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Signature OB/GYN

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How often do I need a Pap smear?

Q-and-A with Margot Watson, M.D., Signature OB/GYN

A Pap smear is used to screen women for cervical cancer. Years ago, women had a Pap smear at each annual visit, but today Pap smears have improved and we know cervical cancer takes many years to develop. Women should start Pap smear screening at age 21. Between the ages of 21-29, women whose Pap smears are normal only need it repeated every three years. Women ages 30 and over should have testing for the human papillomavirus (HPV) with their Pap smear.  HPV is the cause of cervical cancer. Women under age 30 are not tested for the virus because 80 percent of sexually active women will have this virus. Most women clear it once they are in their 30s. Once we confirm that the virus is not present, that patient can extend the duration between her Pap smears even further, to every five years (though she should still have an annual gynecological exam). In the event that we do detect precancerous cells on a woman’s cervix, or if she tests positive for HPV, she will need more frequent testing.

We strongly recommend that both girls and boys be vaccinated against HPV at age 12. We can make cervical cancer much less common in just one generation!

Pap smears typically continue throughout a woman’s life, until she reaches the age of 65, unless she has had a hysterectomy. If so, she no longer needs Pap smears unless it is done to test for cervical or endometrial cancer). At that point, if a patient has had two normal Pap smears in the past 10 years and she has not had any seriously precancerous cells in the past 20 years, she can stop screening altogether.

Signature OB/GYN follows these standards, as recommended by the American College of Obstetricians and Gynecologists. We ensure that our patients are undergoing all of the tests they should have, but we also want to make sure patients are not undergoing tests that aren’t necessary. We educate our patients and encourage them to ask us questions, so that they are clear on what tests they should have done, at what age, and  why.