Screening for Cervical Cancer

The newest recommendations for screening for cervical cancer from ACOG have changed the way we treat our patients.

Part of these changes reflect what we now know about cervical cancer; almost all cases are caused by HPV and sometimes, HPV will clear on its own. But, that is no excuse not to get your pap smear! Pap smears are the best way (and so easy!) to screen for cervical cancer and to let us know if you might be one of those women who needs more testing to look for abnormal cells.

So, if you are under age 21, we are not recommending pap smears. This is because the likelihood of an HPV infection clearing before it causes cervical cancer is very good. Even if it doesn't clear up on it's own, cervical cancer is so slow to develop, that by the time you start doing paps at age 21, we'll still have plenty of time to catch it and treat it if need be.

Women between the ages of 21 and 29 should have pap smears every other year. There may be good reasons to do pap smears more often, like having an abnormal result or other problems with the cervix.

Women over age 30 can go to having their pap smears every 2-3 years if (and this is a big if!) their last three paps have been normal, they have never had abnormal cells on a biopsy of the cervix, they don't have HIV or otherwise immunocompromised, and don't have a history of DES exposure. Sometimes, we will check an HPV test to reassure ourselves that the risk of developing cervical cancer is low.

Women who have had a hysterectomy (with removal of the cervix!) for reasons other than cancer can also stop having pap smears. Again, unless they have risk factors for cervical cancer like previous abnormal cells, new sexual partners, HIV, DES exposure, or being immunocompromised.

Women over the age of 65 without risk factors (see above) and with three normal pap smears previously can also stop getting pap smears. Remember that new sexual partners is a risk factor!

Now, all this is not to say that women can stop coming to the gynecologist every year. No! Women still need annual exams to screen for sexually transmitted infections, other gyn cancers, discuss birth control, and to review other women's health issues.

Also, remember that an HPV vaccine is available and very effective at preventing and reducing the risk of cervical cancer, abnormal pap smears, and genital warts!