How often do I need a Pap test?

Q: My gynecologist has me come in for annual pelvic exams and a Pap test every three years. But a good friend just told me that she has a Pap test plus an HPV test every five years and nothing in between. Which approach is correct? We’re both 52 and healthy.

A: I’m glad you asked this question. There’s a lot of confusion around this issue, mostly because the screening recommendations have changed in recent years. First of all, the U.S. Preventive Services Task Force (USPSTF), the organization that reviews scientific evidence to make recommendations for preventive care, now only recommends a pelvic exam, which was long considered a fundamental aspect of the annual wellwoman visit, when a woman’s medical history or symptoms warrant one. In other words, there’s no one-size-fitsall routine schedule anymore.

To screen for cervical cancer, the USPSTF’s most recent guidelines include three screening options for women between the ages of 30 and 65: a Pap test every three years, a test for one of the high-risk types of human papillomavirus (better known as HPV, the virus that can cause cervical cancer) every five years or a combination of the HPV test and a Pap test every five years.

And while a recent study suggests that the co-testing your friend’s doctor recommends enhances the detection of cervical cancer in women over age 30 more than either test alone, I recommend discussing this issue with your health-care provider so you can clarify which type of screening you need, based on your personal medical history.

Finally, keep in mind that women who have had negative Pap tests for 20 years no longer need the tests after the age of 65.