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Cervical cancer screening tests can help your doctor find and treat abnormal cell changes on your cervix before they develop into cervical cancer. These tests may be done as part of a pelvic exam.
There is also a test called a primary HPV test. This is a newer test for women ages 25 and older. A woman who has this test doesn't need to have a Pap test.
Experts, such as the U.S Preventive Services Task Force (USPSTF) and the American College of Obstetricians and Gynecologists (ACOG), agree that women should begin screening at age 21 and continue until they are age 65. Women who have had a hysterectomy and no longer have a cervix don't need to have tests (unless a woman had the hysterectomy because of cervical cancer).
If you are younger than 21 and are sexually active, it's still a good idea to have regular testing for sexually transmitted infections.
These guidelines apply to women who have never had a serious abnormal Pap test result. If you don't know if you have ever had such a result, talk with your doctor.
Women 21 to 29
You start having Pap tests at age 21. Women younger than 21 shouldn't be screened, except for women who are infected with human immunodeficiency virus (HIV).
If any of your tests are abnormal, you may need to be tested more often.
Women 21 to 29 usually aren't tested for HPV, because they are at low risk of cervical cancer. The virus is common in younger women, and their immune system usually gets rid of it. The exception is the newer test called the primary HPV test, which can be started at age 25, and redone every 3 years.
Women 30 to 64
For women in this age group, most experts say:
The ACOG guideline includes information on the newer primary HPV test for women ages 25 to 64.footnote 1 With a normal result from the primary HPV test, a woman can continue to be screened every 3 years. Screening should stop at age 65 for a woman with a normal screening history. A woman who no longer has a cervix shouldn't have a primary HPV test.
Women 65 and older
Women ages 65 and older may no longer need to be screened for cervical cancer. Talk with your doctor about what's right for you.
Most experts say that after you turn age 65, you no longer need screening tests if:
Women who have had a hysterectomy
A hysterectomy is surgery to remove the uterus, usually including the cervix. Sometimes the cervix is not removed. You and your doctor can decide on the right screening based on your medical history.
If you don't know if you still have your cervix, talk with your doctor.
Abnormal changes on your cervix may be minor or serious. Minor changes may go away on their own, especially if you are younger than 30.
If you have serious changes-which means the cells are the type that could turn into cancer-you may need more regular checkups and Pap tests. You may need treatment to remove the abnormal cells.
If you have a Pap test and an HPV test, your doctor will look at the results of both and decide what kind of follow-up tests you might need.
Experts agree that some women may need to be tested more often if they:
Pap test and HPV test are both normal
Pap test is normal, but HPV is abnormal
Pap test is abnormal, but HPV test is normal
Pap test and HPV are both abnormal
Pap test result isn't clear
Sometimes the results of the Pap aren't clear. There might not be enough cells to test. Or the cells may show very small changes that aren't certain. If this happens:
Primary HPV test is abnormal
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American College of Obstetricians and Gynecologists (2016). Cervical cancer screening and prevention. ACOG Practice Bulletin No. 157. Obstetrics and Gynecology, 127(1): 185-187. DOI: 10.1097/AOG.0000000000001256. Accessed January 4, 2016.
Other Works Consulted
Centers for Disease Control and Prevention (2013). Cervical Cancer Screening With the HPV Test and the Pap Test in Women Ages 30 and Older. Accessed Sept. 17, 2013: http://www.cdc.gov/cancer/hpv/pdf/HPV_Testing_2012_English.pdf.
Sawaya GF, et al. (2015). Cervical cancer screening in average-risk women: Best practice advice from the Clinical Guidelines Committee of the American College of Physicians. Annals of Internal Medicine, 162(12): 851-859. DOI: 10.7326/M14-2426. Accessed June 19, 2015.
ByHealthwise StaffPrimary Medical ReviewerSarah A. Marshall, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineKathleen Romito, MD - Family MedicineSpecialist Medical ReviewerKirtly Jones, MD - Obstetrics and Gynecology, Reproductive Endocrinology
Current as ofMarch 28, 2018
Current as of:
March 28, 2018
Sarah A. Marshall, MD - Family Medicine
& E. Gregory Thompson, MD - Internal Medicine & Kathleen Romito, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology, Reproductive Endocrinology
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