November 4, 2026

How Often Do You Need a Pap Smear? Guidelines by Age

Medically reviewed by Dr. Merlin Brown, MD — Board-certified Internist.

Most people need a Pap smear every 3 years from age 21 to 29. From 30 to 65, you can choose a Pap every 3 years, an HPV test every 5 years, or both together every 5 years. Many people can stop after 65 if recent results were normal. Your doctor may advise more frequent testing.

What Is a Pap Smear, and How Is It Different From an HPV Test?

A Pap smear (also called a Pap test) collects cells from the cervix. A laboratory then checks them for changes that could turn into cancer. The Pap test looks for precancers, which are cell changes on the cervix that might become cancer if not treated.

An HPV test looks for something different. It checks for the virus (human papillomavirus) that can cause those cell changes. In simple terms, the Pap test looks for damage, and the HPV test looks for the cause.

Why does this matter?
HPV is very common. By age 50, at least 4 out of every 5 women will have been infected with HPV at some point. Most infections are harmless. The World Health Organization (WHO) reports that in 90% of people the body controls the infection by itself. Problems arise when a high-risk type stays in the body. According to the CDC data about 10% of women with HPV on the cervix develop long-lasting infections that raise cervical cancer risk.

The good news is that cervical cancer grows slowly. It usually takes 15 to 20 years to develop after HPV infection. Regular screening is designed to catch changes during that long window. Removing precancers prevents cervical cancer over 95% of the time.

HPV Test vs. Pap Smear: What’s the Difference?

Both tests use a sample of cells from the cervix, and they can be done at the same visit. When both are done together, it is called co-testing. The difference is what the lab looks for:

Difference	Pap smear	HPV test
What it checks	Cervical cells for abnormal changes	Cervical cells for high-risk HPV
What it finds	Precancers and, sometimes, cancer cells	The virus that can cause precancer
Ages	21 to 65	30 to 65
If normal, repeat in	3 years	5 years
Main limit	May miss abnormal cells that are present	A positive result does not mean you have cancer

Pap Smear Guidelines by Age

Age	Recommended screening	How often
Under 21	No screening needed	Not applicable
21 to 29	Pap test	Every 3 years
30 to 65	HPV test alone (now preferred by HRSA)	Every 5 years
30 to 65	HPV and Pap together (co-testing)	Every 5 years
30 to 65	Pap test alone	Every 3 years
Over 65	Stop only if your doctor confirms your history is normal	Ask your doctor

Pap smear after 30: Your options widen at 30. HPV tests become more useful at this age because, as the Office on Women’s Health explains, HPV is common in women younger than 30 but usually goes away on its own in these women. Testing for it earlier would often flag harmless infections.
What’s new in 2026: HRSA now considers high-risk HPV testing as the preferred option for women with average risk age 30-65, and offers a self-collection option. Pap testing is also available and continues to be recommended until age 29. American Cancer Society recommends repeating self-collected samples every 3 years if negative and clinician collected samples, every 5 years. Another option is to begin screening at age 25 with an HPV test, as recommended by the American Cancer Society. There is a slight variance from one major group to another, so please consult your doctor to obtain your desired schedule.
What age do you stop Pap smears? If you’ve had at least three normal Pap tests or two normal HPV Tests over the last decade and no prior precancer on your cervix, your doctor might recommend discontinuing the test once you reach age 65. You might need to continue if you had some abnormal results recently or if you have never had regular screening. Never decide on your own. Always consult your doctor first.

Who Is It Right For, and Who Should Be Careful?

According to the National Cancer Institute (NCI), everyone who has a cervix aged between 21 and 65 should have cervical screening, including those who are not sexually active, have had the HPV vaccination and/or are post-menopausal. The HPV vaccine will not protect you from all high-risk types of HPV infection so it is still important to follow screening guidelines.

Those who have had a complete hysterectomy (removal of the cervix) for non-cancerous or non-abnormal reasons may not require regular cervical screening. However, if you have had a hysterectomy for cervical cancer or pre-cancer or still have your cervix then talk to your provider about next steps.

You may need testing more often if you:

Are living with HIV or have a weakened immune system
Were exposed to diethylstilbestrol (DES) before birth
Had a recent abnormal result or biopsy
Have had cervical cancer

Note: These groups are listed by the National Cancer Institute. WHO advises that women living with HIV be screened every 3 years starting at age 25.

Risks, Limits, and Warning Signs

Screening is safe, but there may be some risks. Possible side effects include the risk of false-positive and false-negative results as well as investigations or treatments that may not have been necessary. A false negative indicates that something has been overlooked. This alone can be an urging reason to return according to the schedule. It is likely that the next tests will catch it.

Most don’t feel pain, they feel pressure. According to the Office on Women’s Health, the test takes only about 5 minutes and the woman may have light spotting afterwards. It generally takes from one to three weeks to get results. Having an abnormal result doesn’t mean cancer. Most small changes will return to normal own their own steam.

Do not wait for your next test if you notice symptoms. Some of the symptoms of cervical cancer that are mentioned in the WHO list are: Bleeding between periods, bleeding after sex, and foul-smelling vaginal discharge. While there may be different causes, they call for immediate attention.

Preparing for the test:
The CDC recommends abstaining from sexual intercourse, douching, and use of any vaginal medications or spermicidal foams 2 days before the test. The test can still be conducted while you are menstruating.

How Southdale Physicians Handles Pap and HPV Screening in Edina

Southdale Physicians provides routine cervical cancer screening with both Pap smear and HPV co-testing for affected women. We comply with all USPSTF and ACOG guidelines, which means that the frequency of your tests will depend on your age and medical history. Many of our patients opt for our comprehensive Female Health Screening Package, which includes Pap smear and HPV testing, clinical breast exam with mammography referral, blood pressure and body mass index measurements, thyroid, lipid profile and blood glucose tests, STI screening according to your risks and preferences. Bundling reduces separate appointments and gives you a full baseline in one visit.

Finally, cervical cancer can be prevented and is a slow developing disease that can be detected early with screening. Just follow your schedule according to your age and medical history, consult your doctor about whether you need an HPV test or a Pap smear or both and never miss your appointments.