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.

Sanaz Majd, MD
Episode #118

How Often Should You Get a Pap Smear?

by Sanaz Majd, MD

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.

Sponsor: This podcast is brought to you by Betterment.com. Betterment offers users an easy way to invest. No prior investing experience is required. Users choose how to allocate their money between two pre-set baskets -- a stock basket and a bond basket. Signing up takes less than 5 minutes, and money can be added or withdrawn at any time without a fee. Users who sign up at betterment.com/housecall will receive a $25 account bonus as long as their initial deposit is $250 or more.

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.

What are your thoughts on this issue? Share it with us on the House Call Doctor’s Facebook and Twitter pages!

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.


Outline of New Guidelines from American Congress of Obstetricians and Gynecologists

Press Release About New Pap Guidelines

Betterment LLC is an SEC Registered Investment Advisor. Brokerage services are offered by Betterment Securities, an SEC registered broker-dealer and member FINRA/SIPC.
Investments are not FDIC Insured. No Bank Guarantee. May Lose Value.
Investing in securities involves risks, and there is always the potential of losing money when you invest in securities.
Before investing, consider your investment objectives and Betterment's charges and expenses.
Not an offer, solicitation of an offer, or advice to buy or sell securities in jurisdictions where Betterment and Betterment Securities are not registered.

Doctor and Patient image from Shutterstock

About the Author

Sanaz Majd, MD

Dr. Sanaz Majd is a board-certified Family Medicine physician who graduated from Drexel University College of Medicine in Philadelphia. Her special interests are women's health and patient education. 

The Quick and Dirty Tips Privacy Notice has been updated to explain how we use cookies, which you accept by continuing to use this website. To withdraw your consent, see Your Choices.