Pap smear is a quick and simple test used to screen women for cervical cancer. Pap smear screening is recommended for women above 21 years of age, who are sexually active and then after every 3 years.Routine Pap testing can be stopped in women who have had a total hysterectomy for benign conditions (noncancerous). But if the hysterectomy was done as a treatment for cervical pre-cancer (or cancer) or you had undergone supracervical hysterectomy (hysterectomy without removal of the cervix) then you should continue having your pap smears done. Women over 65 years of age with previously normal Pap smear results in the past can stop cervical cancer screening after consultation with your gynecologist. However, if their previous pap smears had any precancerous lesions (like CIN2 or CIN3) they should continue their regular screening with Pap tests.
How can women avoid Pap Smear Tests:
The rationale behind stopping pap test screening at 65 years is that there is less than 1 in 1000 possibility that a woman >65 years of age with previously normal Pap smear results will develop precancerous lesion or cancer cervix. This is because HPV virus( the virus causing cervical cancer is a latent virus, which can take 20-30 years to develop into a high-grade dysplasia, which is a precursor to cancer of the cervix. However, these women should resume Pap screening if their risk factors increase, the main one being a new sexual partner.
But women who had never had a pap test done before had higher rates of CIN or cervical cancer. So they should continue with the routine screening. The guidelines for testing are the same even for women who have received the HPV vaccine.
Women at high risk like those with organ transplant, HIV infection or DES (diethylstilbestrol) exposure while in the womb should consult their doctor regarding their screening.
Thus you should discuss your options with your doctor so as to decide what’s best for you based on your risk factors.