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When Should a Teen Get Her First Pap Smear?

The guidelines for PAP smear testing have recently changed. Find out at what age a teen should get her first PAP smear – and how often women in their young adult years need this test.

Pap smears are a vital screening tool for diagnosing cervical cancer – and it’s important that all women, young and old, follow the recommended guidelines for getting this exam – to protect their health. When is the best time to start? A year ago, the guidelines for when a teen should get their first PAP smear were changed by the American College of Obstetrics and Gynecology. Here’s what the new guidelines say.

At What Age Should Teens get a First PAP Smear Test?

The new American College of Obstetrics and Gynecology guidelines recommends that teens get their first PAP smear at age 21. Previously, the recommendation was for teens to get a first PAP smear three years after becoming sexually active – or no later than age twenty-one.

A PAP Smear Test is a Screening Tool

A PAP smear test screens for cervical cancer, but it can also detect HPV, or human papilloma virus, a virus which increases the risk of developing cervical cancer. Only certain types of HPV increase the risk of cervical cancer – and there’s now a vaccine that protects against seventy-percent of the HPV strains that cause cervical malignancies.

Most doctors recommend that teens and women get this vaccine at age eleven or twelve – or before they become sexually active. Teens that aren’t vaccinated against HPV and have any type of disease that reduces immunity should get a PAP smear test prior to age 21.

How Often Should Young Women Get a PAP Smear Test after the First One?

The new guidelines recommend that women in their twenties be screened every two years, while women in their thirties can wait three years between screenings – but only after they’ve had three negative PAP smear tests in a row.

Why Did the Age for First PAP Smear Change?

The age for first PAP smear was revised due to the very low incidence of cervical cancer in women under the age of 21. In addition, many teens and younger women find PAP smear screening to be stressful and anxiety-provoking, which also played a role in the guideline changes.

On the other hand, any teen that experiences abdominal pain, bumps or sores in the pelvic region, missed periods, pain with urination, vaginal itching, or bleeding between periods needs to see a doctor, who may recommend a PAP smear test.

The Bottom Line?

The guidelines for when a teen should get a PAP smear has changed, but most doctors still recommend that a teen have her first gynecology visit at around age fifteen. Usually a pelvic exam isn’t required unless a teen is having symptoms. This is a chance for a teen to feel more comfortable with seeing a gynecologist – without having a pelvic exam or PAP smear test.

References:

Medscape.com website. “No Pap Smears for Women Under 21: Guidelines”

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  1. nice post…..great work.

  2. Hi Kristie,
    I thought this would make a great blog post for my lady readers. You can find this at http://christonecipher-friends.blogspot.com/2010/07/when-should-teen-get-her-first-pap.html
    Blessings,
    Chris

  3. Why would earth would any women need to get used to seeing a gynaecologist? We don’t see gynaecologists unless we have a health problem or we’re pregnant and referred by our GP’s.

    21 is still too young for pap tests and results in high numbers of false positives for no benefit – 25 or 30 should be the earliest starting age and only 3 to 5 yearly.
    Finland has the lowest rates of cervical cancer in the world and sends the fewest women for biopsies (fewer false positives – almost all referrals are for false positives) They offer 5 to 7 tests in total – 5 yearly from age 30.

    The test is intrinsically unreliable and the cancer is rare, always was and was in decline before screening started – the test was also never properly evaluated before release…we’ll never know whether pap tests are really helping, but we do know if they help anyone, the numbers are very small.
    Lifetime risk of cc is 0.65% (less than 1%) (around 0.45% are possibly helped by pap tests and 0.20% get false negatives)
    Lifetime risk of referral after an abnormal pap test in the States – 95% (due to over-screening and inappropriate screening)
    the risk is 77% in Australia and 65% in the UK.

    Unnecessary biopsies and treatments can damage the cervix and cause cervical stenosis that can lead to endometriosis if menstrual blood can’t escape with the cervix scarred shut – surgery may be required also, infections and infertility may occur OR
    cervical incompetence – miscarriages, high risk pregnancy perhaps requiring cerclage, premature babies and c-sections and psych issues.
    LEEP and cone biopsies carry the most risk.

    Women under 30 don’t benefit from pap tests but produce huge numbers of false positives – 1 in 3 pap tests will be “abnormal” – false positives caused by normal changes in the maturing cervix or by harmless and transient HPV infections.

    “No country in the world has reported a decline in the incidence of or the mortality from cervical cancer in women under 30, irrespective of cervical screening. Many countries do not perform cervical screening in under age 30.”
    Taken from “Cervical cancer screening” by Assoc Prof Margaret Davy, Director, Gyn-oncology, Royal Adelaide Hospital and Dr Shorne, GP. (on line)
    The very rare case that happens in a woman under 30 is usually missed by pap tests – these women get a false negative result which can falsely reassure and lead to a woman ignoring symptoms and delay seeing a Dr.
    So, screening does not benefit women under 30, but causes worry, fear and harm.
    Older women should also review their risk profile and if they want testing, adopt a program that protects you from the much higher risk of false positives.

