Table 1.

Professional Medical Society Guidelines for Pap Smear Screening Intervals

American Cancer Society, 20029	After initiation of screening, cervical screening should be performed annually with conventional cervical cytology OR every 2 years using liquid-based cytology; at or after age 30, women who have had 3 consecutive, technically satisfactory normal/negative cytology results may be screened every 2 to 3 years (unless they have a history of in utero DES exposure, are HIV positive, or are immunocompromised by organ transplantation, chemotherapy, or chronic corticosteroid treatment).
American College of Obstetrics and Gynecology, 199510	All women who are or who have been sexually active or who have reached age 18 should undergo an annual Pap test and pelvic examination. After a woman has had 3 or more consecutive, satisfactory annual examinations with normal findings, the Pap test may be performed less frequently in a low-risk woman at the discretion of her physician.
	Certain high-risk factors have been associated with the development of cervical intraepithelial neoplasia and cervical carcinoma. The College recommends that when 1 or more of these risk factors is present, more frequent Pap tests may be required. High-risk factors include:
	Women who have had multiple sexual partners OR whose male partners have had multiple partners
	Women who began sexual intercourse at an early age
	Women whose male sexual partners have had other sexual partners with cervical cancer
	Women with current or prior human papillomavirus infection or condylomata or both
	Women with current or prior herpes simplex virus infection
	Women who are infected with the human immunodeficiency virus (HIV)
	Women with a history of other sexually transmitted diseases
	Women who are immunosuppressed (such as those who have received renal transplants)
	Smokers and abusers of other substances
	Women who have a history of cervical dysplasia or cervical cancer or endometrial, vaginal, or vulvar cancer
	Women of lower socioeconomic status
American College of Physicians, 19915	Women should be screened at least every 3 years starting in their early 20s, and continuing into their 60s. For most women, a 3-year frequency is appropriate. Some women, however, might prefer more intensive screening (for example every 2 years or even annually). If there are questions, women should be given information on the expected benefits, risks, and costs, and allowed to choose.
U.S. Preventive Services Task Force, 19968	There is little evidence that annual screening achieves better outcomes than screening every 3 years. Pap tests should be performed at least every 3 years (“B” recommendation). The interval for each patient should be recommended by the physician based on risk factors (e.g., early onset of sexual intercourse, a history of multiple sex partners, low socioeconomic status). (Women infected with human immunodeficiency virus require more frequent screening according to established guidelines.)