Pap Screening Guidelines

Most women schedule a Pap test every year because it is part of their normal routine. It is important to know that the screening guidelines have changed and you may not need a yearly Pap test. However, it is important to see your healthcare provider every year for routine lab work and a physical exam (including a breast/pelvic exam).

This may be confusing, but the following information should answer your questions. The recommendations were published in 2012 by the American Society for Colposcopy and Cervical Pathology.

  • <21 Years: NO PAP REQUIRED

  • 21-29 Years: Pap every 3 years if the results are normal (HPV testing should NOT be done if Pap is negative for ASC-US)

  • 30-65 Years: You have two options

  1. Pap with HPV cotesting every 5 years if both results are negative
      • If your Pap is normal, but HPV positive: repeat Pap in 1 year
      • If HPV 16 or HPV 16/18 positive: refer for colposcopy
      • If HPV 16 or HPV 16/18 negative: repeat Pap with HPV cotesting in 1 year

    OR

  2. Pap every 3 years if the result is normal
  • >65 Years:  No screening if prior screening was negative and no history of CIN2+ (Cervical intraepithelial neoplasia 2+) within the past 20 years

  • After hysterectomy: No screening if you do not have a cervix, no history of CIN2, and no history of cervical cancer.

Frequently Asked Questions:

Question: I do not understand the difference between a Pap smear and an HPV test. I thought they were one in the same.

Answer: No – they are different, but ordering both tests (cotesting) can be done from the same collection of cervical cells if your are between the ages of 30 and 65.

  • The Pap test (also known as Pap smear and cytology screening) is used to screen for abnormal, or pre-cancerous cells that could lead to cervical cancer.
  • The HPV test detects high-risk HPV types that can lead to cervical cancer. If you test positive for a high-risk HPV, you need to have more frequent testing.

Question: I had the HPV vaccine. Can I still contract HPV?

Answer: Yes – you can contract another strain of HPV. There are more than 100 strains of HPV. Some of these strains cause cervical cancer or genital warts, and other strains may resolve on their own with time. That is why it is important to follow your healthcare provider’s recommendations.

Question: I am 20 years old and I have had three sexual partners in the past two years. Do I need a Pap?

Answer: No. Your will start Pap screening when you turn 21. However, you should schedule an appointment if you would like to discuss birth control options; HPV vaccination; other symptoms such as vaginal pain, burning, or itching; or if you are interested in STD screening.

Question: I am 66 years old and I have a new sexual partner. Do I need a Pap smear?

Answer: No – as long as your prior screening was negative and you were not diagnosed with CIN2 in the past 20 years.

Question: I had a hysterectomy. Do I need a Pap smear?

Answer: Please see the response above.