Why it's done

A Pap smear is used to screen for cervical cancer.

The Pap smear is usually done in conjunction with a pelvic exam. In women older than age 30, the Pap test may be combined with a test for human papillomavirus (HPV) — a common sexually transmitted infection that can cause cervical cancer. In some cases, the HPV test may be done instead of a Pap smear.

Who should have a Pap smear?

You and your doctor can decide when it's time for you to begin Pap testing and how often you should have the test.

In general, doctors recommend beginning Pap testing at age 21.

How often should a Pap smear be repeated?

Doctors generally recommend repeating Pap testing every three years for women ages 21 to 65.

Women age 30 and older can consider Pap testing every five years if the procedure is combined with testing for HPV. Or they might consider HPV testing instead of the Pap test.

If you have certain risk factors, your doctor may recommend more-frequent Pap smears, regardless of your age. These risk factors include:

• A diagnosis of cervical cancer or a Pap smear that showed precancerous cells
• Exposure to diethylstilbestrol (DES) before birth
• HIV infection
• Weakened immune system due to organ transplant, chemotherapy or chronic corticosteroid use
• A history of smoking

You and your doctor can discuss the benefits and risks of Pap smears and decide what's best for you based on your risk factors.

Who can consider stopping Pap smears?

In certain situations a woman and her doctor may decide to end Pap testing, such as:

• After a total hysterectomy. After a total hysterectomy — surgical removal of the uterus including the cervix — ask your doctor if you need to continue having Pap smears.

  If your hysterectomy was performed for a noncancerous condition, such as uterine fibroids, you may be able to discontinue routine Pap smears.

  But if your hysterectomy was for a precancerous or cancerous condition of the cervix, your doctor may recommend continuing routine Pap testing.

• Older age. Doctors generally agree that women can consider stopping routine Pap testing at age 65 if their previous tests for cervical cancer have been negative.

  Discuss your options with your doctor and together you can decide what's best for you based on your risk factors. If you're sexually active with multiple partners, your doctor may recommend continuing Pap testing.