It may not be your favorite part of routine medical care, but a Pap test (or Pap smear) could save your life.
“The Pap smear is the main screening test for the detection of pre-cancerous cells of the cervix as well as for early diagnosis of cervical cancer,” says Dr. Lisa Underwood, an OBGYN affiliated with Sharp Mary Birch Hospital for Women & Newborns. “Getting regular cervical cancer screening is the key to prevention.”
Named for Dr. George Papanicolaou, better known at Cornell University Medical College as “Dr. Pap,” the Pap test is one of the best ways to screen women for cervical cancer and test for human papillomavirus (HPV).
HPV is the most common sexually transmitted infection in the U.S. and accounts for 70 percent of cervical cancers worldwide, according to the U.S. Centers for Disease Control and Prevention (CDC). Although up to 80 percent of women have HPV in their lifetime, very few women with HPV will ever get cervical cancer, says Dr. Philip Diamond, chair of Sharp Rees-Stealy's OBGYN department.
“Having HPV just means that you need to be screened more frequently,” he says. “The most effective way to prevent cervical cancer is to be vaccinated against HPV.”
Screening saves lives
When Dr. Pap began training doctors on how to perform the exam in the 1940s, cervical cancer was the number one cause of death for women. Between the 1950s and the 1990s — after Pap tests were adopted by primary care doctors and gynecologists as part of a woman’s routine exam — that rate decreased by more than 60 percent.
According to the CDC, cervical cancer is the most preventable type of female cancer. Despite the wide availability and routine use of the Pap test, roughly 12,000 U.S. women are still diagnosed with cervical cancer every year. More than half of women diagnosed with cervical cancer did not receive Pap tests as recommended.
“OBGYNs and primary care doctors play an integral role in the prevention of disease and promotion of health, which is why it is so crucial that women take advantage of the services we provide at their well-woman exam,” says Dr. Underwood. “This periodic visit is the most important visit for a woman, as it provides an excellent opportunity for the patient and the physician to form a partnership and set goals aimed at improving and maintaining a healthy lifestyle and minimizing health risks.”
While you should discuss your risks and screening schedule with your doctor, recommendations from leading experts in cancer and gynecological medicine offer these screening guidelines for women with no history of cervical cancer or HPV, or with a low risk for cervical cancer. If you have a recent abnormal Pap test, you should discuss your screening needs with your doctor.
How often you should receive a Pap test, by age
In your 20s
You don’t need to receive your first Pap test until age 21, even if you are sexually active before then. If the test is normal, then you should be screened every three years until age 30.
Ages 30 through 65
Beginning at age 30, a test for HPV is added to the Pap test, which results in much better detection of abnormalities. That’s why this age group can safely be screened every 5 years, as long as the results of both tests are normal.
After age 65
If you have a history of normal Pap tests and negative tests for cervical cancer, you can stop getting screened at age 65.
At all ages
Women who had their cervix and uterus removed (hysterectomy) generally do not need further screening for cervical cancer. To be safe, confirm this with your doctor.