Under Age 21
- ACOG doesn't recommend pelvic examinations for girls < 21 unless they have been sexually active or have a medical complaint such as pelvic pain, vaginitis or irregular menstrual periods
- If a younger girl is sexually active, ACOG recommends a pelvic exam, Pap smear, and STD testing (including for chlamydia and gonorrhea) within three years following first intercourse
Age 21 to 30
- Pelvic examinations with Pap smears should begin at age 21 for women who have not been sexually active
- Thereafter, annual screening should continue up to age 30 (given higher risk for HPV in this group)
- Screen sexually active women 25 and under for chlamydia. Urine based testing is adequate.
Over 30
- Screening can be cut back to every two or three years whenever a woman has three consecutive test results that were normal (provided she has no conditions that affect the immune system, was not exposed to the drug diethylstilbestrol (DES) while in utero (before birth), and has no other medical problems that require annual or semi-annual examinations)
- Routine physical pelvic exams should continue annually.
65 and Older
- Although routine pelvic exams should continue after age 65, under certain conditions, Pap smears can be discontinued at this point
- If three consecutive Pap smears are normal and there have been no abnormal results during the previous 10 years (with no history of cervical cancer, HIV or other conditions that affect the immune system, is at no risk of acquiring STDs, and was not exposed to DES) Pap smears can be eliminated from the annual exam
Exceptions
If a woman of any age has a complete hysterectomy for reasons other than cancer and has never had cervical cancer or abnormal Pap smears, Pap testing may be eliminated from routine pelvic exams, according to ACOG guidelines.
- ACOG doesn't recommend pelvic examinations for girls < 21 unless they have been sexually active or have a medical complaint such as pelvic pain, vaginitis or irregular menstrual periods
- If a younger girl is sexually active, ACOG recommends a pelvic exam, Pap smear, and STD testing (including for chlamydia and gonorrhea) within three years following first intercourse
- All women between ages 19 and 64 who are sexually active should be tested for human immunodeficiency virus (HIV)
Age 21 to 30
- Pelvic examinations with Pap smears should begin at age 21 for women who have not been sexually active
- Thereafter, annual screening should continue up to age 30 (given higher risk for HPV in this group)
- Screen sexually active women 25 and under for chlamydia. Urine based testing is adequate.
Over 30
- Screening can be cut back to every two or three years whenever a woman has three consecutive test results that were normal (provided she has no conditions that affect the immune system, was not exposed to the drug diethylstilbestrol (DES) while in utero (before birth), and has no other medical problems that require annual or semi-annual examinations)
- Routine physical pelvic exams should continue annually.
65 and Older
- Although routine pelvic exams should continue after age 65, under certain conditions, Pap smears can be discontinued at this point
- If three consecutive Pap smears are normal and there have been no abnormal results during the previous 10 years (with no history of cervical cancer, HIV or other conditions that affect the immune system, is at no risk of acquiring STDs, and was not exposed to DES) Pap smears can be eliminated from the annual exam
Exceptions
If a woman of any age has a complete hysterectomy for reasons other than cancer and has never had cervical cancer or abnormal Pap smears, Pap testing may be eliminated from routine pelvic exams, according to ACOG guidelines.
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