Why Do I Need a Pap Smear?

So, what’s a Pap test and why would I need one? With a Pap, your healthcare provider takes a small collection of cells from your cervix to screen for precancerous cells or cervical cancer. You don’t need a Pap smear screening until age 21, even if you’ve been sexually active for years (see Why Wait).

What Your Result Means

A normal Pap result means there are no abnormal cells. An unclear result means your cervical cells could be abnormal, but it could also be the result of an infection or pregnancy. An abnormal result means that cell changes were found, which are likely caused by the human papillomavirus (HPV)—this doesn’t necessarily mean that you have cervical cancer.

There’s been a lot of chatter lately about how often you should have a Pap test. Here are some basic guidelines:

• If your first Pap smear at age 21 is normal, it’s only necessary for it to be repeated every 3 years until age 30. During ages 30-65, experts recommend a Pap plus HPV screening every 5 years. It’s also acceptable to have a Pap every 3 years, although experts prefer the Pap-plus-HPV screening.
• If it’s not normal and you’re 24 years old or younger, there’s a good chance you won’t need any other testing or biopsies—just another Pap smear in 12 months, not 3 years.
• If your result is abnormal again or if you’re over age 24, you’ll probably need more testing with a special microscope exam of your cervix and maybe a biopsy test called a colposcopy.

For women between ages 30 and 65 years, your healthcare provider will do the Pap smear and also test separately for HPV. If both tests are negative, your risk of cervical cancer and pre-cancer is very low, and it’s safe to extend your screening interval. Talk to your provider and see what they recommend for you.

Why Wait Until Age 21?

The reason for waiting until age 21 to get a Pap smear—and yes, it’s safe to wait—is because cervical cancer is rare in healthy, young women. They often get exposed to human papillomavirus (HPV), the virus that causes cervical cancer, but it typically goes away on its own. HPV can cause cancer when it remains in the cervical cells for many years.