The national Pap test guidelines seem to have changed a lot over the years, with new guidelines debuting in 2009, some updates again in 2012 and now in 2013 it appears that some final decisions have been approved.
It used to be that a woman started having their Pap smears in the teenage years and went yearly for the rest of her life. While yearly physicals with her health care provider are important, a yearly Pap test is not necessarily required.
According to most major women’s health and gynecology groups, a woman should have her first Pap smear at 21 years of age, rather than at 18 years old or age of first intercourse.
The younger the woman, the healthier her immune system is therefore she is more likely to clear any abnormal cells caused by the human papilloma virus (HPV).
If the results are normal, she is to have a Pap test every three years. Abnormal results may require more frequent follow up testing.
Once a woman turns 30 years old, the HPV test is added on to her Pap smear as various factors, including age and immune system, may reduce her ability to clear the virus from her cervix.
If her Pap smears continue to remain normal, she can continue with the "every three years" recommendation. If her results are abnormal, she again may require additional work-up and more frequent testing.
The new guidelines state that unless a woman has a history of a higher grade abnormal Pap result, she can stop having Pap smears at 65 years of age. She should continue to have yearly physicals with her health care provider however.
Additionally, if a woman has had a total hysterectomy in which her cervix was also removed for non-cancerous reasons she does not need further Pap smear testing.
However if she still has her cervix or if her hysterectomy was due to higher grade lesions or cancer, she will need to talk with her health care provider as she still needs some screening.
Remember that the purpose of Pap smear screening is to evaluate the cells of the cervix for abnormal changes due to HPV and cervical cancer.