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Anti cyclic citrullinated peptide (anti CCP) is a test which is highly associated with rheumatoid arthritis. It is not necessary to test positive to have rheumatoid arthritis, but most individuals who are positive have or will develop RA. That being said, there are exceptions to this rule, particularly if the test is not strongly positive. In particular, there is growing data to suggest individuals with pulmonary (lung) issues may test positive and not develop RA. In some instances, it may be worthwhile monitoring your joints with a rheumatologist over time to ensure you do not develop rheumatoid arthritis.