Mammograms are not the only women’s screening test to have its recommended guidelines changed (although it has received most of the press).  The American College of Obstetricians and Gynecologists (ACOG) has updated their PAP smear testing guidelines as well. (I should clarify that it was the US Preventive Task Force (USPSTF) that recommended against ACOG’s screening mammogram guidelines. USPSTF recommends mammogram screening starting at age 50 while ACOG maintains its current advice that women receive routine screening at age 40. In other words, the people who recommended mammogram screening changes are not the same people who have recommended this change in pap smear guidelines).

There are 2 different Pap smear screening techniques: the conventional Pap smear slide (the old school but acceptable way) and the liquid-based process. The liquid-based test (which we do at Akasha) filters out blood, inflammatory cells and other debris while also being capable of testing for HPV, gonorrhea and Chlamydia.

As of December 2009, ACOGs PAP smear recommendations are:

• Cervical cancer screening via PAP smear testing should begin at age 21.
• PAP smears are recommended every 2-years for women between the ages of 21 years and 29 years (more frequent pap smears are indicated if a women had abnormal pap smears in the past, is HIV-positive, immunosuppressed or who was exposed to DES in utero).
• Women aged 30 years and older who have had three consecutive negative pap smears, tested negative for high-risk HPV and who have no history of moderate cervical dysplasia (CIN 2) or severe cervical dysplasia (CIN 3), are not infected with HIV, are not immunosuppressed and who were not exposed to DES in utero may extend the interval between pap smears to every 3-years.
• Pap smears are unnecessary in women who have had hysterectomies (uterus removed) for benign diseases (fibroids, endometriosis) and who have no histories of CIN.
• Discontinuation of pap smears after age 65-70 is acceptable in women with three or more negative tests and with no history of abnormal pap smears.
• Women with histories of CIN 2, 3 or cancer should undergo annual screenings for 20 years after treatment.

While Pap smear recommendations have become less frequent, it is still important to have a women’s health check-up yearly. A complete physical exam should be done annually in addition to a pelvic exam (feeling uterus and ovaries) and STI testing, as indicated.