How often do I really need to get a Pap smear?

It's safe to say that most of us don't exactly look forward to getting a Pap smear. Despite the discomfort they cause, they’re still extremely important: they screen for cervical cancer, which is the fourth most common cancer in women worldwide. That means knowing when—and why—to get a Pap smear is crucial information. Read our Q&A with Maven Nurse Practitioner Rebecca Callahan to get the 411 on Pap smears.

What is a Pap smear?

A Pap smear is a procedure to test for cervical cancer. It involves collecting cells from the cervix with a small soft brush. The test only lasts a few minutes, and may be mildly uncomfortable but should never hurt. During a Pap smear, it’s important to breathe and try to stay relaxed to feel more comfortable. 

Here are some tips to make your next Pap smear easier: 

• Talk to your provider about any anxiety or fear you have—being open about how you’re feeling will help them best administer the exam. Ask them to walk you through exactly what will happen and tell you what they’re doing during the process. 
• If you’re feeling discomfort, ask if you can use a smaller speculum or if you can insert the speculum yourself. 
• Try a different position—some people feel less discomfort with Pap smears if they are lying on their side or on their back. 
• Avoid getting a Pap smear on your period, when you may experience additional pain and sensitivity.  

Do I need to get a Pap smear every year? 

No—the official recommendation used to be that you should have a Pap smear annually, but the guidance was updated in 2012. It’s now recommended that you get a Pap smear once every three to five years. If you’re between the ages of 21-29, you should have one every three years. If you’re over 30 and low-risk, you can extend the interval to every five years. And if you’re under 21, you don’t need a Pap smear, even if you’re sexually active. 

Spreading out Pap smears allows providers to cut down on invasive follow-up tests, since testing more often increases the chances of spotting lesions that might clear up without medical intervention. Low-level abnormalities typically clear up on their own over time, making frequent follow-up tests unnecessary. That being said, if your provider recommends a colposcopy or other procedure after an abnormal Pap smear, it’s important to follow up. 

What if I’m considered high-risk? 

If you have particular concerns or a history of abnormal Pap smears, your provider may recommend you get them more frequently. Talk to your provider to figure out a plan that makes sense for you. Certain risk factors may lead your doctor to recommend more frequent Pap smears at any age, including: 

• A diagnosis of cervical cancer 
• Exposure to diethylstilbestrol (DES) before birth
• HIV infection 
• A history of smoking
• A Pap smear found precancerous cells 
• A compromised immune system

Do I still need an annual gynecological check-up? 

Yes—a typical check-up includes a pelvic exam where your provider will examine external genitalia for rash or infection, check your cervix and vaginal walls for problems, and feel for any abnormalities in your reproductive organs. Even if you’re not due for a Pap smear, these other elements of a pelvic exam are important for ensuring you’re in good health. 

Does a Pap smear also include an HPV test? 

If you’re between the ages of 30 and 64, your Pap smear will include a co-test to screen for high-risk forms of HPV. That’s because certain strains of HPV cause 90% of cervical cancer cases, according to the CDC. If you’re under 30, however, you won’t get checked for HPV, since your body can usually clear it within a year or two on its own without any type of treatment or intervention. 

The addition of the HPV co-test is one of the reasons that the recommended time between tests was extended—it allows healthcare providers to more accurately determine a patient’s risk for cervical cancer, making yearly testing less necessary for low-risk patients. Wider rates of HPV vaccination has also made cervical cancer-causing HPVs increasingly rare. 

Should I be worried about cervical cancer? 

Though it used to be one of the leading causes of death among women in the U.S., cervical cancer is now one of the most preventable types of cancer. That said, cervical cancer symptoms are hard to notice, so the best way to protect yourself is to get a regular Pap smear. This allows your provider to spot any abnormal cell changes and treat them before they become cancerous. 

What about other testing? 

Even if you don’t get a Pap smear at every yearly check-up, it doesn’t mean you won’t need other testing done. Swabs for STDs or yeast infections may require a procedure that’s similar to a Pap smear. It’s important to realize that these tests aren’t the same though—Pap smears screen specifically for cervical cancer, and won’t give you results regarding STDs or other conditions, with the exception of the HPV co-test. 

If you have more questions before or after your Pap smear, Maven has on-demand providers who can help. Sign up for Maven today to talk to a Maven Nurse Practitioner or Maven OB-GYN.