Pap tests are the foremost weapon against cervical and certain other gynecological cancers, and has been able to transform survival rates from these cancers. So that women can obtain maximum benefit of these tests, pap smear guidelines are issued by a number of associations such as The American Congress of Obstetricians and Gynecologists (ACOG), The American Cancer Society (ACS) as well as The U.S. Preventive Services Task Force (USPSTF).
Though there are small differences in guidelines that each association has issued, the guiding principles are essentially the same. We look at the ACOG pap smear guidelines that are most often quoted and followed for effective early detection of cancer and precancerous changes of the reproductive tract.
First pap test
It is recommended that a woman should undergo her first pap smear at age 21. Earlier guidelines suggested that a woman should undergo her first test for cervical cancer screening about 3 years after first having sexual intercourse.
The new approach is more conservative and bases itself on the fact that adolescents have very low cervical cancer risk and cell abnormalities that females of this age group have will usually resolve on their own. However females ought not to wait until 21 to have their first consultation with a gynecologist.
Pap smear guidelines between 21 and 30 years of age
Women between the age of 21 and 30 should undergo pap smears every 2 years. Either the liquid based cytology or standard pap tests can be used.
Guidelines between 30 and 65 years
Women over the age of 30 should undergo pap tests every 3 years if they are seen to have no history of cervical cancer and has had three or more normal pap tests in a row. Though pap tests may be needed only every three years, the pap smear guidelines still advise women to undergo their annual pelvic exam.
When to stop pap testing
Women who have had normal pap smear results for years can consider stopping testing altogether after the age of 65 or 70. Also women who have had a total hysterectomy (removal of the uterus as well as the cervix) need not undergo pap tests unless the reasons for the hysterectomy was cancer, in which case the woman should continue being tested even afterwards.
When to undergo more frequent testing than recommended by the pap smear guidelines
Certain women who are perceived to have a higher risk of the cancer should undergo testing more frequently than once in two years (between 21 and 30 years of age) and once in three years (from 30 to 65 years). A family or personal history of the cancer, or abnormalities being detected in previous pap tests are factors that could require more frequent testing.
The ACOG pap smear guidelines also recommend that women with weakened immune systems, should have more frequent testing: having HIV, or undergoing chemotherapy will compromise the immune system and make a woman more prone to disease. Also women who were exposed to diethylstilbestrol (DES) before birth should have their tests more frequently.