Recently, I had an abnormal Pap smear. After having a colposcopy and biopsy of my cervix, I was diagnosed with the HPV virus. My doctor couldn't tell me much about this condition. I am hoping you could provide me with some much-needed information.

L.

First let me explain some of the terms in your question. Most women know that a Pap smear is the screening test used to detect early cancerous and precancerous changes of the uterine cervix, the part of the womb that protrudes into the vagina. Public health officials recommend yearly Pap smears for all women over 18 and for women under 18 who are sexually active. Certain findings on a Pap smear require further investigation with a technique called colposcopy, which is basically a magnified examination of the cervix using a special stereo-view microscope. With such techniques, most abnormalities can be detected at an early stage.

Researchers have long suspected that cervical cancer is related to a sexually transmitted disease, because the risk of developing cervical cancer is directly associated with the number of sexual partners a woman has had. For example, health surveys of Catholic nuns show that they almost never develop the disease. Today, there is nearly overwhelming evidence that the cancer is caused at least in part by the human papillomavirus (HPV). This is the same group of microbes that cause common warts and plantar warts, painful growths on the soles of the feet. Some of these viruses also cause genital warts, which are called condylomata acuminata.

There are many different varieties (serotypes) of HPV, only a few of which are associated with cervical cancer. Genital warts are usually caused by serotypes numbered 6 and 11. Cervical cancer is usually associated with serotypes 16 and 18 and sometimes 31. Why does this matter? Because simply having a genital wart does not necessarily mean that a woman is at high risk for cervical cancer.

You should find out which serotype of HPV you have. If it is not one of those associated with cervical cancer, then you have little to worry about. Unfortunately, if it is a serotype associated with malignancy, you can do little other than have frequent screening tests. There is currently no consensus on exactly how a woman's HPV infection should alter the frequency of screening, however. If you indeed have a high-risk serotype, a reasonable approach would be to see a gynecologist for repeated Pap smears and HPV tests every six months until several consecutive smears are normal, and then move to yearly screening. This is definitely not the only acceptable approach, however.