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No More Annual Paps, Ladies

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No More Annual Paps, Ladies

Like many health-conscious women, for twenty-some years, I’ve hauled my naked self into the gyno’s office to get my annual Pap. My cooch literally starts cringing the day I make the appointment and doesn’t relax until after the whole shebang is finito.

But good news, ladies! The U.S. Preventive Services Task Force is releasing new guidelines on cervical cancer screenings that will likely change all that.

New Pap Smear Guidelines For Low Risk Women

  • No Pap smears necessary before the age of 21, even if you’re sexually active. (Teens, you can relax. Even if you get HPV, chances are good that your strong immune systems will clear it before it becomes a problem, and avoiding early screening may prevent unnecessary surgeries like LEEP procedures that may predispose you to pregnancy complications like miscarriage and preterm birth from incompetent cervix.
  • From 21-30, Pap smears are recommended every three years, instead of yearly. Combining the Pap test with HPV testing every three to five years is the preferred strategy for women aged 30 and older. Annual Paps are specifically recommended against.
  • No Paps after 65. Screening is not recommended for women 65 or older who have had three or more normal Pap tests in a row and no abnormal Pap test results in the past 10 years, or who have had two or more negative HPV tests in the past 10 years.
  • Women who have a normal Pap result and a positive HPV test result should repeat both tests or receive a gene test determining whether they have HPV 16 and 18, which cause 70% of cervical cancers. (Old guidelines recommended immediate colposcopy, but not anymore.)
  • Women with a mildly abnormal Pap result (called ASCUS) and a negative HPV test result should follow up with either HPV testing plus a Pap test, or HPV testing alone, at intervals of three years or longer.(In other words, ASCUS with negative HPV is not considered abnormal.)
  • Women who have been vaccinated against HPV should begin cervical cancer screening at the same age as unvaccinated women, i.e. at age 21.

If your Pap smears have showed precancerous changes on your cervix in the past, like mine have, the rules are different. So ask your doctor to make sure you understand what guidelines apply to you.

BEFORE YOU GET TOO PSYCHED and start dancing the hoochie coochie…

Keep in mind that you’ll still need annual physical exams. Most docs still recommend an annual physical, including an internal pelvic exam for women (and possibly, though it’s controversial, annual breast exams.)  Your doctor will still likely require that you get your annual exam before she’ll refill your yearly medications, such as birth control pills or hormone replacement. But at least you can skip the scary metal duckbill!

Next: Why the changes?

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Lissa Rankin

Lissa Rankin, MD is a mind-body medicine physician, founder of the Whole Health Medicine Institute training program for physicians and other health care providers, and the New York Times bestselling author of Mind Over Medicine: Scientific Proof That You Can Heal Yourself.  She is on a grassroots mission to heal health care, while empowering you to heal yourself.  Lissa blogs at and also created two online communities - and She is also the author of two other books, a professional artist, an amateur ski bum, and an avid hiker. Lissa lives in the San Francisco Bay area with her husband and daughter.


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6:35PM PDT on Apr 17, 2012

I have one every 2 years as recommended by my GP here in Australia. If it's painful, get a new doc/ob-gyn. OK we all know it's not fun just a few minutes every 2 years may save your life, so quit bitching.

6:18PM PDT on Apr 17, 2012

Living in the UK then Australia I always dreaded my bi-annual PAP smears because I used to bleed for days afterwards. In 2003 I had a full hysterectomy, during which - of course - they removed my cervix. Since then - like clockwork and despite reminding them every time that I no longer have a cervix - I have received bi-annual reminders for my PAP smear from the GP who recommended and organised my hyster. Kinda makes you worry about the medical profession.

7:05AM PDT on Apr 9, 2012

Great to know, really ! Thank you for the article : now I can reassure my worried boyfriend. :)

9:16PM PDT on Apr 7, 2012

gotta love the pap....NOT!

5:40AM PDT on Apr 7, 2012

Thanks for the info Lissa.

12:36PM PDT on Apr 2, 2012

A yearly pap always seems ridiculous overkill to me. Thanks for the info.

5:16PM PDT on Mar 28, 2012

Jane B. i randomly read your comment and glad i did because this information didnt sound right to me. i was thinking about a pap smear and that its not only looking for hpv and i was thinking to myself "what about women who have several sex partners? shouldnt a doctor check their vaginas yearly?" i hate how women treat a gyno visit like some horrible process. i found that just relaxing and staying still goes a long way

11:28PM PDT on Mar 25, 2012

I get my papsmears and really don't have a problem doing so. I'm a former healthcare professional, and I believe in certain forms of healing yourself but i have my limits. I'm not going to start talking to and being "nice" to my cervix to keep cancer away. Cancer runs in almost all my family member, and I have uterine conditions. I will be getting my pap smears and feeling good about doing it. A few minutes of being uncomfortable beats dying of cancer and chemo.

1:45AM PDT on Mar 25, 2012

Good news. Thank you.

9:30PM PDT on Mar 24, 2012

Alas, it doesn't seem much help if you're between 30 and 60.

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Disclaimer: The views expressed above are solely those of the author and may not reflect those of
Care2, Inc., its employees or advertisers.

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