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Johns Hopkins Health Alert

Do You Still Need a Pap Test?

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If you're getting a yearly Pap test, you may be getting screened for cervical cancer more often than you need to. And if you're older than 65, you likely don't need a test at all. That's according to new guidelines suggested by the U.S. Preventive Services Task Force (USPSTF) for the screening of cancer of the cervix, the lower portion of the uterus that connects to the vagina.  Here’s what you should know. 

Annual Pap tests began during the 1950s and have significantly lowered the cervical cancer death rate through early detection. However, according to the task force, cervical cancer screening offers little or no benefit to women over 65 who've had three normal Pap tests in a row. Formerly, it was recommended that women stop testing at age 70. 

The task force suggests a Pap test every three years for healthy women between ages 21 and 65 who have had sexual intercourse and have a cervix. And they recommend testing for women over 65 who've never been screened. 

The USPSTF also compared the conventional Pap test with the newer liquid-based Pap test and found that both are equally effective in detecting precancerous lesions (abnormal cells). The liquid-based approach renders it easier to interpret in a cytology lab. 

Another advantage of the liquid-based Pap test is that doctors can use it to screen for human papillomavirus (HPV), which can lead to cancer, while screening for precancerous lesions. Doctors believe that all cases of cervical cancer start with an HPV infection -- but not all HPV infections become cancerous. Other risk factors, such as smoking, a family history of cervical cancer, a weakened immune system and a poor diet, appear to influence the development of cervical cancer. 

The HPV test is more sensitive than the Pap test but produces more false-positive results indicating precancer. Unfortunately, these false positives can lead to patient anxiety, added health costs and unnecessary medical procedures that carry their own set of risks. Therefore, the task force isn't prepared to recommend HPV screening for women older than 30 until better evidence of its benefits is available from larger, long-term clinical trials. Some organizations, such as the American Cancer Society, disagree and urge women over 30 to get tested for HPV. 

Experts do agree that early detection is the best weapon against cervical cancer. Talk with your doctor about a screening schedule, if needed, based on your personal risk factors.

Posted in Healthy Living on March 7, 2012


Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer


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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.


Do women over 65 need a PAP test if they are taking hormone replacement ?

Posted by: Betty Lou | March 10, 2012 12:57 PM

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