Pap Smears after age 65

Well as it turns out I just learned something about this. I had a total hysterectomy at age 38. And since 60 all my gyn docs have said I don’t need one (actually I’m not sure I’ve had one since my hysterectomy).

This year, new doc and asked “have you ever had an abnormal pap?” Well yes I did in my 20’s .. had cryosurgery for it. Well, she says “we need to do a pap”. And it showed low grade squamous cells. Biopsy taken on Colposcopy showed same as pap - but I’m good for another year.

So.. did you ever have an abnormal Pap? And the guidelines are just that. I’d you want one you can have one.

Thx for replying. I didn’t know that you need a pap after a hysterectomy.
Since you’re be had normal pap smears since 1990, I was told I can’t have any more. I’m not sure my doctor will allow me to have one just because I want one.

It’s not how long you’ve had normal paps, it’s did you EVER have an abnormal one? And if that answer is yes - he will have to do it and the insurer will have to pay.

I hadn’t had an abnormal one in 50 years and only normal ones between the abnormal one and my hysterectomy. But here and now _ 50 yrs later I had an abnormal result - had a biopsy which was same as pap. And I get another pap in a year

Do you recall ever having an abnormal one? If not, count your blessings and you are done.

What's really sad about the pap smear debate is that Cervical cancer grows so slowly. So the equation for testing and this is for all testing, paps, mammograms everything. Is the equation takes into account your age. How quickly cancer can grow because as we age cancer grows far slower than in our youth. So at 65 if you say had a slow growing cancer it may not kill you till your well into your 70's and they figure something going to kill you. It overburdens the system to continue to test people. The "system" is set up to reap the highest profits all while not bankrupting the country. The term "cost effective" is used in medicine today because its the way it's set up. Always remember this, you are your best advocate, if you want the test demand it!

I had cryotherapy 30 years ago. Not sure if I had an abnormal Pap smear in the following 5 years. I feel like I may have had an abnormal reading 5 years after the cryotherapy, but I had a second reading and it ended up being normal. So that was about 25 years ago.

I do know that the preceding ten years from today, they were all negative.

This is from Mayo Clinic:
In general, women older than age 65 don’t need Pap testing if their previous tests were negative and they have had three Pap tests, or two combined Pap and HPV tests, in the preceding 10 years. However, there are situations in which a health care provider may recommend continued Pap testing.

Women with a history of cervical cancer or high-grade, abnormal Pap tests over the past 20 years should continue cervical cancer screening.

Thank you, Gigi. I so agree with you, and I’m willing to pay out of pocket and will most likely still be told not to do it. So am I to insist upon it? Do I find yet another doctor who will perform it?
Here’s another debate- if you have dense tissue, they put a warning on your mammogram. My doctors alway say that the risks are sooooo low. I believe there are two states where sonograms are required for further testing. My niece in NY was required to have the sonogram because she has dense breast tissue. And they ended up finding a very small cancer! Thankfully they found it so early and she had surgery to remove it. She may have had radiation as well. How scary is that?

Well I’m glad I had a GYN who didn’t care when my abnormal pap in the past was. And she couldn’t look at the past 10 years of pap results because no one did one.
I have a friend who is a hospice nurse and she says the incidence of vulvar cancer in old women would shock us.

I’m going to write him in my portal that I still want to get Pap smears. If my doc will not do it, then I’ll find one who will. It’s a shame because I really like him.

Exactly. They are required to warn me that I have dense breasts and so may miss small tumors. They are not required to look harder or smarter. Or to push back on insurers who are discouraging it.

I, too, was told that I no longer needed Pap tests and was thankful due to vaginal dryness that made it so painful, but last year at age 68 noticed some slight bleeding and had to have one (uterus intact). No signs of cancer, but have been advised to have yearly pap.