How Often Should You Get a Pap Test?

Regular screenings are and always have been one of the most important things women can do to preserve their health. Unfortunately, COVID caused many women to delay the scheduling of routine screenings and now many have gone one, two or even three years without essential screenings, including Pap tests. While the recommended timing for Pap tests recently changed, it shouldn’t be considered a reason to further delay this essential and life-saving screening.

If you are not up to date you on screenings, contact your provider to schedule an appointment. While you’re there, your provider can help you plan for future screenings based upon your age and health history. You may be happy to learn that annual Pap tests may no longer be needed. Here’s why:

Thanks to recent discoveries about how cervical cancer develops over time and a new screening test for the human papillomavirus (HPV), the time between the formerly annual Pap test may now be as much as three to five years.

In combination, these two tests offer valuable insight into a woman’s risk of developing cervical cancer and an in-the-moment look at the health of her cervix.

Specifically, a Pap test looks for abnormal cells that may develop into cancer over time while the HPV test screens for strains of HPV that are most likely to cause pre-cancers and cancers of the cervix in the future. Tests may be performed alone or together.

The current cervical screening recommendations from the American College for Obstetrics and Gynecology is as follows:

• Women ages 21 to 29 should have a Pap test alone every 3 years. HPV testing alone can be considered for women who are 25 to 29, but Pap tests are preferred.
• Women ages 30 to 65 have three options for testing. They can have both a Pap test and an HPV test every 5 years. They can have a Pap test alone every 3 years. Or they can have HPV testing alone every 5 years.
• After age 65, you can stop having cervical cancer screenings if you have never had abnormal cervical cells or cervical cancer, and you’ve had two or three negative screening tests in a row, depending on the type of test.

More frequent screenings may be recommended if you:

• have a history of cervical cancer
• are HIV positive
• have a weakened immune system
• were exposed before birth to diethylstilbestrol (DES), a hormone given to pregnant women between 1940 and 1971

While you may not need a Pap test every year, every woman should have an annual pelvic exam. Unlike the Pap, which focuses on the cervix, a pelvic exam looks for issues related to your uterus and ovaries, other types of cancer, infections, and sexually transmitted diseases. If you’ve had a hysterectomy, speak to your doctor about how often you should have a pelvic exam.

If you have questions about which screenings are right for you and when, contact your doctor.

Kimberley Sampson, MD, is the chair of the Department of OB/GYN at Southwestern Vermont Medical Center, part of Southwestern Vermont Health Care, in Bennington.