Preventing Cervical Cancer: Why Pap Test Rules Have Changed

When some women see their health care providers for the next annual checkup, they may learn that the timing of certain procedures have changed. 

The guidelines for Pap smears and HPV screenings have been modified in recent years. If women are not sure how this will impact them specifically, they should check with their doctor’s office when they schedule their next full visit, just to be prepared. 

Each year, more than 13,000 women have been diagnosed with cervical cancer in the United States and 4,000 women die of the disease. Cervical cancer affects the cervix, which is the narrow opening to the uterus. It is caused by some types of HPV, or human papillomavirus, which is a common, sexually transmitted infection. If detected early, this type of cancer is highly treatable. 

How it’s detected. There are two screening tests commonly used to detect early cases of cervical cancer, or to help prevent them. For both tests, a doctor will collect mucus and cells from the cervix, and those are examined in the laboratory.  

  • The Pap smear (or pap test) can detect precancerous conditions, or cellular changes on a woman’s cervix that might become cervical cancer if left unrelated. 
  • The HPV test can detect the virus that causes these cellular changes. 

When these screenings are done. In 2018, a U.S. health care prevention task force announced new guidelines for cervical cancer screenings. According to the Centers for Disease Control and Prevention, women should be following this screening schedule: 

Women ages 21 to 29: If your Pap test is normal, a doctor may say you can wait years until your next screening. 

Women ages 30 to 65: Women in this age range have three options: 

  • A Pap test only: If the result is normal, a doctor may say you can wait three years until your next test. 
  • An HPV test only: This is known as primary HPV testing. If the result is normal, a doctor may say you can wait five years until your next test.  
  • An HPV and Pap test: Called co-testing, this method combines both screenings. If the result is normal, a doctor may say you can wait five years until your next test.  

Women older than 65: A doctor may say you do not need these screenings if you have had normal test results for several years.  

Why these guidelines were updated. The most recent guidelines replaced those issued in 2012. The major change in the current guidelines is the recommendation for screening every five years if doing the HPV test alone for women ages 30 to 65, as an alternative to screening every three years, if just getting a Pap test. The updates were made after health officials reviewed evidence in the different screening methods and testing timelines and determined this new schedule would offer the best chance at preventing cervical cancer, according to the National Cervical Cancer Coalition 

Tips to prepare for a Pap or HPV test. When you schedule a doctor’s appointment that will include one of these screenings, make sure it will not be during an expected period. The CDC also offers these tips if you are within two days of your appointment: 

  • No tampon use 
  • No douching 
  • No sexual intercourse 
  • No use of birth control foam, cream or jellNo use of medicine or cream in your vagina 


Photo credit: Getty

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