When to Do

When Is the Right Time to Start Pap Smear Testing?

It is recommended to start cervical cancer screening at 21 years of age, even if:

• One feels perfectly healthy. This is because early changes in cervix often have no symptoms. And screening helps catch them before they become cancerous.

• One is vaccinated for HPV. This is because the vaccine is preventive. It doesn't clear the already existing viruses that can be dormant and asymptomatic for a long time.

International Guidelines

We follow the latest evidence-based clinical guidelines for cervical health, including:

• ACOG (American College of Obstetricians and Gynecologists) Updated Cervical Cancer Screening Guidelines

• FOGSI (Federation of Obstetric and Gynaecological Societies of India) Guidelines for India

Age group	Recommended test and frequency
<21 years	No screening needed even if sexually active
21–29 years	Pap smear every 3 years
30–65 years	3 options: Pap smear + HPV Test every 5 years (preferred option) Pap smear alone every 3 years HPV Test alone every 3 years
>65 years	No screening if prior results normal
Post-hysterectomy	No Pap smear needed if cervix removed & no cancer history
Special cases: Previous abnormal Pap or a positive HPV test Cervical cancer in the past HIV infection A weakened immune system (due to chemotherapy/ autoimmune disorders)	Frequent screenings at least once every year

Note

In the FOGSI Indian guidelines only difference is that the start age is at 25 years instead of 21 years.

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Medically reviewed by

Dr Poonguzhali Liston

Researched by

Dr Poonguzhali Liston

Written by

Dr Poonguzhali Liston

References

1. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening#fullrecommendationstart

2. https://www.fogsi.org/wp-content/uploads/2018/03/FOGSI-GCPR-March-2018-final.pdf