What is a Pap smear?
A Pap smear is a noninvasive medical procedure in which a physician collects a small sample of cells from the cervix using a flexible plastic brush. The cells are then looked at under a microscope to detect cellular abnormalities that may be signs of cancer or may develop into cancer at a later time. Often, particularly in women over 30, the procedure is done in conjunction with an HPV test. This is because most types of cervical cancer are caused by HPV, which is the most common STD in the US. Although the body is able to effectively fight off most instances of HPV, many doctors will monitor women with these infections more closely until it has cleared up.
Why are Pap smears performed?
Pap smears were introduced as a method of identifying early stage cervical cancer, which allowed for more effective treatment. With modern technology, Pap smears are now able to identify precancerous as well as cancerous cells by looking for cellular abnormalities. This allows doctors to treat their patients early, which in turn allows for a better chance to cure patients of the illness before it gets worse. As cancer grows, it metastasizes, or spreads to other parts of the body, which makes treatment much more difficult and painful and decreases the chances that the treatment will work as intended.
When should I start getting Pap smears?
Although most medical organizations recommend that women start getting regular Pap smears at age 21, the proper age to begin these tests will vary from woman to woman depending on her own sexual activity and family medical history.
Women who are sexual active at a younger age may be at higher risk for contracting HPV depending on how many partners they have had, and their partners’ sexual histories. They therefore may be advised to begin undergoing Pap smears even before they turn 21. Additionally, women with a family history of cervical cancer may be at a higher risk for developing this cancer due to genetics, and their doctors may recommend they begin getting Pap smears at a younger age.
In women who have never been sexually active and do not have a family history of cervical cancer, some doctors may determine that they do not need to start Pap smears until they are older than 21. This is because they are the lowest-risk patients for developing cervical cancer since they will not have been exposed to HPV and likely have no genetic link to the cancer. However, the decision to defer Pap smears is left to the doctor, and many may choose to begin testing at age 21 to ensure that no precancerous markers are missed.
Your doctor will be able to determine more precisely whether you need to begin testing before age 21, if you should begin at that age, or if you can wait until you are older.
How often should I get Pap smears?
Depending on a woman’s age and family medical history, the recommended time between Pap smears may vary slightly. However, most guidelines recommend that women between ages 21 and 29 get a Pap smear every two to three years, and those between ages 30 and 65 recommend that the test be performed every three to five years. In younger women who are sexually active or who have a family history of cervical cancer, a doctor may recommend that she begin Pap smears earlier, as these women may be at higher risk for developing cervical cancer.
When can I stop getting Pap smears?
Over the age of 65, the risk of getting cervical cancer decreases, so women generally do not need to undergo regular Pap smears once they reach this age. This is particularly true if a woman has gotten regular Pap smears in the past without any signs of irregularities. In general, if a woman aged 65 or older has had three negative, or noncancerous, Pap smear results, her doctor will not recommend that she continue getting Pap smears. If, however, she has had abnormalities, her doctor may recommend that she continue getting Pap smears until she has about a 10-year window of normal Pap results.
Women who have undergone a total hysterectomy, a procedure in which her entire uterus including her cervix has been removed, will no longer require Pap smears after the procedure, if the procedure was done to combat noncancerous conditions. If, however, the procedure resulted from an instance of cervical cancer or precancerous cells, many doctors will recommend that the woman continue getting routine Pap smears to monitor for any future abnormalities, as the woman may be at higher risk for redeveloping cancer in the area.