Colposcopy is a vaginal exam used to confirm cervical cell changes caused by human papillomavirus (HPV), which can lead to cervical cancer. It is recommended for women with level 3 cellular changes, often associated with HPV and increased cancer risk. HPV is common but not all women who need colposcopy have it. Other causes of cervical cancer include heredity, smoking, and prolonged use of oral contraceptives.
Human papillomavirus (HPV) is a sexually transmitted disease that occurs in about 40 different strains and is known to cause cervical cancer. A colposcopy is a thorough vaginal exam that involves taking samples of cells from the cervix. The connection between HPV and colposcopy is that doctors can use the test to confirm changes in cervical cells that have been or may have been caused by HPV.
Normally, doctors look at diseases of the vagina, cervix, and other reproductive structures through regular annual Papanicolaou tests or Pap smears. Doctors use long swabs to collect samples of cells from the vagina and cervix. Lab professionals examine cell samples to check for abnormalities. If the results are abnormal, the next step is colposcopy.
Most women fight the HPV virus naturally. Some female bodies are unable to do this, and the virus persists for years. If HPV stays in the body for long periods, it can cause cellular changes.
Doctors rate the level of cellular changes on a scale of 1 to 5, with level 1 being normal and level 5 being cancer. Women who have level 2 results are generally not asked to have a colposcopy because level 2 changes often resolve on their own while women battle the HPV virus or while the cervix heals from other minor injuries. Cervical cell changes are checked again with one or more follow-up Pap smears. Colposcopy is recommended at level 3, as cellular changes at this level are often associated with HPV and increased cancer risk.
During a colposcopy, a doctor washes the inside of the vagina and cervix with a very mild solution similar to vinegar. The acidity of the solution causes areas with abnormal cells to turn white. The doctor then examines the white areas with a colposcope, which is like a microscope. A biopsy is often taken from the areas of concern.
HPV is an extremely common virus; about half of all sexually active men and women get it at some point. Of those with the virus, about 90 percent fight the infection within two years and have no symptoms. The percentage of women who have HPV and therefore require colposcopy is quite low, even if the virus is prevalent. Only about 1 percent of women who have a level 3 result from a Pap smear and subsequent colposcopy will develop cervical cancer within two years. The likelihood of contracting HPV and needing colposcopy increases with increased sexual activity, however, because only sexual abstinence can ensure that a person does not contract HPV.
The connection between HPV and colposcopy is clear, but not all women who need colposcopy have HPV. A separate HPV test is needed to determine if a woman has HPV. Even when a woman has HPV and a colposcopy is recommended because of cervical changes, that doesn’t necessarily mean that the HPV led to those changes, because there are other causes for cervical cancer. Examples of these causes include heredity or a genetic predisposition; to smoke; and prolonged use of oral contraceptives.
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