When you see your gynecologist for your annual exam this year, you may be surprised to learn that you don’t need a Pap smear. New guidelines from the American College of Obstetricians and Gynecologists (ACOG) say that most women don’t need cervical cancer screening more often than once every 3 to 5 years. The new guidelines are published in the November issue of Obstetrics & Gynecology.
“The evidence clearly shows that less frequent cervical cancer screening is warranted,” says David Chelmow, MD, chair of obstetrics and gynecology at Virginia Commonwealth University School of Medicine in Richmond, who helped develop the new guidelines.
Under the new guidelines — previously updated in 2009 — women age 30 to 65 who have had three normal Pap tests for three years in a row should have a Pap test combined with human papillomavirus (HPV) testing every 5 years. If HPV testing is not available, women can get a Pap test by itself, every 3 years. ACOG advises that women younger than 21 do not need screening for cervical cancer or HPV, whether they are sexually active or not.
Women age 30 to 65 who have had three normal Pap tests for three years in a row should have a Pap test combined with human papillomavirus (HPV) testing every 5 years.
“We know that HPV infections are very common but most are transient and don’t progress to cervical cancer,” says Dr. Chelmow. Only a fraction of women with chronic HPV infection will have cervical abnormalities that cause cancer. In addition, even if cells are precancerous, it takes years for them to convert into invasive cancer, according to ACOG.
“With co-testing (both Pap smear and HPV testing), screening every five years provides an excellent balance between achieving extremely low cancer rates while avoiding the potential harms of unnecessary interventions,” says Dr. Chelmow.
Before you reach for the phone and cancel that appointment, remember that annual wellness exams are still necessary because they include a clinical breast exam, pelvic exam and counsel on any other gynecologic problems you’re having.
The guidelines also suggest that women age 21 – 29 years get screened for cervical cancer every 3 years rather than every 2 years. Women older than 65 years no longer need screening if they meet certain qualifications.
Always talk with your doctor, because some women will need more frequent screening.