Does a virgin need a Pap smear?

Dear Alice,

Does a virgin need to have a Pap smear? Is cervical cancer the only disease a Pap smear detects? What are the means of contracting cervical cancer and any other possible diseases detected by the Pap smear?

— New at this

Dear New at this,

Keeping up with the different health recommendations can certainly be confusing, so it's great that you're being proactive about your preventive care! The Papanicolaou test (also known as a Pap test or Pap smear) is used to detect cell changes or abnormal cells on a cervix that may become precancerous or cancerous (the test may also be used to detect non-cancerous changes, too). Previously, it was recommended that people with cervixes begin getting Pap tests three years after becoming sexually active or by the age of 21, whichever came first. However, the United States Preventive Services Task Force (USPSTF) recently updated the recommendations, which now make no mention of previous sexual history. You also ask about how a person contracts cervical cancer. Folks don't actually catch cervical cancer: current research points to certain high-risk strains of the human papillomavirus (HPV) as the main cause of cervical cancer. Perhaps you're ready for more details on Paps? By all means, please continue reading!

Regarding the updated screening recommendations: the change was due to the finding that young people under the age of 21 were less likely to be diagnosed with cervical cancer and that if abnormal cervical cells were present, they were more likely to resolve on their own. The current recommendations are for people with cervixes aged 21 to 65 to be screened for cervical cancer every three years, and for those aged 30 to 65 to be screened every three or five years, depending on the type of testing selected. More specifically, the Pap test may also be paired with an HPV test within those three or five year intervals. HPV is typically transmitted through genital contact, such as vaginal, anal, or oral sex. With that in mind, the Pap test is certainly a useful initial tool to identify and work toward preventing the development of cervical cancer.

As far as results of a Pap test are concerned, there are three possible findings:

  • Normal (sometimes called negative): no abnormal cells were detected, and there is no action required until the next routine test
  • Unclear: the medical provider doesn't know whether the cells collected are normal or abnormal, and may do more testing right away to rule out potential problems, or may do another Pap test in six months or a year
  • Abnormal: cells collected from the cervix look abnormal

In the event that abnormal cells are found, additional testing may be recommended to further investigate the finding, which (depending on the specific abnormal result) may include an HPV test. 

Though HPV is the most common cause of cervical cancer, testing positive for HPV doesn't necessarily mean that cancer will develop — it can take years for abnormal cells to develop into cervical cancer. The good news is that in some cases, the immune system will fight HPV and the abnormal cells will resolve on their own. A positive HPV test following an abnormal Pap test may result in further monitoring of the cells (i.e., more frequent Pap tests) and a specific treatment plan.

No matter your sexual history, though, speaking with a gynecologist or reproductive health care specialist will help you determine if it's the right time to start getting a Pap test and help answer any other questions you might have about your sexual health. You may also ask them about getting the HPV vaccine, which typically provides the most protection against the strains of HPV that typically cause cervical cancer when you're vaccinated before becoming sexually active. Want to learn even more about this topic? Consider chatting with a health promotion professional to get more information.

Last updated Mar 13, 2020
Originally published Dec 21, 1995

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