Medically Reviewed by Gary H. Emerson, MD
Ever since 1943, when Dr. George Papanicolau published his work on “Diagnosis of Uterine Cancer by the Vaginal Smear,” the “Pap” test has been an annual experience for most women.
That is – until several years ago when the US Preventive Services Task Force issued new guidelines, which were quickly adopted by the American College of Obstetricians & Gynecologists (ACOG) and the American Cancer Society.
“The Pap smear has been spectacularly successful in cutting cervical cancer by more than 50% since it has been widely used,” says McLeod Gynecologist Gary Emerson, MD. “However, increased knowledge of the Human Papilloma Virus (HPV), a better understanding of the benefits versus potential harms of a Pap test, and a desire to avoid unnecessary procedures led to the new guidelines.”
One reason for the new guidelines is an understanding that cervical cancer takes 10-20 years to develop. As a result, the more frequent screenings are not needed.
Here’s a BRIEF SUMMARY:
- Women under age 21 should not be screened with a Pap test.
- Age 21-29 you should have a Pap test every 3 years – but not be tested for HPV, unless you have an abnormal Pap test.
- Age 30-65 should have both a Pap test and HPV test every 5 years. The American Cancer Society notes that it’s also fine if a woman wants only a Pap test every 3 years.
- Over age 65, you should continue to be screened ONLY if you have been diagnosed with cervical precancerous tissue. If you’ve had regular screenings with normal results, there’s no need for continued regular cervical cancer screening.
- If you’ve had a hysterectomy that included removal of the cervix – and have no history of precancerous lesions or cervical cancer – the recommendation is against regular screening.
- If you’ve had the HPV vaccine, you should continue screening based on your age group above.
- Women with exposure to the drug DES (when their mother was pregnant with them), women with HIV infection, or the subject of an organ transplant should talk with your doctor about more frequent screening.
Two important points to keep in mind:
- ACOG continues to advocate an annual “Well Woman” exam by your Gynecologist, even if a Pap or HPV screening is not recommended each year.
- Under the Affordable Care Act, health insurers are only required to cover cervical cancer screening outlined in the guidelines. Check with your Gynecologist or insurer to determine what is covered under your plan.
Find a Gynecologist near you.
Sources include: McLeod Health, American College of Obstetricians & Gynecologists, American Cancer Society, US Preventive Services Task Force, American Society for Colposcopy & Cervical Pathology