Screening for cervical cancer is done to spot changes in the cells of the cervix that could potentially result in cancer. Such screening can involve cervical cytology (known as Pap test or Pap smear) or testing for HPV (human papillomavirus), or a combination of both. For most women, such screening should happen on a regular basis.

If detected at an early stage, cervical cancer is easier to treat. Once the cancer starts spreading and symptoms surface, treatment becomes much more of a challenge. How often one needs to go for screening and which tests to undertake, would hinge on the age and medical history of the person.

Even those vaccinated for HPV are advised to go for cervical cancer screening. Women are encouraged to go for screening once they reach 21, regardless of when they start having sex.

How often should cervical cancer screening be done?

Women aged between 21 and 29 should just go for a Pap test every 3 years. Sometimes, HPV testing is considered for women 25 to 29. But Pap tests are usually the preferred mode in this age bracket.
Women in the 30 to 35 age group have three screening options. They can either go for a combination of a Pap test and an HPV test every five years, or simply go for a Pap test every 3 years. Alternatively, they can go for HPV testing alone once in 5 years.

When can one stop cervical screening?

Women can stop cervical screening post-65 in case:

They don’t have a precedence of moderate to extensive abnormal cervical cells or cervical cancer
Plus, they have notched up either 3 negative Pap tests on the trot, 2 negative HPV tests back-to-back, or 2 negative combination tests consecutively in the past decade. The latest test should have been undertaken in the past 3 to 5 years, based on the test type

Do women who have had a hysterectomy still need to be screened?

Depending on whether the cervix was removed, the trigger for the hysterectomy and if there’s a precedence of extensive cervical cell changes or cervical cancer, women who have undergone hysterectomy might still need screening.

This is because even after the cervix is removed during hysterectomy, cervical cells can still remain at the top of the vagina. Those with a history of extensive cervical cell changes or cervical cancer, should continue to get screened for 20 years after the procedure.

What are the exceptions to cervical screening guidelines?

You might be advised screening more frequently if you:

Are HIV positive
Have a compromised immune system
Were exposed to a drug called diethylstilbestrol (DES) sometimes prescribed to expecting women in the 70s
Received an irregular cervical screening test or biopsy result
Have had cervical cancer

Why is screening not advised before one turns 21?

It is widely established that the incidence of cervical cancer is extremely rare in this age group, with less than even 1 in 1000 cervical cancer cases striking young women aged 15 to 19. Women usually get the HPV infection soon after they start having vaginal intercourse. However, these infections usually disappear within a couple of years on the outside, and don’t precipitate any changes in the cervical cells. Doctors concur that screening among this age group doesn’t cut down the incidence of cervical cancer, while it could result in needless medical treatment.