How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. C. Your Own Question
Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 3064
Experience:  30 years of experience and an award-winning educator.
Type Your OB GYN Question Here...
Dr. C. is online now
A new question is answered every 9 seconds

My daughter is 28 years old and has only had one partner

Customer Question

My daughter is 28 years old and has only had one partner (and divorced in Nov 2013 due to his numerous indiscretions in the marriage). She has her HPV series done as a teenager and pap smears done annually.. April 2013 and April May 2014 were completely normal and was tested twice for HIV which was also normal. Her pap smear in May 2015 came back abnormal so a colp was done...diagnosis came back as cervix outer-squamous mucosa with reactive changes negative for dysplasia
cervix inner vessel-high grade squanous intrapithelia lesion (CIN2)
ENDO CERVICAL-positive for low grade squamous intraepithelial lesion (CIN1)
She is now scheduled for surgery/procedure of a conization. The provider is more concered with the endo cervical area and when ask, so if you don't get everything what happens next and we were told let wait to discuss at the preop appoinment. Please advise on what we are to expect-also if she has never had any other sexual encounters in her life..had HPV imms as a teenager (yes I know the vaccine does not cover all HPV viruses) how in such a short time (from May 2014 to May 2015) does this advance so quickly. Thank you for your time-Pauline
Submitted: 2 years ago.
Category: OB GYN
Expert:  Dr. C. replied 2 years ago.

Hi, It's Dr. C. Board certified Ob-gyne with special expertise in the management of cervical disease and HV.

It's most likely that the HPV has been present on her cervix for a number of years before causing the abnormal. It takes at least 4 years for HPV to cause changes that require treatment, usually 10 years+.

In her age group, we don't typically test for HPV apart from an abnormal pap. So it was likely there previously but not causing abnormal cells enough to show up on the pap yet. Once a woman reached age 30, we test for HPB separately along with the pap. The reason for that is that a + hpv after age 30 is more likely to have been there for a while, long enough to cause enough precancerous changes on the cervix for us to be concerned about. The pap smear is not a perfect test and misses some abnormalities as well.

I suspect she is scheduled for a LEEP cone biopsy. This will remove all the abnormal cells. And the specimen will be examined to make sure of that. There is a small chance that the HPV and precancer can recur over time but if the HPV is not type 16 or 18, the risk is fairly low, about 5% or less. The recurrence risk is higher if she is positive for types 16 or 18. Those 2 types are in the vaccine. If possible, her HPV type can be determined and if not 16 or 18, the LEEP is probably going to be a cure for her.

I hope this was reassuring and helpful. Please reply if I can clarify anything.

Expert:  Dr. C. replied 2 years ago.
Any further questions? I was to be sure you have the most helpful information for your situation.
If not further questions, please provide a rating for my service. I aim for excellent and appreciate your feedback. Thanks.