Pap Smears Every Three Years

8/04 UPDATE: Guidelines from the American College of Obstetricians and Gynecologists recommends that women over the age of 70 who are sexually active, continue to get Pap smears. The US Prevnentive Task Force states this need not be annually.

Young women are told to get their first Pap smear at age 21 or within three years of becoming sexually active.

Study Supports Pap Test Every Three Years

Excerpted from an article by Amanda Gardner HealthDay Reporter

New evidence supports existing recommendations that Pap smears be performed only once every three years for women who are at a low risk for cervical cancer.

For women over the age of 30 who have already had negative annual Pap tests at least three years in a row, extending the interval between tests increases the risk of cervical cancer only by about three in 100,000 women.

The Papanicolaou test, which detects abnormalities in cells before they actually become cancer, is the most widely used cancer-screening test in the United States.

Guidelines from the American Cancer Society and the American College of Obstetrics and Gynecology recommend that low-risk women -- those over the age of 30 with previous negative tests -- get Pap smears less often than annually.

The information in the current study can be used by physicians and patients to make decisions about how often to screen.

The researchers noted the number of positive Pap smears and then calculated the estimated cancer risk.

The estimated extra risk of cancer for women aged 30 to 44 who have had three consecutive negative tests was two in 100,000 women, for women aged 45 to 59 it was one in 100,000, and for women 60 to 64 years it was one in 100,000.

The overall cancer risk in each group would then be five in 100,000, two in 100,000, and one in 100,000 respectively. Having annual Pap smears produced no difference in the oldest age group.

The prevalence of cancer decreased as the number of previous negative tests accumulated.

There are advantages to going in for an annual Pap smear, as women get more tests and share health information at the doctor visit.

"The information [in the current study] only applies to women over the age of 30 who have had three annual negative Pap smears," says Dr. Sarah Feldman, author of an accompanying editorial and director of the Pap smear evaluation center at Brigham and Women's Hospital in Boston. "It does not apply to the general population."

"Individual women should first and foremost speak with their clinicians to see if they are indeed good candidates for less screening if they desire to be screened less often than annually," Sawaya says.

More information

To see Pap smear guidelines, visit the American College of Obstetrics and Gynecology (

For more on the National Breast and Cervical Cancer Early Detection Program, visit the U.S. Centers for Disease Control and Prevention (

(SOURCES: George F. Sawaya, M.D., associate professor, obstetrics, gynecology and reproductive sciences, University of California, San Francisco; Sarah Feldman, M.D., M.P.H., director, Pap smear evaluation center, Brigham and Women's Hospital, Boston; Giuseppe Del Priore, M.D., associate clinical professor, gynecologic oncology, New York University School of Medicine, and associate professor, gynecologic oncology, Albert Einstein College of Medicine, New York City; Oct. 16, 2003, New England Journal of Medicine)

Our source: HealthDayNews Oct. 16 issue of the New England Journal of Medicine.

Women W/O a Uterus Do NOT Need Pap Smears

JAMA, 6/04

Liquid-Based Cytology No Better than Conventional Pap

J Obstetrics & Gyn, January 2008

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