How often do YOU need a pap?

The Pap smear used to be done every year. . . guidelines have changed.  Read on. . . We perform paps on women to screen for abnormal cells on the cervix.  Cervical cancer is a disease of sexually active women, related to infection with specific high-risk strains of HPV.  Risk factors are earlier onset of sexual activity, multiple partners, cigarette smoking, and immunosuppression.

Initial screening is not suggested (by most professional groups) until age 21.  We now know that adolescents who have intercourse and contract HPV may have transient cervical changes and most resolve spontaneously, without any treatment.  At age 21 a pap should be offered to all women, regardless if they have ever had sexual intercourse.

At the other end of the age spectrum, Medicare first started reimbursing for Pap smears in 1990 because studies showed 40% of elderly women had NEVER had a pap.  How amazing!  There are no studies to show the effectiveness of screening women older than 65.  Paps may be considered in patients with positive HPV status, current sexual activity, or recent new sexual partners.  Also, older women who have not been screened should have Pap tests annually until they have had three normal tests.  No more paps needed for screening in those with adequate previous testing and no risk factors.

Screening frequency intervals have changed for those 21 to 65.  Most US guideline-issuing organizations recommend screening every two to three years for women older than 30, more frequent for younger women or those with risk factors (HIV infection, immunocompromise, in utero exposure to diethylstilbestrol, prior abnormal paps, or prior cancer).

If you’ve had a hysterectomy for non-cancerous reasons, no more Paps are needed.

For more information the CDC has a great brochure:

Hope this helps.

About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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