January is National Cervical Cancer Detection Month. The Pap smear (also called a Pap test), is an important exam in the detection of cervical cancer – it checks for changes in the cells of your cervix. The cervix is the lower part of the uterus (womb) that opens into the vagina (birth canal). The Pap smear can tell if you have an infection, abnormal (unhealthy) cervical cells, or cervical cancer.
The Pap smear has been around since 1941 and has made a huge difference in reducing the number of women who develop cervical cancer. The question of how often you should get a Pap smear has become a confusing one recently because guidelines have changed over the years. The Pap smear is now much more accurate than it was in 1941 and physicians’ understanding of who develops cervical cancer, and when, have changed as well. As a result, the “annual” Pap smear may, in fact, not need to be annual for you.
Here are the current (2011) guidelines*:
1. You should get your first Pap smear at age 21 regardless of whether or not you have ever had sexual intercourse.
2. If you are between 21 and 29 you should have a Pap smear at least every 2 years.
3. If you are 30 or older you can safely have a Pap smear every 3 years IF:
- • You test negative for the HPV virus (the sexually transmissible virus that is strongly associated with cervical cancer. The HPV test can be done at the same time as your Pap test);
- • Your last 3 Pap smears have been normal;
- • AND if you have never had an abnormal Pap smear.
4. If you have a suppressed immune system (HIV infection, transplant recipient, etc.), you should have a Pap smear every year.
5. If you are 65 years of age or older, you can stop having Pap smears if you have not had an abnormal Pap smear in the last 10 years (assuming you have had at least 3 normal Pap smears in that time frame).
6. If you have had your cervix and uterus removed for reasons that were not cancer, you can stop having Pap smears.
Even though you may not need a Pap smear every year, there is more to an annual visit than just the Pap smear. It is still a good idea to visit your physician at least once a year to discuss your individual health situation and other screening tests that you may need.
*Source: ACOG (American Congress of Obstetrics and Gynecology), US Preventative Services Task Force.
