A Pap smear checks cells from your cervix for changes that could turn into cervical cancer. Screening starts at 21: a Pap test every 3 years until 29, then an HPV test or a Pap plus HPV test every 5 years from 30 to 65. Many people over 65, or after certain hysterectomies, can stop.
A Pap test looks for abnormal cells on the cervix, the opening of the uterus at the upper end of the vagina. Finding cell changes early means they can be watched or treated before they become cancer.
There are three ways to screen, all using cells from the cervix (ACOG):
| Age | What ACOG recommends |
|---|---|
| Under 21 | No screening. Cervical cancer is very rare in teens, and HPV usually clears within 1 to 2 years. |
| 21 to 29 | Pap test every 3 years. |
| 30 to 65 | HPV test every 5 years, or co-test every 5 years. |
| Over 65 | You may stop if you meet the conditions below. |
The US Preventive Services Task Force (USPSTF) recommendation from 2018 is similar, and also lists a Pap test alone every 3 years as an option from 30 to 65. USPSTF says that topic is being updated.
You may need screening more often if you have a history of cervical cancer, HIV, a weakened immune system, or a mother who took a drug called DES during pregnancy (ACOG).
Even if you don't need a Pap test every year, ACOG says regular well-woman visits still matter for birth control, menopause questions, vaccines and breast and pelvic exams.
You lie on an exam table with your feet in footrests. Your clinician gently places a speculum in the vagina to see the cervix. MedlinePlus notes this may cause a feeling of cramping or pressure. A small, soft brush or swab then collects cells from the cervix, which usually doesn't hurt. The test takes only a few minutes, and the sample goes to a lab.
Tell your clinician if you are nervous, have pain with exams, or have had a hard experience before, so the exam can go at your pace.
ACOG suggests avoiding these for 2 days before your test, because they can hide abnormal cells or cause false results:
A test can be done during your period, but ACOG suggests scheduling it for another time if you can.
Self-collection lets you collect your own vaginal sample with a swab instead of having a speculum exam for the HPV test. ACOG says self-collection kits are approved for women aged 25 to 65. A USPSTF draft recommendation also says that from 30 to 65, HPV testing every 5 years, collected by yourself or by a clinician, gives a good balance of benefits and harms. If the HPV test is positive, you would need follow-up testing with a clinician.
An abnormal result is common and does not mean you have cancer (ACOG). Cell changes often go back to normal on their own, and even high-grade changes usually take several years to become cancer.
Next steps depend on your age and the type of result. You may only need a repeat test. If changes are confirmed, you may need a colposcopy, a closer look at the cervix, or a biopsy. High-grade changes may need treatment to remove the abnormal cells (ACOG).
After a hysterectomy: If your cervix was removed for a reason that was not cancer, and you have no history of high-grade cell changes, you may be able to stop. You still need screening if your cervix was not removed, or if you have had high-grade changes or cancer (ACOG, MedlinePlus).
After 65: ACOG says you can stop if you have no history of moderate or severe abnormal cells or cervical cancer, have had regular screening, and over the past 10 years have had three negative Pap tests, two negative HPV tests, or two negative co-tests in a row.
After the HPV vaccine: Keep screening on schedule. The vaccine protects against the most common cancer-causing HPV types, but not all of them (ACOG).
Does a Pap smear test for HPV? A Pap test alone looks for abnormal cells. An HPV test is a separate test, though it can use the same sample. A co-test does both.
How long do Pap smear results take? It varies by lab. Ask your clinic how and when you will get your results, and call if you haven't heard back.
Can I get a Pap smear if I haven't had sex? Screening starts at 21 either way. ACOG notes that HPV can rarely spread through genital contact without vaginal sex, and smoking and HIV also affect risk.
I'm in menopause. Do I still need Pap smears? Yes, until you meet the criteria to stop after 65. Menopause alone is not a reason to stop.
Is a pelvic exam the same as a Pap smear? No. A pelvic exam checks the uterus, ovaries and genital area. A Pap smear collects cells from the cervix. They are often done at the same visit, but not always (MedlinePlus).
Due for a Pap smear or well-woman exam? Pap smears are done in person at our San Antonio clinic. Book a visit or call (210) 903-1030. In-clinic in San Antonio • Telehealth for women located in Texas (for visits that don't need an exam) Yaso Wellness Health Clinic, 1907 Goliad Rd, San Antonio, TX 78223
Education only, not medical advice. In an emergency, call 911.
Leticia Vargas, MD, OB/GYN, sees patients at Yaso Wellness Health Clinic in San Antonio. About Dr. Vargas
Education only, not medical advice or a diagnosis. In an emergency, call 911.
