In the presence of a normal Pap smear but positive HPV, what is the follow-up recommendation?

In the context of a normal Pap smear with a positive HPV test, the recommended follow-up is to have a repeat Pap and HPV co-testing in one year. This approach is based on guidelines from the American College of Obstetricians and Gynecologists (ACOG) and the American Society for Colposcopy and Cervical Pathology (ASCCP), which suggest that women aged 30 years and older who have a normal Pap result but positive HPV should undergo a repeat test after 12 months. If the follow-up Pap smear remains normal and the HPV test is still positive, further investigation such as colposcopy may be required.

This recommendation is crucial as it allows for monitoring of the cervix without immediately subjecting the patient to invasive procedures, given that many women with a positive HPV do not progress to pre-cancerous lesions or cervical cancer, especially when the Pap results are normal. It also reflects the understanding that HPV infections can be transient and may clear up on their own in many cases.

Other options imply different follow-up strategies, such as directly proceeding to colposcopy or immediate biopsy, which are not recommended unless specific abnormal findings are present. Therefore, annual follow-up testing after an initial normal Pap result helps strike a balance between