How Often Do You Need a Pap Smear?
By Christina Elston
Women no longer need to undergo a Papsmear every year to screen for cervical cancer. The U.S. Preventive Services Task Force and the American Cancer Society have agreed on new guidelines for how often and at what ages women need to receive a Pap smear:
• Women under 21 do not need to be screened, even if they are sexually active.
• Ages 21 to 29 (except those with immune problems) should have a Pap smear every three years. Testing for the human papillomavirus (HPV) isn’t recommended because infections are common in this age group, but not persistent (and only persistent infections increase risk for cervical cancer).
• Ages 30 to 65 can opt for a Pap smear plus a test for human papillomavirus (HPV) every five years.
• Ages 65 and older (with adequate previous screening) can discontinue screening.
• No one needs annual Pap smears.
The American Cancer Society recommendation also advises women who’ve had the HPV vaccine to continue undergoing routine screening because the vaccine doesn’t protect against all HPV strains associated with cancer, and the length of protection it does offer is still uncertain.
Why back away from yearly cervical testing? Experts say that screening often leads to more false-positive tests, over-diagnosis, and the risk of unnecessary treatment – without saving more lives.
The guidelines were published in a March issue of the Annals of Internal Medicine with an accompanying editorial that added some important food for thought: Approximately 50 percent of cervical cancer cases are diagnosed in women who’ve either never been screened, or haven’t been screened for five years or more. The United States lags far behind Australia and the United Kingdom in promoting the HPV vaccine to young women at ages when it will protect them best – before they become sexually active. Only 32 percent of eligible women in the United States have received the full course of the vaccine. Improved efforts to protect young women, and to get all women screened regularly, would go a long way toward saving lives, the editorial says.
The editors also note that many women who do get screened use the annual occasion to check in with their doctors about other health issues. Even without Pap smears, this should continue. So when it comes to your gynecologist, don’t be a stranger. Annual pelvic and breast exams are still recommended.
