"When Can I Stop Getting Pap Smears?"
Ever wonder when you can retire from Pap smears without putting your health at risk?
Most women would rather schedule a root canal than a Pap smear (at least with the root canal, you get laughing gas or local anesthesia). But Pap smears have saved countless lives since the 1940s, and as a gynecologist, they’re the bread and butter of what we do.
When done right, they’re only 5-10 minutes long and painless. (If yours isn’t, that’s a problem. Talk with your doctor!)
Still, after decades of stirrups and paper gowns, it’s fair to wonder: When can I stop doing this?
The short answer: It depends. Most guidelines say you can stop at 65 if you meet certain criteria. But why that age? It comes down to what we’re screening for and why your risk changes over time.
What Are We Actually Screening For?
Cervical cancer. Or more specifically, the changes that lead to it.
Pap smears detect abnormal cervical cells, and nearly all those changes are caused by persistent HPV infection (human papillomavirus).
Because HPV is transmitted sexually, your risk of developing cervical cancer drops as you age, especially if you’ve had consistently normal results and aren’t exposed to new partners.
The 3 Key Criteria Over Age 65
According to ACOG, you can stop cervical cancer screening at 65 if you check three boxes:
- At least three consecutive negative Pap tests or two consecutive negative HPV tests in the past 10 years.
- No history of abnormal results (like CIN2 or higher).
- No history of cervical cancer, pre-cancer, and you’re not immunocompromised.
Meet all three? Congrats, you’ve retired from Pap smears.
- Doctor’s Note: This does not mean you can ditch your annual gynecology exam. Gynecologists are primary care doctors for the entire woman. We screen for breast disease, depression, anxiety, metabolic syndrome, heart disease, osteoporosis, etc.
And foregoing the pap smear doesn’t mean skipping the speculum. Your doctor should still be doing a visual inspection of the vagina and cervix.
What If You’ve Had a Hysterectomy?
If your cervix was fully removed for benign reasons (think fibroids or heavy bleeding) and you have no history of precancer, you’re off the hook.
But if your cervix was left in place—or your hysterectomy was done because of cancer or high-grade changes—you definitely still need screening.
What About New Sexual Partners?
If you’re over 65 and have been busy (wink wink), then yes, you could technically be exposed to HPV again. However, ACOG doesn’t recommend restarting screening.
- The Why: At this age, your body is much better at clearing HPV infections, and new cases rarely progress to cancer.
Can I Keep Doing It for Peace of Mind?
After decades of testing, it can feel strange to just…stop.
But unnecessary Pap smears can lead to a cascade of false positives, anxiety, unwarranted procedures, and mounting costs, all without improving outcomes.
It’s not worth the trouble, as cervical cancer is rare if you’ve had adequate prior screening. That’s the magic phrase: adequate prior screening. If you’re under 65, keep showing up to your annual appointment.
But if you’re over 65 and meet the criteria? Ask your doctor if it’s time to cross it off for good. For many women, it’s a medical milestone worth celebrating!
