How often do I need a Pap test? Cervical Cancer.

September 23, 2018

The 2018 United States Preventative Services Task Force recommendations for cervical cancer screening

Hi, Dr. Jim, here. I’ve got some great news today for women about Pap smears. The United States Preventive Services Task Force has recently released new recommendations for the frequency of Pap smear testing. I think you like them, and I’m happy to share them with you today.

First off, you should understand the technology around acquiring a Pap smear; acquiring the specimen necessary for evaluation.

Here’s what that’s all about: first, the “old-fashioned” Pap smear is actually known as cytology. It’s where we take a little device like this, and gently broom the cervix to get cells, then look at them under a microscope to see if there’s any inflammation or infection or evidence of cancer. From there, we advance to more recent screening technology called high risk HPV (hrHPV). There are several strains of the HPV or human papillomavirus. Several are more likely to cause cancer of the cervix, so the goal here is to collect cells for the high-risk strains. In this instance, we do the same thing. We gently broom the cervix, get some cells and then evaluate them for high risk human papillomavirus.

So that’s the technology, what are the United States Preventive Services Task Force recommendations?

  • For women under age 21, the recommendations are no cytology, no hrHPV, no cervical cancer screening.
  • On the other hand, for women aged 21 to 30 the current recommendation is cytology alone every three years. That’s the “old-fashioned” Pap smear done every three years in that age group.
  • For women age 30 to 65 the recommendations are a little bit different and little more confusing, but here are:
    • Cytology alone (the old-fashioned Pap smear) every three years or
    • Alternately, there’s combination testing, which is more specific and sensitive. Combination testing adds high-risk HPV testing to the old-fashioned Pap smear. That really puts it all together for you, and when you do that, testing is every five years
    • On the other hand, you can also do just the hrHPV alone and that’s also every five-year, so that’s kind of cool too
    • Of course, the decision on what exactly to do in this age range is between you and your health professional
  • So, what about the recommendations for women above age 65? If you’ve never had an abnormal Pap smear, and if you don’t have risk for cervical cancer like a past history for sexually transmitted infections, you never have to have Pap smears again! Isn’t that awesome. No more screening for cervical cancer.
  • What about women who’ve had a hysterectomy? If you have had a hysterectomy and it was for reasons other than cervical cancer, you don’t have to have Pap smears again either!

There you have them – the 2018 cervical cancer screening recommendations by the United States Preventive Services Task Force, also known as the USPSTF. And their recommendations are evidence-based, so you can rely on them; they are backed by the Agency for Healthcare Research and Quality.

This is Dr. Jim for Be Healthy! Be Happy! hoping that this message powers your path to happiness!

Reference: United States Preventive Services Task Force: Cervical Cancer Screening. Online [available at]: Accessed September 23, 2018.