The guidelines as to who should undergo testing and on what schedule have been a controversial and sometimes confusing matter. These recommendations have also changed over time. There are even some significant differences among the current guidelines, which have been developed by different medical organizations.
Generally, pap screening is recommended for all women who are 18 years old or over or who are sexually active. (For example, a sexually active 16 year old girl should have a Pap smear.)
Although the recommended frequency of testing is usually once per year, a woman's clinician may recommend more frequent Pap smears based upon her personal medical history.
Pregnancy does not prevent a woman from having a Pap smear. Pap smears can be safely done during pregnancy.
For women 65 years or older, current screening guidelines provide that women who have had at least three (3) documented normal Pap smears no longer require screening. Practically speaking, if a clinician sees a woman over age 65 who has not been regularly screened, the clinician generally recommends annual Pap testing three years in a row and then discontinuing screening, or at least decreasing its frequency, if all three Pap smears are normal.
For women who have had a hysterectomy, recent recommendations state that Pap screening can be discontinued as long as the hysterectomy was not done because of cancer or precancerous conditions of the cervix.