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Last Updated: 12/9/2013  

Papanicolaou Smear

The Pap smear is a screening test for cervical cancer that involves the collection and examination of exfoliated cervical cells during a speculum exam.

Indications
  • Use the Pap smear as a screening test to detect preinvasive cervical intraepithelial neoplasia and invasive cervical cancer.

  • High -value care: Initiate cervical cancer screening in women at age 21, regardless of sexual activity history, and avoid screening before age 21.

  • Perform cervical cancer screening with cervical cytology every 3 years in women aged 21 to 65 if routine HPV testing is not done.

  • Do cervical cytology plus HPV testing (co-testing) or just HPV testing every 5 years in low-risk women aged 30 to 65 who wish to lengthen their screening interval.

  • Discontinue cervical cancer screening at age 65 in women who have been adequately screened with normal Pap smear results and are not otherwise at high risk for cervical cancer.

  • Discontinue cervical cancer screening in women who do not have a cervix, including those who have undergone a hysterectomy for benign disease.

DOI: 10.7326/physpro1016
The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP.
Authors and Disclosures:
Jason D. Wright, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Sarah Pickle, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.

The following editors of ACP Smart Medicine have nothing to disclose: Deborah Korenstein, MD, FACP, Editor in Chief; Richard B. Lynn, MD, FACP, Editor; and Davoren Chick, MD, FACP, Editor.

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