Pap Smear Confusion? Understanding the New Guidelines for OBGYN Screening

Cedric A. Walls, MD, is board certified in obstetrics and gynecology and has a special interest in providing compassionate, comprehensive women’s health care for all stages of life.

As doctors and scientists learn more about women’s health, the American Congress of Obstetricians and Gynecologists (ACOG) has updated its guidelines about when and how to screen patients for cervical cancer. While it’s great that the guidelines are updated to reflect the latest research, all those changes can be confusing for patients.

Here’s what you need to know about when to see your OBGYN, and what you can expect from each visit:

Cervical Cancer Screenings

An important part of the OBGYN visit is to screen for cervical cancer and sexually transmitted diseases (STDs). We do that two ways:

• Pap smears, which examine cells collected from the cervix to look for signs of infection, cancer or precancerous changes
• Tests for human papillomavirus (HPV), a virus that can be transmitted through sexual contact and can cause cancers, including cervical cancer

We used to recommend getting Pap smears every year — a recommendation that helped the rate of cervical cancer in the U.S. drop significantly over the last few decades. But we now know that cervical cancer takes many years to develop, so less frequent screenings can still identify the disease early. As a result, we no longer recommend annual Pap smears for most women.

Instead, the current ACOG guidelines recommend cervical screenings based on age:

• Age 21-24: You should have your first Pap smear at age 21 and have it repeated every 3 years. Because cervical cancer rarely, if ever, occurs in young women, we don’t recommend they have HPV testing or procedures such as colposcopy (a procedure to view the cervix and uterus) and LEEP (a procedure to remove abnormal cells).
• Age 24-30: Women in this age group should have the same testing done as women in their early 20s. However, we may use colposcopy and LEEP procedures in women in this age range.
• Age 30-65: Women in this age group should have a Pap smear plus an HPV test every 3 years.
• Age 65 and up: Women in this age group who have no history of abnormal cervical cells and no recent positive Pap smear results can stop having cervical cancer screenings.

Annual Visits for Whole-Body Health

Just because you don’t need a Pap smear every year doesn’t mean you shouldn’t plan to visit your OBGYN annually. After all, there’s a whole lot more to women’s health than cervical cancer screenings.

I recommend annual appointments with your OBGYN to cover topics such as:

• Breast exams and breast health
• Diet and exercise recommendations
• Bone health and osteoporosis
• Colon health
• Fertility and family planning
• Conception and pregnancy
• Birth control

It’s important to me to see my patients regularly to build a relationship with them and help them manage their health from head to toe.

If you’re due (or overdue) for an annual office visit, Inova Obstetrics & Gynecology can provide both routine check-ups and the most advanced specialty care.