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For years, the guidelines from the US Preventive Services Task Force stopped recommending an annual pap smear, and yet, some women are still surprised to hear from their gynecologists that they can now skip a few years. For most, cervical cancer screenings are needed only every three to five years, and a pap smear is no longer the sole method.
How is cervical cancer screening carried out?
The purpose of that awkward moment at your gynecologist appointment, where you're placed in stirrups, is to check for signs of cervical cancer. The majority of cervical cancer cases are linked to a prolonged HPV infection. Don't worry—many sexually active individuals have been exposed to HPV at some point without even realizing it. In most cases, the immune system clears the infection, but occasionally, the virus can persist for years, leading to abnormal cell growth in the cervix, which may result in cancer. Although there’s no cure for HPV, regular screenings can catch most cancers before they develop into a serious issue.
During a pap smear, your gynecologist will collect cells from your cervix and send them to a lab, where a technician will smear them onto a slide and examine them under a microscope. This examination looks for clues, such as unusual shapes, that could indicate potential cancerous changes. This procedure is also known as cervical cytology or a Papanicolaou test.
A newer test, known as hrHPV testing, looks for the presence of the HPV virus itself on the swab. This test specifically targets high-risk strains of HPV, while some versions of the virus are generally harmless. The hrHPV test was added as an option for routine screenings in 2012, the same year it was confirmed that screening could be done every three to five years instead of annually.
The latest guidelines from the US Preventive Services Task Force state the following:
Individuals under 21 do not need cervical cancer screenings at all.
From ages 21 to 29, a "cervical cytology" test, also known as a pap smear, is recommended. Your healthcare provider collects cells from your cervix and sends them to a lab for examination to detect any signs of cancer or pre-cancer. This test should be performed every three years.
For those aged 30 to 64, screening every five years is an option if your healthcare provider sends your cervical sample for HPV testing instead of, or in addition to, the traditional pap smear.
If you're 65 or older, and you have no history of cervical cancer or high-grade lesions, no further tests are required.
Are pap smears becoming outdated?
Some news articles suggest that pap smears may be fading out (especially for those over 30), but that doesn’t mean what you might think.
Whether you opt for a pap smear, an HPV test, or both, the experience in the exam room remains the same: you'll position yourself with your legs apart, and your provider will use a speculum to gently open your vagina. Then, they will use a tool, typically a brush or a small plastic spatula, to collect a sample from your cervix.
The previous guidelines from 2012 mandated that testing every five years include both cytology and an HPV test. The 2018 update is a minor change: healthcare providers now have the option to order just the HPV test. However, this doesn’t mean the pap smear process is disappearing—the main difference lies in what happens to the swab afterward.
