How Often Should You Get a Pap Smear?
Did you know that pap smears are no longer recommended annually? If not, you’re not alone. House Call Doctor has the scoop on the new medical guidelines for pap screenings.
Did you know that pap smears are no longer recommended annually? If not, no worries, you are not the only one. On a daily basis I see patients who come in for a pap smear surprised to find that they are actually not due for one. And newer guidelines have extended pap screenings even further, so I thought it would be good time to touch on this subject today.
How Often Should You Get a Pap Smear?
Did you ever wonder how medical recommendations made by your doctor came to be? Well, doctors are encouraged to practice using medical guidelines. And these guidelines are based on research that is done by various expert groups. The United States Preventative Services Task Force (USPSTF) is one such group that provides these expert opinions on various preventative issues in health, such as pap smears.
A pap smear is a specific test for cervical cancer in women. If you aren’t sure what a pap is or want to learn more about this test, make sure to check out my previous episode on this topic, called Pap Exam 101.
It used to be that women were told to have a pap smear every year. That is no longer the case. Nowadays, doctors recommend a pap screening every three years for most women. In 2009 American College of Obstetricians and Gynecologists (ACOG), another expert group, recommended screening every 2 years for women between age 21 and 29, and every 3 years for women 30 and older, with a few exceptions (if you have a history of CIN 2 or 3, HIV, in utero exposure to DES, or are immune-compromised).
Now, even newer guidelines from USPSTF say that women between age 30 and 65 can get their paps done every 5 years, rather than 3 – but only if they were tested for Human Papilloma Virus (HPV) at their last pap. This is just an extra swab that your doctor can use along with your pap smear.
Here are the other details of the new guidelines:
Every 3 year screening is still recommended for those age 21 to 29, and any woman over age 29 who didn’t have an HPV test with her last pap.
No paps needed if:
- You have no cervix due to a hysterectomy and no history of cancer of the cervix.
- You are over age 65 with 3 normal paps in a row, or 2 normal paps/HPV combo tests within the previous 10 years (as long as the last test was within 5 years).
- You are younger than 21.
No HPV testing recommended for women younger than 30 due to high prevalence of HPV in this age group that subsequently clears on its own.
Other groups, such as the American Cancer Society, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology have also agreed on an increase in the intervals between screenings.
Why Not Get a Pap Smear Every Year?
Some patients actually get really nervous when I give them the new recommendations because they’re so used to the annual screening. But as long as you follow your doctor’s recommendations and get your pap smear when it’s recommended by your doctor, chances of cervical cancer are very low for the following reasons:
Cervical cancer is caused by an STD, Human Papilloma Virus (HPV). Women in long-term monogamous relationships with a normal pap smear every year are considered low risk for developing cervical cancer.
Cervical cancer is a slow growing cancer that takes years to typically develop.
More frequent pap exams have been shown to be harmful due to unnecessary testing and procedures that can pose problems later on in life, especially in women of child-bearing age who become pregnant later on.
Not getting a pap smear doesn’t mean you shouldn’t have a yearly female check up, however. And STD testing is separate -- a pap smear is not necessary in order to test you for STDs.
So in summary:
Women between 21 an 29 should get a pap smear every 3 years.
Women between 30 and 65 should get a pap smear plus an HPV test preferably every 5 years, or a pap smear alone every 3 years as an alternative. Ask your doctor if your pap includes a test for HPV.
Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
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