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Summary

Pap tests or Pap smears are important to detect cell changes which, if left untreated, could develop into cervical cancer. The risk of developing cervical cancer increases with age.

Pap tests are important to detect cell changes which, if left untreated, could develop into cervical cancer. The National Cervical Screening Program recommends that all women between the ages of 18 and 70 years who have ever been sexually active should have a Pap test every two years.

The most common type of cervical cancer usually takes around 10 years to develop. Having a Pap test every two years is recommended, unless your doctor advises you to have one more frequently.

The risk of developing cervical (neck of the womb) cancer increases with age. Yet according to PapScreen Victoria, older women often mistakenly believe their risk of cervical cancer is low, perhaps because they have had a hysterectomy, are widowed, or are no longer sexually active.

Around 43 per cent of Victorian women diagnosed with cervical cancer are aged over 50 years and the majority of women who develop the disease have never had a Pap test.

Risk factors


Certain types of the human papillomavirus (HPV) can cause the cell changes that, if left untreated, may lead to cervical cancer. Other factors may also play a role alongside HPV infection. These include:
  • Increasing age
  • Smoking
  • Long-term use of oral contraceptives
  • Lower levels of immunity
  • Early age of first sexual intercourse and childbirth
  • Presence of other sexually transmitted infections such as chlamydia.
Remember that having a Pap test is your best protection against developing cervical cancer.

The Pap test and what it can detect


A Pap test checks for changes to the cells of the cervix that may lead to cervical cancer if left untreated. A Pap test is not a diagnostic test and does not detect cervical cancer. Further tests are required to diagnose cervical cancer.

A Pap test does not check for ovarian cancer or any other types of cancer or conditions in the reproductive system. It does not check for sexually transmissible infections (STIs).

A small number of Pap tests show changes in the cells of the cervix, but most of these changes are caused by HPV infection. These usually clear up naturally or are easily treated. In a very small number of cases, the changes may develop into cervical cancer if left untreated. When detected early, changes to the cells of the cervix are easy to treat.

Some of the reasons why women don’t have regular Pap tests


According to research from the National Cervical Screening Program, reasons why Australian women don’t have regular Pap tests include:
  • Not knowing how important the Pap test is and what it detects
  • Pressing work and family commitments
  • Forgetting to keep track of the time interval between Pap tests
  • Other health concerns that take priority
  • The belief that cervical cancer ‘won’t happen to them’
  • The misconception that the Pap test detects cancer, not the presence of abnormal cells
  • Fear of cancer
  • Embarrassment about the procedure
  • Fear of discomfort during the procedure
  • Difficulties in accessing appropriate healthcare services.

Pap tests after menopause


Menopause occurs when a woman stops ovulating and her monthly period (menstruation) stops. A postmenopausal woman is no longer fertile, but this doesn’t reduce her risk of cervical cancer. The incidence of cervical cancer increases with age, so women over 50 years of age should continue to have regular Pap tests.

Lesbians


Lesbians should have regular Pap tests. As HPV is spread through genital skin contact, it is recommended that all women who have been sexually active, including lesbians, should have Pap tests every two years.

Long-term monogamy


Many older women who have been married and monogamous for decades mistakenly believe that screening is only appropriate for women who have multiple sex partners. All women who have ever been sexually active should have regular Pap tests until the age of 70.

Long-term abstinence


Since cervical cancer has been associated with sexual activity, women who have been celibate for some time – such as some divorced and widowed women – may mistakenly believe they are no longer at risk. It doesn’t matter how long it’s been since you last had sex, all women who have ever been sexually active should have regular Pap tests until the age of 70.

Social stigma


Since cervical cancer has been associated with sexual activity, some women may shy away from having Pap tests in case they are perceived as promiscuous. However, any woman who has ever been sexually active should have regular Pap tests until the age of 70.

Screening is still important after some types of hysterectomy


A hysterectomy is the surgical removal of the womb (uterus). This procedure is used to treat a variety of conditions including heavy or painful periods, fibroids and endometriosis.

Some women still need regular Pap tests following hysterectomy, including women who:
  • Still have their cervix
  • Have had the hysterectomy as part of treatment for gynaecological cancer
  • Have ever had a significant abnormality detected on a Pap test
  • Have never had a Pap test in their life or have not had regular Pap tests.
Women who are unsure if they should keep having Pap tests should check with their healthcare professional. If the healthcare professional has no records of the operation, an internal examination or a cell sample may be required.

Stopping the test at 70 years


Women who have had at least two normal Pap test results in the five years before turning 70 can stop having Pap tests. Those women in the over-70 age group who have not been having regular two-yearly Pap tests or have had abnormal results from recent Pap tests may need to keep having Pap tests for a few more years. Women should ask their doctor or nurse for advice. If you are over 70 and you want to keep having Pap tests, that’s fine too. Discuss this with your doctor.

Where to get help

Things to remember

  • The risk of developing cervical cancer increases with age.
  • Around 43 per cent of Victorian women diagnosed with cervical cancer are aged over 50 years.
  • Over 80 per cent of women diagnosed with invasive cervical cancer have had no or an inadequate screening history.
You might also be interested in: Want to know more?

Go to More information for support groups, related links and references.
This page has been produced in consultation with and approved by:

PapScreen Victoria

(Logo links to further information)
PapScreen Victoria

Last reviewed: May 2011

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Pap tests or Pap smears are important to detect cell changes which, if left untreated, could develop into cervical cancer. The risk of developing cervical cancer increases with age.



Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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