How Often Should You Have a Pap Smear?

Cervical Cancer Screening Guidelines

A pap smear slide.
A pap smear slide.. Environment Images/UIG/Getty Images

How often should you have a Pap smear? The answer to that question has changed quite a bit in the past 10 years. If you haven't kept up with the newer recommendations, you may be giving the wrong answer to other women. Routine annual screening is a thing of the past for women who have had no abnormal findings, but getting a Pap smear regularly is still important to reduce the development of cervical cancer.

The frequency in which women get Pap smears is not the same for everyone. How often a woman needs a Pap smear depends on several factors, like age, general health, and findings from previous Pap smears. Here are the recommendations of the American Cancer Society and the American College of Obstetricians and Gynecologists as modified in 2012.

When to Have Your First Pap Smear

A woman should have her first Pap smear at age 21 and not before.

  • She should have a Pap smear even though she has received the human papillomavirus (HPV) vaccine also known as Gardasil.
  • She should have a Pap smear at age 21 regardless of the age at which she became sexually active, and whether or not she has yet been sexually active.
  • If you missed the deadline at age 21, it's not to late to start. Make it a part of your next check-up. Having a regular Pap smear may considerably reduce your risk of developing cervical cancer.

    How Often to Have a Pap Smear Before Age 30

    Between the ages of 21 and 30, women should have a Pap smear every three years. If your first is at age 21, your next should be at age 24 and then at age 27 and at age 30. If you have a normal Pap smear, they should not perform HPV testing at these ages.

    How Often to Have a Pap Smear from Age 30 to 65

    At age 30, women have the option of having an HPV test along with their Pap smear.

    The HPV test identifies women who are infected with high risk strains of HPV that could lead to cervical cancer, if left unmonitored or untreated.

    Now you can wait five years between tests if you have both a Pap test and an HPV test at the same time. If you have only a Pap smear performed, then it should be repeated every three years.

    Women who have had previous abnormal Pap smears, infected with HPV, or at high risk for cervical cancer may need to be screened more frequently.

    Age Sixty-Five and Over

    At age 65 to 70, women who have had no abnormal Pap smears within the last 10 years may discontinue having regular Pap smears. This is a decision that has to be made with a physician or other clinician. For women who have a previous history of cervical cancer, abnormal Pap smears, or are at high risk for developing cervical cancer, should continue having regular screenings for 20 years after those findings.

    Who Needs More Frequent Pap Smears?

    Women at high risk of cervical cancer may be given more frequent Pap smears based on their health status.

    This could be the result of weakened immunity, such as for women with HIV, or because they have had abnormal findings on their Pap smears. If your health care team advises more frequent testing, discuss the reasons for it with them so you understand why it is being done.

    Sources:

    American Cancer Society. Cervical Cancer: Prevention and Early Detection. 12/11/2014. Accessed 12/7/2015.

    American College of Obstetricians and Gynecologists (ACOG). Screening for cervical cancer. Washington (DC): American College of Obstetricians and Gynecologists (ACOG); 2012 Nov. 17 p. (ACOG practice bulletin; no. 131).

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