Cervical Cancer Screening Guidelines

Are Annual Pap Smears Necessary?

pap smear device
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If you've been getting a Pap smear every single year for cervical cancer screening, it's probably safe to reconsider. Here's what you need to know about the latest Pap smear guidelines.

What Is a Pap Smear?

A Pap smear is a test to detect cervical cancer that requires having cells scraped from the opening of the cervix to be examined under a microscope.

Screening has been found to reduced cervical cancer deaths by allowing doctors to find cancer early and treat it, or prevent it from developing in the first place. Pap smears are part of routine gynecological visits that, until 2012, was recommended annually for all women 21 and older.

Current Guidelines

Both the American Cancer Society and the United States Preventive Services Task Force updated their recommendations in March 2012, moving away from annual Pap smears to a three-year schedule for most women. That's because cervical cancer generally takes 10 to 20 years to develop, making annual testing an unnecessary medical procedure for most women. The current guidelines are as follows:

  • All women should begin cervical cancer screening at age 21.
  • Women between the ages of 21 and 29 should have a Pap test every 3 years. They should not be tested for HPV unless it is needed after an abnormal Pap test result.
  • Women between the ages of 30 and 65 should have both a Pap test and an HPV test every 5 years. It is also OK to have a Pap test alone every 3 years.
  • Women over age 65 who have had regular screenings with normal results should not be screened for cervical cancer.
  • Women over age 65 who have been diagnosed with cervical pre-cancer should continue to be screened.
  • Women who have had a total hysterectomy do not need Pap smears unless the hysterectomy was performed for cancer or precancerous conditions. Women who have had a subtotal hysterectomy (leaving the cervix intact) need to follow the same guidelines as for other women and continue Pap smear screenings for cervical cancer until they are 65 years old.

Exceptions to the Rules

The new recommendations do not apply to women who've been diagnosed with cervical cancer or a high-grade precancerous cervical lesion. Women who were exposed in utero to diethylstilbestrol (an estrogen drug found to cause cancer), or women with compromised immune systems, such as those who are HIV positive.

It's important to note that an estimated 50 percent of diagnosed cases of cervical cancer in the United States occur in women who have never had a Pap smear. Another 10 percent of diagnosed cases of cervical cancer occur in women who have not had a Pap smear in the last five years. Your best protection against a future diagnosis is to strictly adhere to your personal healthcare provider's advice about when you need to be screened for cervical cancer. Talk with your doctor to develop a Pap smear schedule that is appropriate for you and your health.


Pap test: MedlinePlus Medical Encyclopedia (U.S National Library of Medicine)

Simon, S. (2012, March 14). New Screening Guidelines for Cervical Cancer.