Cervical health screening, used to detect HPV or abnormal cervical cells, used to be a routine part of our annual women’s well-woman exams. However, after decades of metadata review, women’s health guidelines have changed.

Routine HPV and cervical cancer screening is free or very low cost through most health insurance plans. If cost is a concern, CDC offers free or low-cost cervical cancer screening tests through the National Breast and Cervical Cancer Early Detection Program.

Updated Guidelines for Well-Woman Screening: HPV Pap Smears & Cervical Health

As women’s healthcare providers, we always want to err on the side of proactive when it comes to detecting or diagnosing diseases in their early stages. That said, we never want to go overboard and submit women to unnecessary numbers of tests.

After decades of reviewing data on women’s cervical health and comparing routine screenings with diagnosis and treatment statistics, the Health Resources and Services Administration (HRSA) issued revised guidelines for cervical cancer screening. These updates follow changes from a few years ago that moved Pap smear screening recommendations from annually (once per year) to every three or so years, depending on age and other factors.

We understand that changes like these can be confusing. Paying attention to digital appointment reminders and alerts via your Patient Portal and our office is the best way to remain up to date on these and other wellness recommendations.

In the meantime, here are the current recommendations by age bracket.

16 – 21 Years Old: Schedule Your First Well-Woman Exam

There are varying schools of thought around when a young woman should have her first well-woman appointment with a GYN. Some believe it’s a good idea after teenagers begin having regular periods. These initial exams can be more like a physical (no internal exam needed) to help you get comfortable with the setting, ask questions, and familiarize yourself with the OB/GYN or Midwife experience.

However, once a young woman is sexually active, we recommend scheduling annual gynecology visits so that we can make sure she’s safe, taking proper precautions, and to screen for and treat STDs. Because human papillomavirus (HPV) is the most prevalent of the STDs, affecting more than 80% of sexually active women at one point in their lives, cervical health screenings are essential by age 21.

21 – 29 Years Old: Schedule Your First Pap Smear

We recommend scheduling annual wellness visits by age 21. There is a direct link between HPV and cervical cancer. By treating HPV early and checking for abnormal cervical cells, we can help to prevent cervical cancer or catch it as early as possible for more successful treatment outcomes.

Should I get HPV testing when I’m 21?

Currently, unless your physician has a specific concern, we do not recommend HPV screening until age 29. HPV is actually very common in this younger age bracket, but it usually goes away on its own. Again, we want to emphasize safe sex is the only sex you should be having if you’re not in a mutually committed, monogamous relationship.

The only barrier methods proven to prevent the spread of HPV and other sexually transmitted diseases are:

• Male condoms.
• Female condoms.
• Dental Dams.

Always wash your hands before and after sexual play and do not share sex toys without thoroughly washing them with soap/water and/or without protection.

After your first pap smear, women with average cervical cancer risk are advised to have pap smears every three years. If you’ve had an abnormal pap smear or have a family history of cervical cancer, we may recommend more frequent screening.

30 – 65 Years Old: HPV Screening

Once you reach age 30, we’ll talk to you about which screenings make the most sense for you based on your lifestyle and personal/family medical history.

HPV Test Only

Odds are that once you turn 30, your clinician will recommend getting an HPV test to create a baseline of information. If you test negative, we typically begin testing every three years after that or as decided by your physician/midwife.

We understand that many women are married and/or in monogamous partnerships during this chapter of their lives, so you may not feel you need another test. However, after decades of providing full-spectrum healthcare for women, we believe it’s best to stick with testing to err on the side of caution and treat anything that may be present, even if it’s unexpected.

Depending on when you have had your last Pap smear, you may not be due for another one the year you turn 30 and will remain on whatever schedule you’re on.

Pap Smear & HPV Test

If you are in the normal risk bracket, we recommend doing the Pap smear and HPV testing together. If both are negative, regular pap smears as decided by your physician or midwife.

Pap Smear Test Only

You also have the option to waive the HPV test and have a Pap smear. If the results come back normal, you’ll continue attending annual well-woman appointments, but Pap smears will be scheduled less often.

After Age 65

Once you are at 65+, we’ll have another conversation about what makes sense for your wellness screenings and tests. Recommendations at this stage of life are based on your history and lifestyle choices.

For example, we may still recommend routine HPV or other STD tests if you’re enjoying a robust sex life with multiple partners.

You may not require further cervical Pap smear or HPV testing if:

• You’ve tested negative for routine Pap smears and HPV tests for the past 10 years.
• You’ve never had precervical or cervical cancer in the past.
• Your cervix was removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.

Visit the ACS’s page on Cervical Cancer Screening for a more comprehensive guide to HPV and cervical cancer screening.

Northwest Women’s Clinic Looks Forward to Seeing You At Your Next Well-Woman Exam

Cervical health screening is a simple, pain-free way to catch HPV or cervical cancer early so we can stop them in their tracks. And while current guidelines have opened up more space between screenings and tests, we want to emphasize that annual well-woman exams are still vital to your overall health and well-being.

Is it time for you to schedule your next annual wellness appointment? Or, do you have questions about your reproductive health or changing body as you move through the different seasons of your life? The team at NWWC is here for you. Call us at 503-416-9971, or use our online Contact form to get in touch.