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Lois McGuire, R.N., M.S.N., W.H.N.P.
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Lois McGuire, R.N., M.S.N., W.H.N.P.
Lois McGuire, R.N., M.S.N., W.H.N.P.
Lois McGuire was a registered nurse in Obstetrics and Gynecology for 20 years. This experience made attending Planned Parenthood of Minnesota for the Women's Health Care Nurse Practitioner Program a natural step. Later she attended Case Western Reserve University to achieve her Master's in Nursing. She has been employed at Mayo Clinic as a nurse practitioner for 15 years. She works with women from adolescence though all the life cycles. Lois is committed to a holistic nursing approach, empowering women to take care of their health.
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June 9, 2009
Blog: Pap smear schedules vary by age, risk
By Lois McGuire, R.N., M.S.N., W.H.N.P.
The Pap smear screening test is one of modern medicine's greatest successes. In areas of the world where it's available, the Pap smear has reduced cervical cancer rates dramatically by detecting infection with human papilloma virus (HPV) and associated changes in cervical cells.
The tradition has been to do a Pap smear annually on all women. Now we are learning that we can decrease the frequency of Pap smears and still protect women.
For example, if you have never had an abnormal Pap smear and you have been with the same partner for a long time, your partner probably doesn't have HPV, so an annual Pap smear is not necessary.
The following questions and answers cover additional recent refinements in Pap smear recommendations.
When should a young woman start having Pap smears?
The recommendation is to have your first Pap smear test three years after you become sexually active or at age 21, whichever comes first. The prevalence of HPV is particularly high in young women soon after they start sexual activity. The good news, though, is that younger women have extremely low rates of invasive cervical cancer, so they usually don't need aggressive treatment for HPV infection.
After I start to have Pap smears, how often do I need them?
From the time you start to have Pap smears until age 30, we recommend a Pap smear every year. If at age 30 you are still in the dating world or have just recently become monogamous (committed to one partner), continue to have a Pap smear every year. Once you have started a long term commitment, you may begin to have a Pap smear every 3 years.
Women age 40 and above still need an annual mammogram, clinical breast examination and pelvic examination. We reduce the frequency of Pap smears, but not visits to a provider.
What if I find myself back in the dating world and I am over 30 years old?
Now you are at risk for HPV again and you should resume annual Pap smears until you are in a committed relationship.
When can I stop Pap smears?
Opinions vary, but most women can stop Pap smears at age 65 or 70 if they've had three consecutive normal Pap smears over the last ten years. But the new-partner rule still applies: Regardless of your age or gynecologic history, a new sex partner puts you at risk again, so you'll need to restart annual Pap smears.
We are all used to getting a Pap smear every year. It can feel uncomfortable to let go of this familiar schedule, but technological progress and accumulated knowledge have made it unnecessary in many circumstances. Talk to your provider each year to assess what your needs are for Pap smear screening.
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