Pap Tests

When you need them—and when you don’t

A Pap test is a test of cells in the cervix. The cervix is the opening between the vagina and the uterus. The Pap test looks for cells that are not normal and can cause cancer of the cervix. This is also called cervical cancer.

Most women ages 21 to 65 need regular Pap tests. But teenage girls and older women usually don’t need them. Here’s why:

Pap tests usually don’t help low-risk women.

Many women have a very low risk for cervical cancer.

  • Cervical cancer is rare in women younger than 21, even if they are sexually active. Abnormal cells in younger women usually return to normal without treatment.
  • Cervical cancer is rare in women over 65 who have had regular Pap tests with normal results.
  • Pap tests are not useful for women who have had their cervix removed during a hysterectomy, unless the hysterectomy was done because there were cancer or pre-cancer cells in the cervix.

Pap tests can have risks.

A Pap test can be uncomfortable and cause a little bleeding.

The test may show something that does not look normal but would go away on its own. Abnormal results cause anxiety. And they can lead to repeat Pap tests and follow-up treatment that you may not need.

The tests cost money.

A Pap test is done during a pelvic exam. Although costs vary across the country and even from practice to practice, any money spent on an unnecessary test is money wasted.

So, when do I need a Pap test?

That depends on your age, your medical history, and your risks.

  • Ages 21 to 30: You should have a Pap test every three years. Cervical cancer takes 10 to 20 years to develop, so you don’t need the test each year. You do not need a Pap test before age 21, even if you are sexually active.
  • Ages 30 to 65: The new guidelines from the American Cancer Society and others say that you can have the Pap test every five years—as long as you have a test for the human papillomavirus, or HPV, at the same time. HPV is a sexually transmitted infection that can cause cervical cancer.
  • Age 65 or older: You do not need Pap tests if your recent ones have been normal. If you have risk factors for cervical cancer, ask your doctor how often you need a Pap test. Risk factors include: pre-cancer cells in your cervix, a history of cervical cancer, or a weak immune system.

This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2016 Consumer Reports. Developed in cooperation with the American Academy of Family Physicians.