Cervical Pap Smears in Older Women

Menopause or hysterectomy doesn't mean testing stops

Having advise with a gynecologist
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The Pap smear is a vital test for all women. This simple-to-perform test can detect abnormal cervical changes long before cells and tissues of the cervix become cancerous.

Despite its proven effectiveness, there remain many myths and misconceptions about the test, not least of which is the belief that older women no longer need them.

The Success of Pap Smear Screening

Cervical cancer is a slowly progressing disease which can take years to develop.

With regular Pap smear screenings, doctors are better able to detect changes in cells that can lead to the development of precancerous tissue and malignancies.

This makes cervical cancer one of the more preventable and treatable diseases today. The only downside is the fact that many women don’t get tested as often as they should, with later diagnoses often resulting in poorer outcomes.

Early diagnosis is key. When combined with a regular program of screening and follow-ups, Pap smear testing is known to reduce the risk of cervical cancer deaths by up to 80 percent.

Pap Smears in Later Life

The frequency of Pap smear tests largely depends on your age, health, personal risk factors, and findings from previous Pap smears.

According to guidelines issued by the American College of Obstetricians and Gynecologists (ACOG), women between the ages of 30 and 65 should have a regular Pap and an HPV test performed every five years.

This is true even if they have already gone through menopause. Alternatively, it’s acceptable for women to undergo the pap smear screening alone, without an HPV test, every three years.

By contrast, women age 65 to 70 who have had three consecutive normal Pap tests and no abnormal findings within the past 10 years can opt to discontinue screenings altogether if they choose.

All told, women between the ages of 35 and 55 are more commonly diagnosed with cervical cancer than women of any other age group. 

Pap Smears After Hysterectomy

If you have had a partial or total hysterectomy, you may need to continue having regular Pap smears. This is especially true if you had a hysterectomy as a result of cancer.

On the flip side, ACOG states that women who have undergone a total hysterectomy due to a noncancerous condition, and who have not had previous abnormal Pap smears, can discontinue screenings, as well.

Insurance Coverage for Pap Smears

Most private insurance companies cover the cost of a Pap smear depending on your specific coverage plan and benefits. Check with your provider for program details and cost.

Medicare, meanwhile, allows enrollees to get a Pap smear every 24 months. If a previous Pap smear was abnormal, or you are at high risk for cervical cancer, a Pap smear test is covered for every 12 months. All women with Part B are covered. There is no cost for the lab test, specimen collection, pelvic exam, or breast exam if our doctor accepts Medicare.

Sources

  • American College of Obstetricians and Gynecologists (ACOG). “ACOG practice bulletin no. 45. Cervical cytology screening.” Int J Gynaecol Obstet. 2003; 83:237-247. 
  • U.S. Department of Health and Human Services (DHHS). Your Medicare Benefits. January 2015 Revised Edition. 

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