Article provided by QIAGEN
Taking the HPV test is one of the steps you can take to prevent cervical cancer or catch it in early stages. And most doctors will honor your request. If not, remember you are the person ultimately responsible for your health. Here’s a few scenarios you may run into when considering the HPV test.
Your doctors may not automatically order the HPV test for you. He or she may be unaware of approval of the HPV test for routine screening. Some doctors and nurses are not aware that the U.S. Food and Drug Administration (FDA) has approved the HPV test for use along with the Pap for routine screening of women age 30 years and older. Some still believe that the HPV test should only be given to women if their Pap test results are unclear (called an ASC-US Pap). Still others simply aren’t familiar with the data supporting the value of the HPV test for routine screening. Medical practice takes a while to change. You can share with your doctor or nurse the recent publication on HPV and HPV testing issued by the American Association of Reproductive Health Professionals.
Your doctor may think the Pap is good enough. Other healthcare professionals may actually recommend against routine HPV testing because they believe that although the Pap May not be perfect, it is good enough. Respond that you know the Pap test catches many women with pre-cancerous cells, but that you would feel more confident if you took the additional step in receiving the HPV test. You may want to refer your doctor or nurse to the April 2006 issue of International Journal of Cancer (“Overview of the European North American studies on HPV testing in primary cervical cancer screening”). This analysis of 11 studies involving more than 60,000 women documented that the HPV test is a more sensitive tool for cervical cancer screening than the Pap alone.
Your healthcare provider may worry that you will be unnecessarily anxious or alarmed if you find out you have a high-risk (potentially cancer-causing) type of the virus. After all, most women fight off the infection before it causes any problems. Assure your doctor or nurse that you have researched the subject, and that you see the HPV test as a way to increase your peace of mind. Your healthcare provider will be more likely to feel comfortable ordering the test for you if he or she knows you already are educated on the virus and HPV testing. Show him or her a brochure on HPV testing, available at (insert Qiagen link here) as evidence that you have educated yourself and know what to expect.
Your doctor may be afraid that you won’t return for your annual visit if your HPV test shows you don’t need cervical cancer screenings. some doctors and nurses fear that once women learn they do not have HPV, and thus only need another HPV and Pap test every three years, they will not come back for an annual office visit. Communicate to your doctor or nurses that you understand the need for regular health checks such as a breast exam – regardless of your HPV status. You can demonstrate this commitment by scheduling your next visit well in advance.
Some healthcare providers may believe that the HPV test could result in the need for other, unnecessary procedures (such as a biopsy to remove cervical tissue for analysis). Respond that you’d rather take the chance on having an extra exam that turns out to be normal, than risk doing nothing until cervical cancer develops. You also might want to refer your doctor or nurse to an article in the October 2007 issue of the American Journal of Obstetrics and Gynecology titled “Consensus Guidelines for the Management of the Women with Abnormal Cervical Cancer Screening Tests.” One of the topics covered is how to manage the care of women who have HPV, but whose Pap results are normal or inconclusive. A short summary of these and other guidelines can be found in this brochure (Qiagen ) on HPV testing. Following these guidelines should help assure that women with HPV do not have any more follow-up tests than when the Pap alone is used. Tell your doctor or nurse that you would like to get the HPV test for “extra peace of mind.”
In advocating for your reproductive health, here are a few other tips around the HPV test:
• Arm yourself with the facts about cervical cancer, HPV and the HPV test. Read the information in this Web site thoroughly. Doctors' offices are very tight on time these days, and they will be more receptive to your requests if they can tell you have "done your homework."
• Call your doctor's or nurse's office before your next exam to find out if the HPV test is offered as part of routine screening for cervical cancer, along with the Pap. Remember: Make sure the office understands that you want the HPV test no matter what the Pap shows. Some doctors and nurses only order an HPV test when your Pap results are inconclusive (called an "ASC-US" Pap).
• If your doctor or nurse says the office does not order HPV testing for all of its female patients who are 30 and older, indicate you'd like them to make an exception for you.
• If your doctor or nurse (or the office staff) responds by saying he/she doesn't think routine HPV testing is necessary, the simplest way to respond is to say that you would still like to have the test "for my extra peace of mind."
• Follow up on test results. Keep calling until you receive an answer regarding your test results.
You may just want to ask your doctor or nurse about the HPV test. However, most laboratories can do the HPV test if your doctor or nurse requests it.
