Pap Smear Guidelines: Here’s How Often You Actually Need a Pap Smear
By Korin Miller | Originally Published August 30 on Self | Featuring Dr. Sherry Ross
Pap smears used to be a no-brainer: You’d see your ob/gyn for your yearly wellness check and would get an annual Pap in the process. But recommendations changed in the last few years and now it’s not advised that women get a Pap test every year, leaving plenty of people super confused about the whole Pap process.
“The new Pap guidelines…have really thrown everyone for a loop,” Michael Cackovic, M.D., an ob/gyn at the Ohio State University Wexner Medical Center, tells SELF. Women’s health expert Jennifer Wider, M.D., agrees. “With so much misinformation circulating after the guidelines were changed, it’s not surprising that women are confused,” she says.
First, let’s go over what’s actually going on down there during a Pap smear.
Hey, there’s no shame in not knowing exactly what these swabs test for. Christine Greves, M.D., a board-certified ob/gyn at the Winnie Palmer Hospital for Women and Babies, tells SELF that she sees plenty of patients who are confused about what a Pap smear does.
A Pap smear is a diagnostic procedure that’s used to screen for cervical cancer in women. The test involves collecting cells from your cervix (the lower, narrow end of your uterus that’s at the top of your vagina), and it can detect changes in your cervical cells that suggest cancer might develop in the future, accoring to the Mayo Clinic. Cervical cancer is a progressive disease, so catching it early with a Pap is crucial.
The importance of getting a regular Pap test has been so ingrained in women that many often think it can do other things—like screen for sexually transmitted infections or ovarian cancer, but that’s not the case, Melissa Goist, M.D., an ob/gyn at the Ohio State University Wexner Medical Center, tells SELF. It’s possible that your gynecologist might also do a swab test for chlamydia and gonorrhea while they’re down there, but that’s technically separate from the actual Pap smear.
The bottom line: A Pap smear only looks for cervical cell changes that can help detect cervical cancer. If you also want to be screened for STIs or have a pelvic exam (where your doctor feels your ovaries and uterus), ask your gynecologist specifically about that. And hey, even though a Pap smear doesn’t do everything, it does a lot. “Pap smears dramatically reduced the number of cervical cancer cases and deaths in our country and continue to be an incredibly important tool in women’s health,” says Dr. Wider.
So how often do you actually need a Pap smear? That depends.
According to the U.S. Preventative Services Task Force and the American Congress of Obstetricians and Gynecologists, women should begin getting Pap smears at age 21 and get another one every three years until age 65. As an alternative, women 30 years and older can opt for a Pap test plus HPV test every five years.
However, if you get an abnormal Pap smear result, you may need to be screened more frequently for some time after that. You would also need more frequent screening if you have a history of cervical cancer, you’re HIV+, you have a weakened immune system, or you were exposed to diethylstilbestrol (a synthetic form of estrogen) in utero.
But here’s the thing: You should still see your ob/gyn annually, even if you’re not due for a Pap smear.
Going to the doctor takes time and effort, so we get that you’d want to skip this annual visit since the guidelines technically say you don’t need that Pap smear every year. Here’s why that’s not a great idea: Your annual gyno visit is an opportunity to go over way more than just your cervical cells. Plus—that annual visit is covered per the Affordable Care Act.
“Getting a Pap smear [is] only a small part of your annual gynecologic exam,” Sherry A. Ross, M.D., a women’s health expert and author of She-ology: The Definitive Guide to Women’s Intimate Health. Period., tells SELF. The other parts include a pelvic exam, a breast exam, STI screening, and medical consultation. This is an opportunity to chat with your gynecologist about any birth control, period, or fertility questions and any gynecological or sexual symptoms that seem a little off. During a pelvic exam, your doctor may look at your labia and perineal area to make sure there are no moles or lumps that look different and then look inside your vagina to see if there are any abnormalities or tenderness that might need more investigation, Dr. Greves says.
So don’t avoid going to the doctor just because you’re not sure if you should or not. “For most women, the gynecologist is the only doctor they see yearly,” says Dr. Ross. If you’re not sure how often you should see your doctor or have a Pap smear, don’t feel weird about asking. “You are not alone in feeling confused on how often you should be coming into the gynecologist,” Dr. Ross says. But, trust us, they want to see you every year.