Q. What should I do if my Pap test is negative but my HPV test is positive?
A. There are 2 management options for women over the age of 30 who have a negative Pap test and a positive HPV test. One option is to repeat both tests in one year. A second option is to do a special HPV test for certain high risk HPV types (HPV types 16 and 18). If the test for HPV types 16 and 18 is positive, the woman needs colposcopy. If the test for HPV types 16 and 18 is negative routine, immediate colposcopy is not necessary but routine HPV testing with Pap testing is repeated one year later. In either case, if either the Pap test or the HPV test is abnormal one year later, the woman needs colposcopy. If nothing is found on colposcopy, the Pap test and the HPV test should both be repeated every year until both are negative. Every time a Pap test or the HPV test is abnormal colposcopy is necessary. This can sometimes become frustrating when the Pap test remains positive year after year and the colposcopy finds nothing, but this sort of careful vigilance is necessary to detect the occasional patient who develops cervical precancer or cancer and the only abnormality is a positive HPV test. | 
