How Often Do You Really Need a Pap Smear?

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By News Team on January 27, 2022

How often do you really need a Pap smear?

The guidelines for the test have changed in recent years, and they take into account your age, medical history and other factors.

“We don’t routinely do annual screenings anymore,” said Heather Greer, M.D., a Carilion Clinic obstetrician and gynecologist.

It is now recommended that women start getting a Pap smear at age 21 and then have one every three years, depending on their test results.

“A woman who has had three consecutive normal Pap smears by age 30 followed by normal HPV co-testing can then go every five years between tests,” Dr. Greer said. “This applies to patients who are low-risk—who have had no new exposure to HPV and whose immune systems aren’t compromised.”

The human papillomavirus (HPV) is a sexually transmitted infection that can increase the chances of developing cervical and other cancers. It is common worldwide. According to Dr. Greer, women who are deemed to be low-risk can keep getting the Pap smear every five years until they turn 65, and if their results are still normal, can then discontinue it.
"We do still want to see our patients every year throughout their lives for a routine pelvic exam, though,” Dr. Greer noted. "This will screen for other potential health problems."
Cervical Cancer Risk Factors
The American Cancer Society lists risk factors that you can’t change, such as family history and your mother having taken the hormone DES while pregnant to prevent miscarriage (it was discontinued in the U.S. in 1971), and factors that you may be able to change. These include:

  • Sexual history: becoming active at a young age, having many partners, having a partner who is at higher risk and contracting chlamydia, which often has no symptoms and is only found through a pelvic exam
  • Long-term use of oral contraceptives; in contrast, using an intrauterine device (IUD) for contraception may lower a woman’s risk for cervical cancer
  • Early first full-term pregnancy (under age 20) or 3 or more full-term pregnancies
  • Lifestyle: a diet low in fruits and vegetables can increase your risk, and smoking doubles your risk and compromises your immune system
  • A weakened immune system, which can be caused by HIV infection, organ transplants or drugs that treat autoimmune conditions

An indirect risk factor is a woman’s economic status and access to affordable medical care, as they are less likely to be screened regularly for cervical cancer or other conditions.
Abnormal Pap Results
What if you have an abnormal Pap smear? Or are diagnosed with cervical cancer? Your doctor would advise you to be tested based on your individual risk factors.

“The American Society for Colposcopy and Cervical Pathology has many algorithms in place that guide how often women with abnormal results should be screened,” said Dr. Greer.   

What hasn’t changed? Agreement that early detection is a good way to safeguard your health.
Learn more about the health screenings every woman needs

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