Pap Smear Every Year? New Cervical Cancer Screening Guidelines Say No

January is Cervical Cancer Awareness Month. According to the American Cancer Society, more than 13,000 new cases of cervical cancer will be diagnosed this year. The good news is that cervical cancer is highly treatable when caught early. And advances in screening methods make it easier than ever to diagnose. The challenge for women: knowing which tests are needed when.

This fall, the U.S. Preventive Services Task Force (USPSTF) released new recommendations for cervical cancer screening. The Pap smear, which was once the go-to test for cervical cancer screening, is no longer the only option.

“We now have two separate tests to screen for cervical cancer,” says radiation oncologist Kara Romano, MD. “Women, with guidance from their physicians, can now choose one or both screening methods depending on their age and medical history. This screening protocol is easily implemented as part of standard primary care or gynecologic care, so we catch the disease before it reaches a cancerous stage.”

Note that, despite the recommendations for less frequent cervical cancer screenings, women should still consider seeing a gynecologist or primary care provider each year beginning at age 13, according to the American College of Obstetricians and Gynecologists. This annual visit will allow women to discuss other health concerns, such as diet and exercise, incontinence or bone density, and share any abnormal symptoms they may be experiencing.

The Latest Cervical Cancer Screening Recommendations

Women 21 and Under: No Screening Required

The USPSTF does not recommend screening for women ages 21 and under. The risk of cervical cancer in this age group is too small to justify it.

Women 21 to 29: Pap Smear Every Three Years

Women ages 21 to 29 should have a Pap smear every three years to test for abnormal cell changes in the cervix.

This is a shift from the “Pap smear once a year” mentality of decades past. Thanks to an abundance of research, we now know that yearly Pap smears aren’t necessary for a majority of women.

Why? First, disease progression — the time between the appearance of precancerous lesions and the development of invasive cervical cancer — is slow. Second, women’s bodies resolve some abnormal cellular changes on their own in time. Screening annually can increase the likelihood of unnecessary follow-up procedures, such as biopsies.

Women 30 to 65: Pap Smear Every Three Years; HPV Testing Optional

Having a Pap smear every three years is sufficient for this age group as well, according to the USPSTF. But women also may choose to have the human papillomavirus (HPV) test or a combination of both tests every five years.

Research confirms that HPV causes almost all cervical cancers, and the HPV test has gained traction as a viable way to screen for the disease. Some HPV strains resolve on their own, but others can lead to cancer.

Identifying the presence of these high-risk strains can be an added precaution to help women catch cervical cancer in its earliest stages. “If the HPV test results are negative for high-risk strains, women don’t have to be tested again for five years, which is a relief for many women,” says Romano.

New Hope for Cervical Cancer Patients

Learn more about a recent HPV discovery at UVA.

Women 65 and Older: Screening Stops

Women 65 and older who are low risk for cervical cancer (women who have had regular, normal testing in the past) don’t need Pap smears or other screenings. Annual checkups, however, should resume. Women should also notify their doctors of any unusual symptoms, such as irregular bleeding, vaginal discharge or painful intercourse.

Eliminating Cervical Cancer Is Possible

Although there’s been great progress in reducing the number of women diagnosed with cervical cancer and survival rates have improved in recent decades, there’s still work to be done. Advances in screening, as well as the availability of the HPV vaccine, put us ever closer to eradicating cervical cancer entirely, says Romano.

We just need everyone to be proactive in educating themselves about HPV, to take steps to prevent the spread of the virus and to get screened regularly for HPV-related cancers.