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?

Why The Changes?

The more we know about cervical cancer screening, the more the scientists learn about the pluses and minuses that accompany screening tests like this. Fortunately, we’ve WAY decreased the risk of cervical cancer by instituting Pap smears. In the 1930’s, cervical cancer was the deadliest women’s cancer. Not anymore. In 2009, only 4,000 women died of cervical cancer, many fewer than almost all other woman-specific cancers. Most cases of cervical cancer now exist in women who haven’t had a Pap smear for 10 years or longer.

On the flip side, Pap smear screening results in lots more testing, lots of procedures, lots more surgery, and consequently, lots more complications. Researchers are trying to find out just the right frequency to keep Pap smear benefits while minimizing the risks associated with overtreatment.

What Can You Do? Heal Yourself

Just don’t skip your Pap smears when it’s your time. Fortunately, unlike ovarian cancers or even breast cancers, most cervical cancers usually begin with precancerous changes that can be detected long before they become cancer, so even if you wait three years for your Pap, the precancerous changes will rarely progress. As long as you get your Pap smears on time and follow your doctor’s recommendations, you shouldn’t go from normal to cancer in three years.

I’m a big believer in self-healing and positive thinking, so start with positive beliefs. Trust that you won’t get cervical cancer. Love your cervix. Heal any sexual traumas from your past so they don’t come rearing their ugly head in the form of gynecological health problems. Kick cancer to the curb of your mind.

Then get your Pap smears on time, just because cervical cancer is so preventable that you don’t want to mess around.


What are you thoughts about the new Pap smear guidelines? Dish!

Yours, in health,


Lissa Rankin, MD: Founder of OwningPink.comPink Medicine Woman coach, motivational speaker, and author of What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend and Encaustic Art: The Complete Guide To Creating Fine Art With Wax.

Learn more about Lissa Rankin here.



Nimue Pendragon

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.

Lyn Simcock
Lyn Simcock5 years ago

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.

Cyrille D.
Cyrille D5 years ago

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

Sheri P.
Sheri P5 years ago

gotta love the pap....NOT!

Kiana S.
Kiana S5 years ago

Thanks for the info Lissa.

Sarah M.
Sarah M5 years ago

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

Mari Garcia
Mari Garcia5 years ago

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

Amy Biggers
Amy Biggers5 years ago

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.

Uddhab Khadka
Uddhab Khadka5 years ago

Good news. Thank you.

Ra Sc
Ra Sc5 years ago

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