    As a low risk woman, I decided not to have pap tests over 25 years ago and recently also declined breast cancer screening. Breast cancer is much more common, but the test produces false positives and over-diagnosis is a serious concern.
    Anyone interested in reading up on the risks and benefits of testing should visit Dr Joel Sherman’s medical privacy forum and under women’s privacy issues, in the side bar, you’ll find my references – research by Dr Raffle, Prof Baum, R. DeMay and the Nordic Cochrane Institute.
    Also, women not yet sexually active do not benefit from testing, nor do women in lifetime mutually monogamous relationships or women who’ve had full hysterectomies for benign conditions.
    All women should make up their own minds about testing – it is never anything more than an offer – to accept or decline as YOU see fit.
    PS Australian and UK doctors do not recommend well-woman exams (except pap tests) – the routine pelvic exam is of poor clinical value and exposes you to risk – more testing, even surgery. Routine breast exams don’t help, but causes biopsies.
    Rectal – too ridiculous for words – none of these exams are necessary for symptom-free women. I’m 52 and have never had a well-woman exam, it’s never even been suggested and I’d refuse it anyway – unnecessary and harmful.

  4. Why would earth would any women need to get used to seeing a gynecologist? We don’t see gynecologists unless we have a health problem or we’re pregnant and referred by our GP’s.

    21 is still too young for pap tests and results in high numbers of false positives for no benefit – 25 or 30 should be the earliest starting age and only 3 to 5 yearly.
    Finland has the lowest rates of cervical cancer in the world and sends the fewest women for biopsies (fewer false positives – almost all referrals are for false positives) They offer 5 to 7 tests in total – 5 yearly from age 30.

    The test is intrinsically unreliable and the cancer is rare, always was and was in decline before screening started – the test was also never properly evaluated before release…we\’ll never know whether pap tests are really helping, but we do know if they help anyone, the numbers are very small.
    Lifetime risk of cc is 0.65% (less than 1%) (around 0.45% are possibly helped by pap tests and 0.20% get false negatives)
    Lifetime risk of referral after an abnormal pap test in the States – 95% (due to over-screening and inappropriate screening)
    the risk is 77% in Australia and 65% in the UK.

    Unnecessary biopsies and treatments can damage the cervix and cause cervical scarring can lead to retention of menstrual blood and cause health problems including infections – surgery may be required also, infertility may occur OR
    cervical incompetence – miscarriages, high risk pregnancy perhaps requiring cervical suture, premature babies and c-sections and psych issues.
    Laser treatment and cone biopsies carry the most risk.

    Women under 30 don’t benefit from pap tests but produce huge numbers of false positives – 1 in 3 pap tests will be “abnormal” – false positives caused by normal changes in the maturing cervix or by harmless and transient HP virus infections.

    “No country in the world has reported a decline in the incidence of or the mortality from cervical cancer in women under 30, irrespective of cervical screening. Many countries do not perform cervical screening in under age 30.”
    Taken from “Cervical cancer screening” by Assoc Prof Margaret Davy, Director, Gynecology-oncology, Royal Adelaide Hospital (on line)
    The very rare case that happens in a woman under 30 is usually missed by pap tests – these women get a false negative result which can falsely reassure and lead to a woman ignoring symptoms and delay seeing a Dr.
    So, screening does not benefit women under 30, but causes worry, fear and harm.
    Older women should also review their risk profile and if they want testing, adopt a program that protects you from the much higher risk of false positives.

    As a low risk woman, I decided not to have pap tests over 25 years ago and recently also declined breast cancer screening. Breast cancer is much more common, but the test produces false positives and over-diagnosis is a serious concern.
    Anyone interested in reading up on the risks and benefits of testing should visit Dr Joel Sherman\’s medical privacy forum and under women\’s privacy issues, in the side bar, you’ll find my references – research by Dr Raffle, Prof Baum, R. De May and the Nordic C Institute.
    Also, women not yet sexually active do not benefit from testing, nor do women in lifetime mutually monogamous relationships or women who’ve had full hysterectomies for benign conditions.
    All women should make up their own minds about testing – it is never anything more than an offer – to accept or decline as YOU see fit.
    PS Australian and UK doctors do not recommend well-woman exams (except pap tests) – the routine pelvic exam is of poor clinical value and exposes you to risk – more testing, even surgery. Routine breast exams don\’t help, but causes biopsies.
    Rectal – too ridiculous for words – none of these exams are necessary for symptom-free women. I\’m 52 and have never had a well-woman exam, it’s never even been suggested and I\’d refuse it anyway – unnecessary and harmful.
    if std testing is required, a simple urine and blood test and self-sample swab is all that’s required.
    Women who want the Pill do not need pelvic exams – just a blood pressure test. Putting obstacles in the way of birth control leads to unplanned pregnancies, abortions, miscarriages and ectopic pregnancies. The medical barriers in the States are being broken down which is great to see…
    See: Dr Robert H from Managing Contraception and access to birth control with no pelvic exam.
    Also, see “Women after birth control get unneeded pelvic exams”.

  5. Is it okay that A seventeen year old not have have a period with the shot or at anytime

  6. Is it okay that A seventeen year old not have have a period with the shot or at anytime

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