Women don't need their first cervical cancer screening -- or Pap test -- until they're 21 years old. And they don't need follow-up exams as often as previously thought, according to current guidelines from the American College of Obstetricians and Gynecologists (ACOG).
Women younger than 30, with normal Pap results should be screened every three years, instead of yearly. Women 30 or older with previously normal Pap results should get a Pap test once every three years, or every five years if co-testing with a human papillomavirus (HPSV) test until age 65, or until they undergo a total hysterectomy (uterus and cervix removed).
ACOG's review of the research points out that screening less frequently prevents cervical cancer just as well, reduces health care costs and prevents unnecessary treatments.
"Younger women who have been exposed to the human papillomavirus (HPV) are more likely to have abnormal Pap smears," said Katherine Patterson, M.D., Marshfield Clinic Wausau Center Family Medicine. "Research has shown that in 80 percent of those cases, an abnormality from HPV exposure will revert to normal without the need for additional screening or treatment."
In younger women, excessive screening and overaggressive treatments have been associated with risks of preterm birth and infertility. "A longer interval between Pap tests may give a woman's body time to convert abnormal cervical cells to normal," Dr. Patterson said.
Women should still see their doctor annually for breast exams, to review other medical concerns and, if appropriate, to check for other types of gynecological cancers, sexually transmitted infections (STIs) and fertility concerns.
HPV is responsible for 70 percent or more of cervical cancers.
The HPV test, sometimes done with the Pap smears, has provided an additional tool to identify women who may be at increased risk for cervical cancer.
"With more and more women being vaccinated for HPV, recommendations for Pap tests may change," Dr. Patterson said. "It's important for women to establish care with a personal provider and follow their provider's recommendations for reproductive health screenings and preventive care."