published Thursday, February 7th, 2013

Ask a doctor: My doctor didn't do a pap smear at my last appointment. Doesn't everybody need one yearly?

Dr. Kristi Hawken-Angevine

Q: My doctor didn't do a pap smear at my last appointment. Doesn't everybody need one yearly?

A: Although this may seem surprising, the answer is no. Pap smears screen for cervical cancer by detecting changes that precede cancer by many years. Several medical groups (including the American College of OB/GYN and the American Cancer Society) agree that for most healthy women: 1) Start pap smears at age 21; if normal, repeat every three years; 2) from ages 30 to 65, it's preferable to perform co-testing with a pap smear and HPV test and, if both are normal, repeat co-testing every five years. The reason for not performing annual pap smears is because many changes on the cervix are transient and resolve spontaneously over time. More frequent screening detects these changes, prompting additional procedures, biopsies and even surgery without increasing identification of cancer. Longer screening intervals avoid this pitfall and allow detection of meaningful changes. However, everyone is unique. Certain women require more frequent screening. Discuss this with your doctor. Together, you can determine the best screening schedule for you.

— Dr. Kristi Hawken-Angevine, University Women's Services; member, Chattanooga-Hamilton County Medical Society

Readers: To submit a question for medical doctors, email it to Clint Cooper at See this space each week for answers.

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