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PAP Smear

Who Should Have A Pap Smear?

Last modified: 
23/04/2012 - 13:11

Contributing Author: Guy Slowik FRCS

Experts estimate that 35,000,000 women in the United States should have regular Pap smears. About one-third of all women who should have regular Pap smears do not.

A girl or woman should have a Pap smear if she:

  • has reached the age of 18
  • is sexually active
  • has been sexually active

A girl or woman should have regular Pap smears even if she has no cancer symptoms. (If she has cancer symptoms, the doctor will perform diagnostic tests to confirm or rule out the diagnosis of cancer.)

The American Cancer Society recommends that a girl or woman have her first Pap smear when she reaches the age of 18 or becomes sexually active. Because cervical cancer progresses slowly, some doctors think that a girl or woman doesn't need to have a Pap smear every year if

  • she's reached the age of 65
  • she's had normal test results for 3 years in a row

Does A Woman Need A Pap Smear After She's Had A Hysterectomy?

  • A woman who has had a hysterectomy should ask her gynecologist or family doctor whether she should continue having regular Pap smears.
  • If a woman had a hysterectomy because she had cancer or a precancerous condition of the cervix, her doctor may advise her to have a Pap smear at least once a year.
  • If a woman who has had a hysterectomy did not have cancer or a precancerous condition of the cervix, her doctor may want to perform regular Pap smears to detect possible precancerous changes in the vaginal wall.
  • Some physicians doubt whether a woman who has had a hysterectomy benefits from having a Pap smear.

Should Older Women Have Pap Smears?

Instances of cervical abnormalities are increasing most rapidly among older women, and 25 percent of all cervical cancers occur in women over the age of 65.

Some doctors doubt that having a Pap smear benefits an older woman who has a history of normal test results. Others argue that older women experience body changes that make it difficult to obtain adequate cervical cell samples and therefore regular Pap smears should be mandatory for post-menopausal women.

A woman who is not sure whether she should continue having regular Pap smears should discuss her concerns with her gynecologist or family physician.

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From Andrew Maynard - Chair of the University of Michigan Department of Environmental Health Sciences, with help from David Faulkner - 2013 Master of Public Health graduate.