New Guidelines Advise less frequent Pap Smears

by Mary Catherine Cochran


Annual Pap smears for most women will become a thing of the past as new guidelines released Wednesday recommend far less frequent screenings for cervical cancer.

Doctors had previously recommended that women should begin getting Pap smears at age 21 or three years after beginning sexual activity and should continue with screenings every year or two, thereafter.

Now, after reviewing scientific evidence, three groups including the American Cancer Society, American Society for Colposcopy and Cervical Pathology and the American Society for Clinical Pathology concluded that not only was annual screening unnecessary, it was potentially harmful.

Cervical cancer, rare in young women, progresses very slowly in women of any age, so slowly researchers say, it is equally effective to screen for cancer at longer intervals between Pap tests.  Frequent testing can cause its own set of problems including false positive test results and unnecessary biopsies and procedures, which can potentially damage the cervix and lead to pre-term labor and low birth weight infants.

The new guidelines, published in the Annals of Internal Medicine with an accompanying editorial, suggest that women begin screening no earlier than age 21; regardless of sexual activity and that screening should occur every three years. Additionally, when women turn 30, women should get a Pap test along with a test for the human papillomavirus (HPV), a sexually transmitted virus that can cause cervical cancer. Guidelines suggest that negative results for both of these tests mean that a woman can wait at least five years to get the tests again.

While Margot Watson, M.D, Department Chair of Obstetrics and Gynecology at Howard County General Hospital, Johns Hopkins Medicine, agrees with the guidelines, she suggests that a conversation between physician and patient is always in order. “Whether Pap smears can be done every three years or every five years depends on whether or not a patient has a history of seriously abnormal Pap smears and so the decision should always be reached in consultation with your physician.” Dr. Watson points out that less frequent Pap smears does not mean less frequent visits to the doctor. “Women should still continue to get yearly gynecologic checkups.”

The new guidelines also recommend that women over the age of 65 should stop getting screened all together as long as they have had adequate prior screening and are not otherwise at high risk for cervical cancer.

The task force recommendations apply only to healthy women. They do not change the advice for women who have unusual symptoms, an unusual Pap test result or a history of dysplasia, cervical cancer, H.I.V. or other illnesses.

If you have questions, be sure to check with your doctor for more information about the new screening guidelines. If you don’t have a gynecologist, reach out to one of our Howard County General, Johns Hopkins Medicine gynecologists.



    Do I still need a Pap smear after having a full Hysterectomy.PS:I am 49 yrs.

    • Linda,
      Your gynecologist is the best person to consult about what screenings you still need. She can review with you your past medical history including your surgical history and provide you with the answers you seek. Generally the answer is, if you still have a cervix, you need to be screened for cervical cancer.

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