Pap smear guidelines have changed in recent years. How often you need one depends on your age, medical history, and other factors.
“We don’t routinely do annual screenings anymore,” says Heather Greer, MD, an OB/GYN at Carilion Women’s. These are the latest recommendations:
- Ages 21 – 29: Most women should begin Pap smears at age 21. If your results are normal, you can wait 3 years between tests.
- By 30: After 3 normal Pap smears and normal HPV co-testing, you can stretch it to every 5 years.
- After 65: If everything has been normal, you can stop Pap smears altogether.
These recommendations apply to women who are low-risk—meaning no new HPV exposure and a healthy immune system.
Why HPV testing matters
The human papillomavirus (HPV) is a sexually transmitted infection that can increase the chances of developing cervical and other cancers. It is very common, affecting millions of people worldwide. Nearly all sexually active people who aren’t vaccinated against HPV will be infected at some point in their lives.
Do you still need annual checkups?
Yes! "We do still want to see our patients every year throughout their lives for a routine exam,” notes Dr. Greer. "This will screen for other potential health problems."
Cervical cancer risk factors
The American Cancer Society notes several risk factors for cervical cancer. Some are out of your control, like:
- A family history of cervical cancer
- Your mother taking DES during pregnancy (a drug discontinued in 1971)
Others are lifestyle or medical factors you may be able to influence, including:
- Sexual history, including early sexual activity and having multiple partners or partners with higher risk
- Chlamydia infection, which often has no symptoms
- Long-term oral contraceptive use (IUD use may lower risk)
- Early first full-term pregnancy (under age 20)
- Three or more full-term pregnancies
- Smoking, which doubles your risk
- Poor diet that’s low in fruits and vegetables
- Weak immune system from HIV, organ transplant medications, or autoimmune disease treatments
- Limited access to regular medical care, which can prevent early detection
What if your Pap results are abnormal?
Don’t panic. Abnormal Pap results are common and usually don’t mean cancer. Your doctor will follow up with you and suggest next steps based on your individual risk factors.
What hasn’t changed? Agreement that early detection is a good way to safeguard your health. If you have questions or it’s time for your screening, reach out to your family doctor or OB/GYN.
