The widespread use of Pap smears has helped significantly reduce deaths from cervical cancer. Since the mid-1970s, the mortality rate has decreased by more than half, mainly due to early detection and treatment of precancerous conditions identified through this screening.
The American Cancer Society estimated 13,820 new cases of invasive cervical cancer in the U.S. in 2024.
What Is a Pap Smear?
A Pap smear is a simple test to screen for cervical cancer by detecting abnormal cells in the cervix. A health care provider gently collects cells from the cervix during the procedure using a small brush or spatula. The cells are then examined under a microscope for signs of precancerous or cancerous changes.
The test is quick, minimally invasive, and typically takes only a few minutes. Regular Pap smears can help catch cervical abnormalities early, making treatment easier and more effective.
When Should You Get a Pap Smear?
Various groups have updated their cervical cancer screening guidelines over the years, creating confusion about when and how often women should receive Pap smears.
In 2020, the American Cancer Society updated its guidelines, recommending cervical cancer screening for people with a cervix starting at age 25 and continuing until age 65. This screening should be done with a primary human papillomavirus (HPV) testing every five years.
If primary HPV testing isn’t available, acceptable alternatives include co-testing with HPV testing and a Pap smear every five years or a Pap smear alone every three years.
The U.S. Preventive Services Task Force (USPSTF) recommends that individuals aged 21 to 29 undergo Pap smears every three years. For those aged 30 to 65, the USPSTF suggests one of the following screening strategies:
- Primary HPV testing every five years.
- Co-testing (HPV testing combined with Pap smear) every five years.
- Pap smear alone every three years.
The American College of Obstetricians and Gynecologists (ACOG), the American Society for Colposcopy and Cervical Pathology (ASCCP), and the Society of Gynecologic Oncology (SGO) endorse these guidelines.
Pap Smear FAQs
How will a Pap smear help?
A Pap smear plays a crucial role in detecting and preventing cervical cancer. Detecting abnormal cells early allows for timely intervention before they progress into cancer.
Early detection also increases the chances of successful treatment and reduces the need for more invasive procedures. In addition, regular screenings contribute to peace of mind and help you stay proactive about your health.
Do you need a Pap smear if you’re not sexually active?
Yes, you may still need a Pap smear even if you’re not sexually active. Although the main cause of cervical cancer is HPV, which is often spread through sex, other factors can also cause changes in cervical cells.
The current guidelines recommend that anyone with a cervix start screening at age 21, regardless of their sexual history. If you have concerns, discuss them with your health care provider to better understand your risks.
Do Pap smears hurt?
A Pap smear isn’t painful for most people, though it may cause mild discomfort. The procedure involves inserting a speculum to gently widen the vaginal canal and allow access to the cervix.
You might feel pressure or a brief scraping sensation when your doctor collects cells. To minimize discomfort, try to relax your muscles and communicate any concerns with your provider. Knowing what to expect can also make the experience more comfortable.
Cervical Cancer Screening FAQs
What are the cervical cancer screening tests?
A Pap smear is just one method of screening for cervical cancer. The term “cervical cancer screening” actually encompasses multiple tests, including HPV testing and co-testing.
This list includes all of the methods doctors use to screen for cervical cancer:
- Pap smear — Checks for abnormal cervical cells that may develop into cancer.
- HPV testing — Detects the presence of high-risk strains of the human papillomavirus (HPV), a leading cause of cervical cancer.
- Co-testing — Combines Pap smear and HPV testing for a more comprehensive screening.
- Visual inspection with acetic acid (VIA) — Used in low-resource settings, this involves applying vinegar to the cervix to highlight abnormal areas.
- Emerging technologies — New methods like liquid-based cytology and AI-assisted diagnostics are being developed to improve screening accuracy.
Cervical cancer facts
Some things you should know about cervical cancer:
- Health experts expect that approximately 4,360 individuals will die from cervical cancer in the United States in 2024.
- The cervical cancer death rate has decreased by more than 50% since the mid-1970s, primarily due to the increased use of screening tests.
- Widespread HPV vaccination efforts have also decreased cervical cancer cases, and together with Pap smears have the potential to prevent most cervical cancer if adopted widely.
- Early stages of cervical cancer often present no symptoms, underscoring the importance of regular screenings.
- A Pap smear is the primary method for detecting cervical cancer and precancerous changes.
Risk factors for cervical cancer
You’re at greater risk of developing cervical cancer if you:
- Are infected with or exposed to HPV.
- Begin sexual activity before age 18.
- Have a history of irregular or suspicious Pap smears
- Have a weakened immune system, such as from HIV.
- Have multiple sexual partners.
- Smoke.
Should I Get a Pap Smear?
If you meet the guidelines for cervical cancer screening, you should talk with your doctor about what’s best for you. Scheduled screenings are critical, and they can answer your questions and address your concerns about Pap smears.
You may not need a Pap smear if you’re:
- Younger than 21.
- Older than 65 with adequate prior screening.
- Have had a hysterectomy for benign reasons.
- Have had recent typical screening results.
You can learn about gynecologic cancer screenings at UPMC Hillman Cancer Center.
Editor's Note: This article was originally published on , and was last reviewed on .