related to HPV, and this is why patients are asked to come back in for follow-up tests and procedures if needed.

2. Reasons for HPV Negative but Abnormal Pap Tests

There are many reasons why women could have an abnormal Pap test despite testing negative for HPV:

Inadequate Sample

If the sample collected for the Pap smear was inadequate or not enough cells were collected, the results could be inconclusive or inaccurate. In such cases, healthcare providers may recommend repeating the smear.

Non-HPV Types

The presence of other types of human papillomavirus (HPV) or non-HPV viruses could cause abnormal cell changes detected through a Pap smear. Since HPV testing only checks for high-risk HPV types, other HPV types could be responsible for the changes.

Non-Infectious Causes

Several non-infectious factors could cause abnormal cells to show up on a Pap smear, including hormonal changes, inflammation, fertility treatments, and the use of certain medications like tamoxifen.

3. What Happens After an Abnormal Pap Smear?

If the results of the Pap test indicate changes in cells, healthcare providers may recommend additional testing or procedures to determine the extent of the changes. These tests could include:


Colposcopy is a test that allows your healthcare provider to magnify and examine your cervix. This test uses a specialized tool (colposcope) that enables your doctor to see any abnormalities more closely. If necessary, your doctor may also perform a biopsy where a small piece of the tissue is removed for testing.

Endocervical Curettage (ECC)

An endocervical curettage involves removing cells from the cervical canal using a sharp instrument called a curette. This test helps doctors get a sample of the cells higher in the cervix to check for abnormalities.

If the changes in the cervical cells are classified as CIN 2 or above, immediate intervention is needed to remove the lesion and prevent it from progressing to cancer.

4. Reducing Risk Factors

While not all cases of abnormal Pap tests can be prevented, there are steps that can be taken to reduce risks. These include:

Safe Sex Practices

Practicing safe sex by using condoms reduces the risk of contracting HPV and other sexually transmitted infections. The fewer sexual partners you have, the less likely you are to contract the virus too.


The HPV vaccine prevents high-risk HPV types that could cause abnormal cervical changes. The vaccine is recommended for females aged 11 to 26 years and males aged 11 to 21 years.

Regular Screenings

Regular screening helps detect any abnormal cells in the cervix early. It is recommended that women begin receiving Pap smears at age 21 or earlier if they are sexually active. Women should also keep up with their regular screenings even after being vaccinated against HPV.


In conclusion, it is possible to have an abnormal Pap smear despite testing negative for HPV. Abnormal Pap test results could be caused by factors other than HPV, such as inadequate samples, non-HPV viruses, hormonal changes, inflammation, medication use, or fertility treatments. Women should remain vigilant about their cervical health, undergo regular screenings, and adopt safe sex practices to reduce their risks. With early detection and appropriate management, the prognosis is generally favorable.

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