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What to Know About Cervical Cancer Screenings

While cervical cancer screening guidelines advise that women need less frequent Pap smears, you still need annual pelvic exams.

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Updated August 22, 2022

By Rachel Kramer, MD, Obstetrician and Gynecologist—Virtua Ob/Gyn

Ladies, don’t be confused. While annual Pap smears (the test that screens for cervical cancer) may no longer be advised if you have normal test results, you still need an annual pelvic exam.

The Pap smear is only a part of the pelvic exam. During your annual gynecological exam, your doctor also checks for skin cancer, uterine masses, pelvic floor issues, sexually transmitted infections, cervical polyps, breast cancer, and more.

Your annual GYN exam also is a great opportunity to identify and treat conditions early, and talk with your doctor about concerns and health changes. For example, if you’re planning to get pregnant or nearing menopause, your doctor can help you prepare and answer your questions. 

Why is cervical cancer screening important?

Pap smears detect the presence of pre-cancerous cells on the cervix, so the condition can be treated before it has a chance to develop into cervical cancer.

Human papillomaviruses (HPVs) are spread by sexual contact and are so common that nearly everyone has one type of the virus. While there are more than 150 related HPVs, only 14 types cause cancer—two of which are responsible for 90 percent of cervical cancer cases.

What are the cervical cancer screening guidelines?

The United States Preventive Services Task Force (USPTF) recommends the following: 

  • A woman should get her first Pap smear at age 21 and continue screening every three years.
  • After age 30, a woman should get a Pap smear every five years.
  • Women age 65 and older who’ve had three normal consecutive Pap smears never need to be tested again. Although, if they're sexually active and change partners, they may want to be tested for other types of STDs.

While these are the general guidelines, there are exceptions. If you have a history of abnormal Pap smears or have been diagnosed with a condition that weakens the immune system, like HIV, you may need to be screened more often. Also, if you're over 65 and have had high levels of cervical abnormality, you may need to continue regular screenings. 

Why are we screening less often for cervical cancer?

For a condition that’s so widespread, it may seem counterintuitive to be screened less often. But, the screening guidelines are based on years of scientific research.

Here’s what we know about cervical cancer screening:

  • The Pap smear is more accurate than ever before.
  • HPVs that cause cancer are slow growing.
  • The body’s immune system can fight off HPVs.
  • More frequent screening can lead to unnecessary treatments.
  • HPV treatments such as cone biopsies or surgical removal can cause complications during pregnancy.

If you have questions or concerns about cervical cancer screening, call your women's health care provider.

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