Despite being almost 100 years old, the Pap test (or Pap smear) is still the gold standard in cervical cancer detection. A Pap test—a screening test you get during a visit with your OB/GYN or primary care provider—is the best way to find cancerous or precancerous cells in the cervix early when the chance for successful treatment is very high.
But guidelines change periodically and you may not need to be screened as often as you have in the past. The changes can be a bit confusing and may leave you feeling uncertain about what to do.
We’re breaking down the most recent recommendations on this important screening for cervical cancer—as well as risk factors and symptoms every woman needs to know—so you can make decisions about your health with confidence.
What is a Pap Test?
A Pap test is a screening test that looks for abnormal cells in your cervix—the lower end of a woman’s uterus—and is usually done during a pelvic exam. To collect these cells, your health-care provider gently opens your vagina with a tool called a speculum to see your cervix and uses a soft, narrow brush or tiny spatula to collect a small sample of cells. The process only takes a few minutes. The cells are sent to a laboratory to check for any cancerous or precancerous cells.
Precancerous cells can be caused by the human papillomavirus (HPV), a common sexually transmitted infection. An HPV test can provide more information about the cells from your cervix and is often done along with the Pap test. It can show whether you have a type of HPV that causes cervical cancer.
Cervical Cancer Screening Guidelines
Several respected health organizations, including the United States Preventive Services Task Force (USPSTF) and the American Cancer Society, develop recommendations on how often you should be screened for cervical cancer and which tests you should get, depending on your age and health history. Talk to your health-care provider about how often you need to get a Pap test or a Pap and HPV test. Most women can follow these current recommendations from the USPSTF:
- Women ages 21-29 should get a Pap smear every three years. Even if you are sexually active you don’t need a Pap test before age 21.
Important note about prevention: Almost all cervical cancer is associated with HPV and there is a vaccine to protect against it. It is recommended that girls and women (boys too!) ages 9-45 years get vaccinated.
- Women ages 30-65 should get:
- A Pap test every 3 years, or
- An HPV test every 5 years, or
- A Pap test and HPV test together (called co-testing) every 5 years
- Women older than 65 should talk to their health-care provider to see if screening is still necessary. You may no longer need a Pap and HPV if you’ve been screened regularly and had normal results.
- Women who have had a total hysterectomy do not need to get a Pap test, unless they have other risk factors.
Cervical Cancer Risk Factors and Testing Frequency
If you have certain risk factors for cervical cancer, your doctor may recommend more frequent Pap tests, regardless of your age. These risk factors include:
- You’ve had cervical cancer
- You had a recent abnormal Pap test or biopsy result
- You are HIV positive
- You have a weakened immune system
Cervical Cancer Symptoms
If you experience any of the cervical cancer symptoms listed below, do not wait for the recommended screening time to be checked. Talk with your health-care provider right away.
- Abnormal vaginal bleeding (after sex, after menopause, between periods, longer/heavier than usual periods)
- Unusual discharge from the vagina
- Pain during sex
The Data on Cervical Cancer Screening.
No one questions the importance of cervical cancer screening. It’s one of health care’s best success stories—cutting the death rate from the disease in half. So don’t miss out on this potentially life-saving opportunity. Talk to your doctor about when you should get Pap and HPV screening tests.