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Pap Tests: When you need them and when you don’t


A Pap test is a test of cells of 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 cervical cancer.

Most women ages 21 to 69 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 69 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.

So, when do I need a Pap test?

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

  • Ages 21 to 29: Most provincial and territorial guidelines recommend that if you are at least 21 years of age and are sexually active you should have a Pap test every three years.
  • Ages 30 to 69: The guidelines from the Canadian Task Force on Preventive Health Care and others say that you should have the Pap test every three years.
  • Age 70 or older: You do not need any more Pap tests if your three previous tests have been normal.
  • Risk factors include pre-cancerous cells in your cervix, a history of cervical cancer, or a weak immune system. If any of these apply to you, ask your health care provider how often you need a Pap test.

How can you protect yourself against cervical cancer?

The best way to protect yourself against cervical cancer is to protect yourself against human papilloma virus (HPV). HPV is a sexually transmitted infection that can cause cervical cancer.

Get the HPV vaccine. Girls should get the vaccine when they are 11 or 12. It is given in three shots over six months. Girls and women ages 13 to 26 should get the vaccine if they have not yet had it.

  • Women who get the vaccine still need regular Pap tests because the vaccine does not protect against all types of HPV that can cause cancer.
  • Boys and men can also get the vaccine. It can help protect them from getting HPV, and from giving HPV to their sexual partners

Reduce your risk.

  • Use condoms. Condoms help reduce the risk of getting HPV. Men who use them are less likely to be infected and to infect their partners. However, condoms do not prevent all infections.
  • Use spermicidal gels. They also help protect against HPV.
  • If you feel you are at risk for a sexually transmitted infection, you should visit your health care provider for testing and an examination.

Don’t smoke. The risk of developing cervical cancer increases with the length of time a woman smokes and the number of cigarettes smoked per day.

Take these steps to make your Pap test as accurate as possible.

  • Make your appointment for at least five days after your menstrual period stops.
  • For 48 hours before the test: Do not have sex, and do not use douches, tampons, birth control foams or gels, vaginal creams, moisturizers or lubricants, or vaginal medicines.

Source: Choose Wisely Canada

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