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A Pap test, or Pap smear, is the most effective screening test for cervical cancer. It's often part of a pelvic exam. Regular testing can help your doctor find and treat abnormal cell changes on your cervix before they develop into cancer.
Women ages 30 to 64 are encouraged to get a human papillomavirus (HPV) test at the same time as a Pap test. The virus can cause cervical cancer and changes in the cervix that can lead to cancer. Certain types of HPV raise the risk of cervical cancer.1
Even if you've already had the HPV vaccine, you still need Pap tests. That's because the vaccine doesn't protect you from all types of HPV. Women who have had the HPV vaccine should follow the same Pap test schedule as women who have not had the vaccine.
Women should start having Pap tests at age 21.2, 1 If you are younger than 21 and are sexually active, it's still a good idea to have regular testing for sexually transmitted infections.
These guidelines apply to women who have never had a serious abnormal Pap test result. If you don't know if you have ever had such a result, talk with your doctor.
You can have Pap tests every 3 years.2, 1
If any of your tests are abnormal, you may need to be tested more often.
Women 21 to 29 usually aren't tested for HPV, because they are at low risk of cervical cancer. The virus is common in younger women, and their immune system usually gets rid of it.
For women in this age group, most experts say:2, 1
Women ages 65 and older may no longer need Pap tests. Talk with your doctor about what's right for you.
Most experts say that you no longer need Pap tests if:2, 1
A hysterectomy is
surgery to remove the
uterus, usually including the cervix.
Sometimes the cervix is not removed. You
and your doctor can decide on the right screening based on
your medical history.
If you don't know if you still have your cervix, talk with your doctor.
Abnormal changes on your cervix may be minor or serious. Minor changes may go away on their own, especially if you are younger than 30.
If you have serious changes—which means the cells are the type that could turn into cancer—you may need more regular checkups and Pap tests. You may need treatment to remove the abnormal cells.
If you have a Pap test and an HPV test, your doctor will look at the results of both and decide what kind of follow-up tests you might need.
Experts agree that some women may need to be tested more often if they:
Sometimes the results of the Pap aren't clear. There might not be enough cells to test. Or the cells may show very small changes that aren't certain. If this happens:
U.S. Preventive Services Task Force (2012). Screening for cervical cancer: Summary of recommendations. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm.
American College of Obstetricians and Gynecologists
(2012). Screening for cervical cancer. ACOG Practice Bulletin
No. 131. Obstetrics and Gynecology, 120(5):
Other Works Consulted
Centers for Disease Control and Prevention (2013). Cervical Cancer Screening With the HPV Test and the Pap Test in Women Ages 30 and Older. Accessed Sept. 17, 2013: http://www.cdc.gov/cancer/hpv/pdf/HPV_Testing_2012_English.pdf.
November 1, 2013
Sarah Marshall, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology
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