Most women can wait three to five years between Pap tests to screen for cervical cancer, according to guidelines released by the American College of Obstetricians and Gynecologists (ACOG).
The latest recommendation, which appeared in Obstetrics and Gynecology and is in line with earlier sets of recommendations, marks a further shift away from annual Pap testing, which was once the standard advice.
Now ACOG and the other groups say most women aged 21 to 29 should have a Pap test no more than every three years.
For women ages 30 to 65, the best option is to have a Pap test, along with a test for human papillomavirus (HPV), every five years. Otherwise, a Pap test alone every three years is"acceptable."
"Women can feel very comfortable with this," said David Chelmow, who heads obstetrics and gynecology at Virginia Commonwealth University and led the development of the ACOG guidelines. "The bottom line is, this is enough."
Cervical cancer is caused by long-term infection with certain types of HPV, a virus that causes warts, including genital warts. But there are over 100 strains of HPV, only some linked to cervical cancer.
The Pap test is done to look for abnormalities in cervical cells that may or may not become cancer. The HPV test helps refine things by showing whether a woman has a strain linked to cervical cancer.
But women younger than 30 should not have the HPV test, Cherlmow said. That's because women that age commonly carry the virus, but for a relatively short time before the immune system wipes it out. So testing young women would largely catch short-lived HPV infections that would not contribute to cancer later.
All the new guidelines, Chelmow noted, are aimed at giving women and doctors clearer direction on how often to do cervical cancer screening - and avoid over-testing.
There is now a vaccine against HPV, and women who have gotten it may wonder if they need cervical cancer screening.
The answer is yes, Chelmow said. "They should follow the same screening recommendations as everyone else."
The American Cancer Society estimates that about 12,200 US women will be diagnosed with cervical cancer this year, and 4,200 will die from the disease.