Pap tests no longer urged for women under 20

Pap smears are no longer being recommended for women aged 20 and younger in Nova Scotia, according to Cancer Care Nova Scotia's revised guidelines.

Cancer Care Nova Scotia changes Pap smear guidelines

Pap smears are no longer being recommended for women aged 20 and younger, according to Cancer Care Nova Scotia's revised guidelines.

The organization announced its updated recommendations for cervical cancer screenings on Wednesday, following reviews of the Canadian Task Force on Preventive Health Care's new guidelines released earlier this year.

"Our updated guidelines reflect increased knowledge of how cervical cancer develops, and a greater understanding of the benefits and potential harms of screening," Dr. Robert Grimshaw, the cancer group's medical director, said in a release.

The Cervical Cancer Prevention Program now advises:

  • Women should start having regular Pap tests at age 21 or within three years of first vaginal sexual activity, whichever comes last.
  • Women between the ages of 25 and 69 should have a Pap test every three years.
  • Women 70 and older who have had three normal Pap tests in a row don't need be screened anymore.
  • Women 70 and older who have not had a string of normal Pap tests should continue getting tested every three years until they do.

Grimshaw said the guidelines will likely change again when health officials get more data about the human papillomavirus vaccination program that started in Nova Scotia schools in 2007. HPV is a common virus transmitted through sexual activity and is the leading cause of cervical cancer.

He stressed that regular Pap smears are still vital to prevent cervical cancer, "but we now have a better understanding of who needs a Pap test and how often."

Some women said the new guidelines send the wrong message.

"They could be sexually active for eight years and not have to get a Pap test because they would only have been 16 at the time and so it's not the best preventative measure at all," said Amanda Nailor.

"I feel like it's more beneficial if you are getting it more frequently instead of waiting three years and then finding out that there is something you have to deal with and it could be too late after the fact."

Grimshaw said young women have stronger immune systems and there's no need to go through the process early, especially since four per cent of Pap test results show false positives.

"Screening those women, though, leads to them coming to see people like me, who take biopsies from their cervices and treat them and that treatment, we've learned, is actually unnecessary," he said.

"They resolve those abnormalities on their own without treatment. If there's abnormalities, they're still present when they're 21 and they'll be detected then and treated then."

Cancer Care Nova Scotia said while it does stand by these new guidelines, women are still urged to speak with their family doctor about what's right for them.


To encourage thoughtful and respectful conversations, first and last names will appear with each submission to CBC/Radio-Canada's online communities (except in children and youth-oriented communities). Pseudonyms will no longer be permitted.

By submitting a comment, you accept that CBC has the right to reproduce and publish that comment in whole or in part, in any manner CBC chooses. Please note that CBC does not endorse the opinions expressed in comments. Comments on this story are moderated according to our Submission Guidelines. Comments are welcome while open. We reserve the right to close comments at any time.