Topic Overview

A Pap test, or Pap smear, is the most effective screening test for cervical cancer. It's often part of a pelvic exam. Regular testing can help your doctor find and treat abnormal cell changes on your cervix before they develop into cancer.

Some women also get a human papillomavirus (HPV) test at the same time as a Pap test. Even if you've already had the HPV vaccine, you still need Pap tests because the vaccine doesn't protect you from all types of HPV. Women who have had the HPV vaccine should follow the same Pap test schedule as women who have not had the HPV vaccine.

Women should start having Pap tests at age 21.^{1, 2} If you are younger than 21 and are sexually active, it's still a good idea to have regular testing for sexually transmitted infections.

These recommendations apply to women who have never had a serious abnormal Pap test result. If you don't know whether you have ever had such a result, talk to your doctor about how often you should be tested.

Women 21 to 30

Women in this age group should have Pap tests every 2 to 3 years, depending on what they and their doctors decide.^{1, 2}

Women 30 to 65

Women in this age group should be tested every 3 to 5 years. Talk with your doctor about what's right for you.

• Some experts say you should have a Pap test every 3 years if you've had 3 normal Pap tests in a row or you've had a combination HPV and Pap test with normal results.¹
• Others say you should be tested every 3 years, but you can go every 5 years if you've had a combination HPV and Pap test with normal results.^{2, 3}

Women 65 and older

Women in this age group may no longer need Pap tests. Talk with your doctor about what's right for you.

• Some experts say you no longer need Pap tests if you've had 3 normal tests in a row and have had only normal tests over the past 10 years.¹
• Others say you no longer need Pap tests if you've had 3 normal tests in a row or you've had 2 normal combination HPV and Pap tests in a row within the last 10 years, and one of those tests was within the last 5 years.^{2, 3}

Women who have had a hysterectomy

A hysterectomy is surgery in which the entire uterus is removed, usually including the cervix. Sometimes the cervix is not removed. You and your doctor can decide on the appropriate screening interval based on your medical history.

• Women without a cervix
  • You don't need Pap tests if the cervix was removed for noncancerous reasons.
  • You may have regular Pap tests if the cervix was removed for precancerous changes, but you may not need them as often if you have no other risk factors.¹
  • You should have regular Pap tests if the cervix was removed for cervical cancer.
• Women with a cervix
  • You should have regular Pap tests until age 65.

If you don't know for sure whether you still have your cervix, talk to your doctor.

Women who need more testing

After any abnormal Pap test, your doctor will recommend follow-up to monitor the cell changes.

Experts agree that some women may need to be tested more often if they:

• Were exposed to DES (diethylstilbestrol) before birth (prenatal exposure).
• Have HIV (human immunodeficiency virus).
• Have a history of abnormal Pap tests or cervical cancer.
• Have a weakened immune system.

For more information, see the topic Pap Test.