When should I get my Pap Smear?


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January is Cervical Cancer Awareness Month. It’s a great time as a lady to go get your annual wellness screenings done. Most women do not know how often they should have cervical cancer screenings(pap smears) performed. More often than not I am getting the question over and over again, “Now how often am I supposed to get my pap smear?” It is confusing nowadays. Just ten years ago we all would have been on the same game plan, which was simple. Go get a pap every year. But now the guidelines have us all confused. So let’s start with why it’s important to be screened and finish with you confidently knowing how often you are to get a pap smear.

So, why do we need to be screened in the first place?

Well it’s really pretty simple. HPV. HPV stands for Human Papillomavirus. There are over 200 strains of the virus with approximately 15 strains being able to infect your genital region that can cause cancer. HPV is so common that the CDC literally states that almost every one will get it at some point in their life if they are ever sexually active. Your risk of HPV goes up with early onset of sexual activity, multiple sexual partners or high risk sexual behaviors(i.e. multiple partners without protection). HPV is linked to approximately 70% of all cervical cancer cases. Cervical cancer is the 4th most common cancer in women.

Therefore, please ladies do two things for me:

1. Think before you have sex. Condoms do not protect against all strains of HPV. Meaning you could still walk away with genital warts.
2. Get your pap smears!

Now, when do I need my first pap smear? And how often do I get a pap smear?

Everyone should get their first pap smear by age 21 no matter when or if you are already sexually active. Again, at age 21 no matter your history get your first pap smear.

After that you need to get a pap smear every 3 years. Your health care provider will then decide if on the pap smear if you need co-testing with HPV or not.

**An IMPORTANT NOTE however is this: You still need a wellness EVERY YEAR!**

There are other physical exams and even possible testing we may still need to do as providers. For example if you are under 25 and sexually active it is recommended we test you for chlamydia and gonorrhea due to the high prevalence of each. In our office this is a simple vaginal swab(q-tip) that we actually have you do yourself in our bathroom. Most health care providers, including myself, still recommend a yearly bimanual exam where we feel your ovaries, fallopian tubes and uterus. But most importantly, this gives you a chance once a year to discuss your health concerns and ways to prevent disease with your health care provider. An added bonus is that insurance covers an annual wellness exam once a year. So no cost to you!

Finally, you don’t have to ALWAYS get a pap smear for the rest of your life. (whoop! whoop!)

When you turn 65 you may STOP pap smears IF you meet the following criteria:
1. You have had NO abnormal pap smears.
2. You have no history of smoking tobacco
3. You have never had HPV related diseases
4. You have no new sexual partners since your last pap smear
5. You have HAD 2 consecutive pap smears without HPV within the past 10 years and the most recent test was done in the previous 5 years.
6. And you have NO history of cervical dysplasia or cancer.
*If you don’t meet that criteria then have a chat with your health care provider. They can then discuss the risks and benefits to continuing your screening process.*

In a nutshell go see your health care provider once a year. They will always be able to help guide you on how often you need health screenings. It’s their job. But if you are 21 or older get a pap smear, no matter your sexual history. Then get one every 3 years until you are 65.

I hope that helps clear up questions you might have had. Feel free to comment further questions below or contact our office at 417-332-3639. And if you don’t have someone you feel comfortable with to get your pap smear, then please give our office a call. We are an all female staff so we completely understand how awkward it feels to get this done and we try our best to make you feel as comfortable as possible with the exam.

As always, I hope you stay happy and healthy.

Carolyn Clark, NP-C