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Pap Smear Frequency Guidelines

October 20, 2016 | Heather Robinson, NP-C

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Pap.jpgWe know it can get confusing. It used to be that women were supposed to visit their gynecologist once a year for a Pap smear. Not only has that changed, but a vaccine for preteens to prevent cervical cancer has left patients and parents wondering how often should I get a Pap smear?

Pap Smear Frequency

First, let’s discuss the purpose of the Pap smear. Simply put, it’s a procedure that collects cells from the cervix and tests them for signs of cervical cancer. Named for prominent Greek doctor Georgios Papanikolaou, who began his research in 1923, the yearly Pap smear has been the gold standard of gynecological preventive care for decades.

The big game-changer came in 2003, when human papillomavirus (HPV) testing became standard and yearly Pap smears were replaced by combined Pap smear/HPV tests done every five years. Here is the logic: Cervical cancer is caused by some strains of the HPV virus. So if a woman does not have the HPV virus, she should still come for annual gynecological examinations, but she may not necessarily need a pap smear depending on age and previous results.

Which raises an interesting question.

If a woman is not sexually active (but used to be) and tests negative for HPV, she would not need any more tests as long as she doesn’t have sex, right? Wrong! The HPV virus can be dormant for years. The same is true, by the way, for a woman in a monogamous relationship.

But if a woman opts just for a regular Pap smear (and doesn’t combine it with the HPV test), she still doesn’t need to have a Pap smear done every year. Depending on age and risk factors, women can talk with their provider regarding frequency of screening.

The rules are a bit different for women in their 20s. Most health care providers don’t even test for HPV because it’s so prevalent at that age, and usually clears on its own. Instead, sexually active women in their 20s should have Pap smears every three years.

All of these numbers may leave women confused about how often to visit their gynecologist, but that’s actually the easy part and the advice has never changed—every year. Sure, you won’t need a Pap smear every time you go, but that’s not the only purpose of your yearly exam.

Consider this the time to take care of yourself. Your health care provider will update your medical history and talk about preventive screenings. Contraception or hormone replacement therapy can be discussed. Breast, pelvic and thyroid exams typically are done every year. Screening blood tests and age-appropriate vaccinations are also options.

The Centers for Disease Control and Prevention recommends that starting at age nine girls receive the Gardasil HPV vaccine. This vaccine can be administered at a gynecology office, a primary care office, or a health department. Young adolescents don’t necessarily need routine gynecologic care, but if they are sexually active, thinking about becoming sexually active, or having trouble with their periods, then they should and can be seen routinely.

The fact is that 80 percent of the population has been exposed to the HPV virus, which means that most girls eventually will be exposed to it as well. Gardasil can help prevent cervical cancer by vaccinating against some strains of HPV. The key is, like all vaccines, it only works before exposure to the virus. Gardasil is given as a three-dose series. It’s also recommended for boys because it protects against genital warts and anal cancer.

While some parents balk at vaccinating for an STD at such a young age, the point is to protect girls long before they are sexually active. Some parents opt to wait a few years before vaccinating their children, but prevention is key. Vaccination does not mean adolescents are ready for sexual activity, but rather that steps are being taken for future health.

The reality is that guidelines are always changing to keep up with the latest research and it can be hard to stay up to date with it all. The best advice? Develop a good relationship with a health care provider who knows you and can help you make the best decisions for your health.

Contact us today to schedule an appointment with one of our women’s health specialists.

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