How Often Should Women Take The Pap Smear Test?
What is a pap smear test?
The Pap smear screening test is done to check for precancers and any cell changes on the cervix surface that might become cancerous if not treated timely. The pap smear test is done to help the doctor examine your vagina using a plastic or metal instrument named speculum to collect some samples of cells and mucus from the cervix and the area around it. The test results of pap screening mainly confirms whether the shape of the cells is normal. The pap smear test is different from an annual gynaecological exam which involves a pelvic exam to check for any abnormalities in vagina, vulva, cervix, ovaries, uterus, rectum and pelvis.
Let’s jump straight into some lingering questions you may have such as: who should get a pap smear test? what can go wrong with a pap smear? can you get a pap smear on period? and what are the latest pap and HPV guidelines?
What’s the best age to get screened?
- For ages under 21: The United States Preventive Services Taskforce (USPSTF) suggests that there is no screening required for women under age 21, as the risk of cervical cancer associated in this age group is too small to justify.
- For ages 21-29: Getting tested as early as 21 is considered good. If the test results look normal then your doctor may schedule the next test after 3 years.
Who should get a pap smear?
- For ages 30-64: In this age group a pap smear is recommended every 3 years or a combination of a pap and HPV test every 5 years. Similar to the 21-29 years age group, screening every 3 years is sufficient according to USPSTP. The reason for a combinative test is given the fact that HPV infection is the prime cause of causing cervical cancer in women. Hence, testing for HPV and its type (whether high risk or low risk) along with a pap smear test could give the doctor a better chance to start developing an appropriate treatment strategy.
Read more on the HPV and risks in “Women and HPV (Human papilloma virus): 5 things to know!”
- For ages 65 and above: This age group can actually skip the screening altogether, given your previous screening history showed normal results for many years and if you’ve had the cervix removed as part of hysterectomy for conditions other than cancer such as fibroids. However, annual check-ups should resume and women should notify their doctors of any unusual symptoms such as vaginal discharge, irregular bleeding or painful intercourse.
Why do they only do the pap smear every 3 years?
Reports suggest that the time taken between the appearance of precancerous lesion and the development of cervical cancer is generally slow. Moreover, some abnormal cellular changes in the women cervix get resolved on their own, thanks to our immune system.
This shift from getting screened every single year to every 3 years is a relief to many, and establishes the fact that it may not be necessary for a majority of women to get tested annually. Getting screened every year may increase the likelihood of unnecessary follow-up procedures, for instance biopsies and higher chances of a false positive and false negative test results.
Can you get a pap smear on your period?
During periods, technically, the pap smear test can be taken normally. However, if possible, it can be rescheduled as the test results might be influenced by the flow. A lighter flow is considered normal. Always consult a doctor to decide what’s right for you when you’re on periods.
5 reasons to not skip a pap test
Since it helps you detect cervical cancer, the pap smear test is far too important to skip. It’s understood that you may be busy and given the current pandemic situation, you must be thinking of waiting until the situation returns to normal. But no, your screening cannot wait!
Read the following 5 reasons to know why you should never skip your upcoming pap screening.
1. It helps prevent cervical cancer
Reports suggest that pap tests and other regular screenings have dramatically reduced the incidences of cervical cancer. Moreover, the pap test remains the most effective screening tool to find out early on if you have cervical cancer. Cervical cancer if diagnosed early is highly treatable.
2. Cervical Cancer is the 4th most common cancer in women globally
Being one of the most prevalent cancer types in women, it is very important to diagnose it early and start a treatment strategy to remove it before it gets too late.
3. Most sexually active humans have HPV and many don’t even know it
As discussed earlier, HPV infection is the prime cause of cervical cancer. Its prevalence in men and women keeps increasing and reports suggest that almost 70% have been infected with the HPV at least once in their lifetimes.
But since most are unaware, only a regular pap smear test can help diagnose the presence of HPV. On a side note, since the discovery of HPV vaccine in 2006, the number of cervical cancer incidence have been decreasing at a good rate.
Read more on the HPV vaccines in “Women and HPV: 5 Things To Know.”
4. Good to discuss other health issues
Your pap test is a good time to discuss any other health issues with your doctor to improve the overall health and find out possible solutions.
5. Early detection and better survival
The pap smears help detect cervical cancers at a very early stage when it’s most treatable. Studies indicate that if found early, the 5-year survival rate of cervical cancer is almost 92 %1,7.
- Cohen, P. A., Jhingran, A., Oaknin, A., & Denny, L. (2019). Cervical cancer. The Lancet, 393(10167), 169-182.
- Perkins, R. B., Guido, R. S., Castle, P. E., Chelmow, D., Einstein, M. H., Garcia, F., ... & Schiffman, M. (2020). 2019 ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors. Journal of lower genital tract disease, 24(2), 102.
- Melnikow, J., Henderson, J. T., Burda, B. U., Senger, C. A., Durbin, S., & Soulsby, M. A. (2018). Screening for cervical cancer with high-risk human papillomavirus testing: a systematic evidence review for the US Preventive Services Task Force.
- Arbyn, M., Weiderpass, E., Bruni, L., de Sanjosé, S., Saraiya, M., Ferlay, J., & Bray, F. (2020). Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. The Lancet Global Health, 8(2), e191-e203.
- Petry, K. U. (2014). HPV and cervical cancer. Scandinavian Journal of Clinical and Laboratory Investigation, 74(sup244), 59-62.
- Wang, R., Pan, W., Jin, L., Huang, W., Li, Y., Wu, D., ... & Liao, S. (2020). Human papillomavirus vaccine against cervical cancer: Opportunity and challenge. Cancer letters, 471, 88-102.
- Ruhl JL, Callaghan C, Hurlbut, A, Ries LAG, Adamo P, Dickie L, Schussler N (eds.) Summary Stage 2018: Codes and Coding Instructions, National Cancer Institute, Bethesda, MD, 2018.