Pap tests for older women

Older women still need health checkups and screening tests. That means continuing to get regular gynecological exams and Pap tests even when you are in or beyond menopause. You likely won't need Pap tests after age 65. But you will still need pelvic exams.

Pelvic exams and Pap tests

Pap tests are often part of a regular pelvic exam for younger women. That’s because the Pap test is one of the best ways to find or prevent cervical cancer. Pap tests can also find problems that aren’t cancer. These problems include abnormalities and infections. A separate test can find out if a woman has human papillomavirus (HPV). This virus is the main risk factor for cervical cancer.

Cervical cancer and other cancers of the vagina and uterus often cause no symptoms. Screening tests and regular physical exams are often the only way to find these problems. The earlier cervical cancer and other female cancers are found, the easier they are to treat.

When can you stop?

Healthcare providers take into consideration many medical factors when deciding when a woman who is 65 or older should stop having Pap tests. Ask your healthcare provider for his or her recommendation. If you have had a normal Pap test for the last 10 years, you may be able to stop having them.

You may still need a pelvic exam, though. A pelvic exam lets your healthcare provider feel your uterus and surrounding organs. This exam can help find problems and some types of cancer.

You may still need a Pap test after age 65 if either of these applies to you:

• You have had a total hysterectomy to treat cervical cancer or precancer. This is often done to be sure that no cancer cells remain or return.
• You had a serious cervical precancer within the last 20 years.
• You are at high risk for cervical cancer because your immune system is suppressed or you were exposed to diethylstilbestrol (DES), a hormone medicine, in the womb.

Medicare coverage

Pelvic exams and Pap tests are covered under Medicare Part B plans. You do not have to pay for these services if your healthcare provider accepts Medicare. Medicare allows both of these exams to be done every 2 years. It will cover 1 screening every 12 months for women who are at high risk for cervical cancer.

These are risk factors for cervical cancer:

• Your mother took DES while pregnant with you.
• You have had a history of STDs (sexually transmitted diseases)
• You have been infected with certain strains of HPV.
• You have had cervical or vaginal cancer.
• You had an abnormal Pap test in the past.
• You smoke or have a history of smoking.
• You have been infected with HIV (human immunodeficiency virus).
• Your diet is low in fruits and vegetables.
• You are overweight.
• You have had 3 or more full-term pregnancies.
• You were younger than 17 at your first full-term pregnancy.

Talk to your healthcare provider about your health history and cervical cancer risk to decide on the best screening plan for you.

Dr. Jack Jacob specializes in Gynecology at Crescent City Physicians, Inc., a subsidiary of Touro Infirmary. After earning his medical degree from Louisiana State University School of Medicine in New Orleans, Dr. Jacob completed his residency at LSU Health Science Center.