What is a Pap smear, and how often do you need one?
A Pap smear checks cells from the cervix, and US guidance from the USPSTF places it every 3 years from 21, with an HPV test every 5 years from 30. In the UK it is called cervical screening and invitations come every 5 years from 25 if you are HPV-negative; either way it is one of the routine health checks for women.
If a Pap smear is coming up and you feel unsure about it, that's common, and the short answers are reassuring. The test does not usually hurt, though the NHS notes it can be uncomfortable or painful for some people, and you can ask to stop at any time. The CDC says it can still be done during your period, and that results can take as long as three weeks to arrive. A Pap smear, also called a Pap test, takes cells from the cervix, the narrow lower end of the uterus, so that changes can be found early. In the US it is often done by a gynecologist or OB-GYN. In the UK, where smear test is the older name, it is usually done by a practice nurse at a GP surgery.
What happens during a Pap smear test?
A Pap smear test takes a small sample of cells from the cervix, and the appointment is short. The NHS says the test itself takes under 5 minutes and the whole appointment about 10 minutes.
Two tools are used. A speculum, made of plastic or metal, gently opens the vagina so the cervix can be seen, and a soft brush collects the cells, which are sent to a lab. The NHS notes that a smaller speculum can be requested, so it's worth mentioning if that would help you feel more comfortable.
The lab can look at the sample in two ways. A Pap test, also called cytology, examines the cells themselves. An HPV test looks for high-risk types of human papillomavirus (HPV). Cotesting means both are done. The schedule depends on which test is used, so it's worth asking which one you are having and noting it alongside the date.
What does the evidence say about cervical screening?
Screening schedules come from published guidelines, and the three most readers will meet all recommend regular testing through most of adult life while differing on where to begin. In the US, the USPSTF's recommendation statement starts with cytology, the Pap test, at 21 and keeps to that single test until 30.
From 30 to 65 the USPSTF accepts three options: a Pap test alone every 3 years, an HPV test alone every 5 years, or cotesting every 5 years. The interval follows the test, so a move to HPV testing lengthens the gap between appointments.
The American Cancer Society (ACS) prefers a primary HPV test every 5 years, starting at 25 and continuing to at least 65. This is why a first test appears at 21 in one place and 25 in another: each age comes from a published guideline, and the difference lies between the bodies that write them.
The UK program sits closer to the ACS. The NHS invites people aged 25 to 64 every 5 years. In England, the gap for those who test HPV-negative moved from 3 years to 5 years in July 2025 (NHS England 2025), so a longer wait for your next invitation than last time can simply reflect that change.
Both US bodies tie the end of screening to your record as well as your age: the USPSTF recommends against screening after 65 only where earlier screening was adequate.
For the vaccine side of HPV, when to get the HPV vaccine is written for the years before screening begins.
How often should you get a Pap smear?
A sensible way to read the schedules is by test and not by calendar year. In the US, a Pap test alone comes round every 3 years, and an HPV test, alone or alongside a Pap, every 5 years. In the UK there is one rhythm: an invitation every 5 years for those who are HPV-negative.
Screening usually stops at 65 if recent results were normal, and in the UK routine invitations run to 64. Because stopping rests on your record, it's worth knowing the dates and results of your latest tests as that age approaches.
Many women find it helpful to talk through timing at a well woman exam, where the date and type of your last test can be matched to the right interval. In the UK the invitation does that job, and your GP surgery can tell you when the next one is due.
What do the guidelines leave open?
The guidelines were written at different times, which explains some of the gap between them. The USPSTF statement dates from 2018 and an update is in progress, while the ACS revised its guidance in 2025, so it's worth checking the date on any schedule you are given.
Where a guideline lists more than one accepted option, as the USPSTF does from 30, it does not rank them. The ACS names a preference, and it also lists self-collected HPV testing, using FDA-approved devices ordered by a provider, as an option every 3 years.
The published intervals also assume a run of normal results and a cervix to screen. The USPSTF does not recommend screening after a hysterectomy that removed the cervix, so it's worth telling your doctor or nurse which operation you had. And because the stopping rules count consecutive normal results, an abnormal result along the way means the usual stopping point no longer applies automatically; your doctor or nurse (in the UK, your GP surgery or practice nurse) can set out what follows for you.
Pap smear and cervical screening by life stage
| Stage | Figure | Why | Read more |
|---|---|---|---|
| Childhood | Not started; first screening at 21 (USPSTF) or 25 (ACS; UK) | Screening begins in the adult years. | Health checks |
| Puberty | Not started | The first test is still some years away. | Health checks |
| Reproductive years | 21: Pap every 3 y; 30: HPV every 5 y (UK: from 25, every 5 y if HPV-negative) | Screening starts and the test type shifts with age. | Health checks |
| Perimenopause | HPV every 5 y, or Pap every 3 y; to about 65 | The interval follows the test used. | Health checks |
| Menopause | HPV every 5 y, to 65 | Screening continues on the same rhythm. | Health checks |
| Postmenopause | Usually stops at 65 if recent results were normal; HPV test | Stopping depends on earlier normal results. | Health checks |
Guidance by country
Facts
Common questions
Does a Pap smear hurt?
For most people, no, though some find it uncomfortable. What tends to help is speaking up before it starts: mentioning that you are nervous, or that an earlier test hurt, lets the nurse or doctor go at your pace and pause whenever you ask. The part with the speculum is over in under 5 minutes, according to the NHS.
Can I get a Pap smear during my period?
Yes, the CDC confirms this for both the Pap test and the HPV test. If you would rather move the date, the office that booked you can offer another one. In the UK, your GP surgery or practice nurse can say whether to keep or rebook the appointment. Mentioning heavy bleeding when you book lets them advise on timing.
How often should you get a Pap smear, and when can it stop?
In the US, every 3 years with a Pap test or every 5 with an HPV test; in the UK, every 5 years, with routine invitations ending at 64. To stop at 65, the USPSTF looks for 3 consecutive negative Pap results, or 2 consecutive negative cotests, within 10 years, the latest within 5 years. The ACS looks for the last 2 normal HPV tests or the last 3 normal Paps.
How long do Pap smear results take?
In the US, the CDC's figure is up to three weeks. In the UK, the nurse or doctor tells you at the appointment when to expect yours, and the NHS suggests calling your GP surgery if you have waited longer than that. It's worth asking before you leave how the results will reach you and who to call with questions.
Is any preparation needed before a Pap smear?
For a Pap test, the CDC suggests leaving out sex, douching, vaginal medicines and spermicidal foam for 2 days beforehand. No preparation is needed for an HPV test. That is US guidance; in the UK, your GP surgery can tell you which test is planned and whether anything is needed before your appointment.
Next steps
A good place to start is to find out when your last Pap smear or HPV test was and which one it was, then ask your doctor, nurse or GP surgery which schedule that puts you on. Bleeding 12 months or more after your last period, or symptoms that are getting worse, are worth a doctor's visit now, without waiting for the next screening date. Screening is not one size fits all: your age, your earlier results and your own preferences all shape it, so the test, the interval and the timing are yours to decide.
See a doctor promptly if you have
- Any bleeding 12 months or more after your last period
- Symptoms that are getting worse
Sources
The guidelines and studies this page draws on.
- Cervical Cancer: Screening (final recommendation statement), USPSTF (2018)
- Cervical Cancer Screening Guidelines, American Cancer Society (2025)
- Cervical screening, NHS (n.d.)
- What happens at your cervical screening appointment, NHS (n.d.)
- Your cervical screening results, NHS (n.d.)
- Cervical Cancer Screening, CDC (n.d.)