Will Pap Smears Become a Thing of the Past?

Will Pap smears become a thing of the past?  I hope so!   One of the most dreaded exams for a female is having a pelvic exam done so their clinician can collect a Pap smear specimen.  The test used to be done each year but the great news is that technology has continued to improve and this is no longer true.      

The Well Woman’s Chart states that cervical cancer screenings are recommended for all women between the ages of 21-65. This does not mean that you need the screening done every year; your age and past results determines your management plan.  These recommendations may not apply to you if you have had a hysterectomy, have HIV, are immunocompromised, were exposed to DES in utero or were treated for high grade dysplasia in the last twenty years.  Your clinician will be able to give you guidance on the timing.  Did you notice that I used the term ‘cervical cancer screening’ instead of just saying a Pap smear?  I used the word Pap smears above but I want you to learn the new wording.  


Your personal risk score

Have you seen the results of your previous test results?  If not, keep looking for it.  If you have access to your patient portal you may be able to look at the actual report.  Do you understand the results?  If you have always have had normal results and do not have the risk factors described above, then the cervical cancer screening intervals are below.

Less than 21 years of age: No screenings

Ages 21-29: Cytology only (Pap smear test) every 3 years

Ages 30-65: You have three options:

    • Cytology only (Pap smear test) every 3 years
    • High-risk Human Papilloma Virus (HPV) test only every 5 years
    • Cytology plus Human Papilloma Virus (HPV) test (co-testing) every 5 years

What if the results were abnormal at some point?  This is where the biggest changes will occur because now it is based on your personal risk score.  There are new algorithms that take your personal results over time to determine what to do next.  There are too many variations for us to discuss here but your clinician should be able to walk you through the decision making process. If they can’t do that, ask for a referral to a gynecologist who can review your specific case.


key points

  • New guidelines were issued in 2020.
  • No screenings done under the age of 21.
  • Yearly Pap smears are no longer the standard of care if your results are negative.
  • The HPV vaccine protects against the virus that causes cervical, vaginal and vulvar cancers.