Don’t mistake a Pap test with an annual exam. Here’s what women need when.
It may seem that recommendations about Pap smears — including how frequently women should get one — change constantly.
“Multiple times a day, I answer questions regarding Pap smear guidelines and when to get a Pap smear,” said Dr. Shana Dowell, an obstetrician and gynecologist with Vanderbilt Women’s Health. “I understand why: They are evolving and we, as women, have it ingrained in many of our minds that ‘we must get a Pap smear every year.’”
In 2012, international experts updated the guidelines based on many evidence-based studies and the results of millions of women. Here is the latest you need to know about Pap smears, and when you should be getting one.
Pap smear vs. annual exam
“It is important to differentiate between an annual exam and a Pap smear,” Dowell said. An annual exam examines your whole body: breasts, ovaries, uterus, vagina and vulva. It’s a great time to discuss contraception needs, sexual health, menopause symptoms or urinary incontinence. A Pap smear evaluates your cervix for whether or not pre-cancerous or abnormal cells are present.
A yearly exam by a gynecologist is recommended for most women—a guideline that has not changed over the years. The interval between Pap smear screenings, however, is longer for most women.
Essentially all cervical cancer is caused by the human papilloma virus (HPV). HPV is transmitted through sexual contact, and the chance of coming in contact with it at some point is quite high. But not everyone exposed to HPV has an affected cervix, and if HPV does cause changes in your cervical cells, this takes a long time to evolve.
“The chances that your body will clear the virus all on its own, without any intervention other than surveillance, is quite high,” Dowell said. “The reason Pap smear screening is so successful is because there is so much time to intervene between a slightly abnormal Pap and a diagnosis of cancer.”
How often do most women need a Pap test?
- The first Pap should be collected at age 21, but not before. It doesn’t matter if you are sexually active prior to that age.
- Between the ages of 21 and 30, a Pap should be collected every three years. Again, you should still go each year for your annual exam.
- Starting at age 30, an additional test is added to your Pap looking for HPV. If your Pap is normal and your HPV is negative, you do not need a Pap collected for five years. It is still recommended to see your gynecologist each year to have all other female organs evaluated.
- After a hysterectomy, a Pap smear is typically not needed, but patients will still need an annual exam.
- Most women can stop having Paps at age 65.
The guidelines will vary based on your specific history. “Make sure to discuss your specific recommendations with your gynecologist,” Dowell said. “And remember, almost every woman should have a yearly appointment with her gynecologist.”
Cervical Cancer Screening
Regular check-ups and screening tests such as Pap tests and HPV screenings can help detect precancerous changes in the cervix. These cervical cancer screenings are done as part of your routine women’s health visit.
