Screening Tests for Adults (50 and Up)

Women who haven't been screened for cervical cancer in 3 years or more or who have never been tested are especially urged to have a Pap smear.

The American College of Obstetricians and Gynecologists (ACOG) recommends that women 30 years of age or older be screened for the presence of human papilloma virus (HPV) with an HPV DNA test in addition to a Pap smear. Postmenopausal women should be tested for HPV only when the Pap smear is abnormal. Persistent infections with certain types (strains) of HPV are now known to be the major risk factor for cervical cancer. Two types of HPV, types 16 and 18, account for about 70% of cervical cancers in the U.S. Cigarette smoking and a compromised immune system have also been associated with the persistence of the HPV infection, which may progress to cancer.

• Women over 30 years old who have been sexually active, have no new risk factors, and have had normal results on both a Pap smear and an HPV DNA test for 3 years in a row should continue to be screened at least every 3 years with both tests. Based on established guidelines and a joint decision between you and your physician, screening intervals may be lengthened for many women once they have had 2 or 3 normal Pap smears in a row.
• ACOG further recommends discontinuing routine screening between the ages of 65 to 70 if three or more consecutive Pap smears are negative or if no other abnormalities have been identified within the last 10 years. Women who have had total hysterectomies for non-cancerous reasons and no other high-risk history could also discontinue routine screening.

How often you should be tested depends on your risk factors such as exposure to DES in the uterus, previous diagnosis of cervical cancer, HIV, or a compromised immune system. If you have these risk factors, you should be tested more frequently than every 3 years. Ask your health care provider for a recommendation on frequency and if this test is still appropriate for you. If you have had a hysterectomy, discuss whether continued screening is of value. In some cases, it is.

Even if you do not need a Pap smear each year, for most women, an annual pelvic exam is still recommended, reminds ACOG.

Sources

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