Are Pap Smears Necessary?
We’re all about being as proactive as possible when it comes to your reproductive health. Pap smears are one of the first steps most people take to learn about what’s happening in their reproductive systems.
But like everything in life, medicine and healthcare evolves and changes, and we need to evaluate what we’ve always done and see if that’s still the best course of action. So what’s the deal with pap smears? Why do we do them and do we need to be doing them? Time to find out!
What Is a Pap Smear?
If you’ve ever had one, you probably don’t need a reminder, but we like to cover all our bases here. If you’re about to get your first pap smear, it’s important to know what to expect. Either way, we can always use a refresher on what it is.
A pap smear screens for abnormal cells in the cervix, especially those that may be cancerous, pre-cancerous, or indicative of HPV. Certain strains of HPV can potentially develop into cervical cancer, which is why pap smears are part of routine reproductive healthcare.
Pap smears are done by using a speculum to see up the vaginal canal, and a soft brush to collect cervical cells from the outside of your cervix. The standard recommendation is to get one every three years from the age of 21 to 30, then less often until the age of 65, unless you start to show signs of cervical cancer.
Are Pap Smears Necessary?
It’s pretty common for typically younger people to get a pap smear, only to get the dreaded phone call that their test showed irregular cervical cells. Then they’re left with anxiety for the foreseeable future as they continue to get pap smears for the next two years until their results are either normal or progress. This leaves people feeling uncertain, yet nervous about their reproductive health but kind of stuck in this waiting game.
Another downside of pap smears is that they can be very triggering for people who experienced sexual trauma, abuse, or medical trauma. If this is you, know that you deserve to feel confident in the decisions you make around your reproductive health and safe with your providers.
The American College of Obstetrics and Gynecology says that this is because their understanding of cervical cancer has changed over time. Cervical cancer can take many years (10 or more sometimes) to develop, so they’ve expanded the amount of time between screenings. Pap smear results are often positive for HPV and irregular cervical cells in young people, but that doesn’t necessarily mean they will develop cervical cancer.
It’s important to get tested for STIs, and communicate with new sexual partners about any you may have. HPV however, is a tricky one, and actually stands for a group of more than 100 related viruses, versus one specific one.
It’s also incredibly common: Around 80% of sexually active people will have HPV at some point in their lives. And of them, about 90% of females with HPV will never show symptoms, and it will clear up on its own in about two years.
Because pap smears are typically done much less routinely than your standard STI test, you don’t always know if you’re carrying it, and thus transmitting it. Something to keep in mind!
The Importance of Reproductive Health Care
Providers still recommend going to your ob-gyn every year but are also starting to reevaluate the importance of regular pap smears. That being said, cervical cancer is the fourth most common cancer for people with cervixes.
Luckily they’ve developed another screening option for HPV – the HPV test. This is typically done after a pap smear shows abnormal cells and is more commonly done in people aged 30 and older. This test is only available for people with cervixes, although males can pass HPV to their sexual partners.
The HPV test does not detect cancer, but instead for certain strains of HPV that can increase your risk of developing cervical cancer.
Back to the question of the day – are pap smears necessary? Overall, yes, pap smears are an important part of reproductive health care and sexual wellness, but you might not need one as often as previously thought.
The current ACOG guidelines for cervical cancers and HPV screenings are:
- Age 21-29: Pap test every 3 years, with HPV testing as an option for people aged 25-29
- Age 30-65: Both a pap smear and HPV test every 5 years, or a pap smear every 3 years, or just an HPV test every 5 years
- After 65: You can stop cervical cancer screens if you never had abnormal cells or cervical cancer, and you’ve had two or three negative screenings in a row
Some exceptions to this are if you have a history of cervical cancer, are HIV positive, have a weakened immune system, or were exposed to DES before birth.
Knowing that you may be at a higher risk for developing cervical cancer can be nerve-wracking, but it also helps you and your medical providers take steps to be proactive about your health like monitoring, further testing, and treating abnormal cells.
If you’re unsure about whether regular pap smears are right for you, this is an important conversation to have with a medical care provider that you trust and feel safe and comfortable with.
It’s also equally as important to know your own body and pay attention if anything feels off, or out of balance. This can help you better care for your health, and advocate for yourself when navigating the healthcare system.
Natasha (she/her) is a full-spectrum doula and health+wellness copywriter. Her work focuses on deconstructing the shame, stigma, and barriers people carry around birth, sex, health, and beyond, to help people navigate through their lives with more education and empowerment. You can connect with Natasha on IG @natasha.s.weiss.