An abnormal Pap smear prompts further evaluation, which often includes a cervical biopsy. Most women experience some anxiety during the 3-4 day wait for biopsy results but few as much as sixty-year old Marlene. She called in tears after several days had passed without hearing anything (her doctor was out of town and had failed to contact her before leaving). As the on-call doc, I was asked to talk with her.
We talked about the result of the biopsy, which confirmed the Pap smear--abnormal but a low level that requires monitoring but no immediate intervention. And we talked about the cause of abnormal Paps: the sexually-transmitted human papillomavirus (HPV). This again brought Marlene to tears as she confessed that she recently had a brief affair (her 80+ year old husband cannot meet her needs she said in so many words). I'll never do that again, she promised and then asked if she should tell either her husband or her ex-lover about the diagnosis of an STD.
Under the guidance of the "keep it simple, stupid" doctrine, I just said no. A difference answer for chlamydia or other STDs, but for the ubiquitous, untreatable and mainly female-problematic HPV, no need to stir up trouble. Just don't ask me how I would feel if the ex's next sexual partner ends up with cervical cancer
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