All women who have ever been sexually active should have regular cervical smear tests from the time they turn 20 until they turn 70.

This includes:

• all women who have been immunised against HPV
• women who are single
• lesbians
• disabled women
• women who have been through menopause
• women who are no longer having sex.

     HPV immunised women must continue to be screened.

Women who have been immunised should continue with screening because the vaccine does not protect against all types of the virus that cause cervical cancer.  Furthermore, no vaccine can guarantee complete protection to everyone immunised.  

All women are advised to start having regular cervical smear tests at the age of 20.  Screening at a younger age is not recommended, even if a woman has had sex.  Screening from 20 onward is recommended because, in New Zealand, it is very rare for women under this age to develop cervical cancer.

Some older women think they do not need to have cervical smear tests, especially if they are no longer sexually active.  However, there is still a chance that abnormal cells will appear in later life and progress to cancer.  If older women continue to have regular cervical smear tests until they turn 70, it is likely that any abnormal cells will be found and treated before they become cancer.                     

It is very unlikely that women over 70 will develop cervical cancer if their previous smears have been normal.  However, women aged 70 and over who have never had a cervical smear test are advised to have a smear test followed by another a year later.  If both tests are normal, no further tests will be needed.                

If a woman has had abnormal smears in the past, her smear taker or doctor will advise her when it is best to stop having cervical smear tests.                       

Women who have never been sexually active do not need to have cervical smear tests.

Women who have had a hysterectomy

Women who have had a subtotal hysterectomy (in which the cervix is not removed) need to continue to have cervical smear tests.

Women who have had a total hysterectomy (in which both the uterus and the cervix are removed) do not usually need to have smear tests unless advised to do so.  Reasons they need to continue to have smear tests might include:

• a history of abnormal cell changes confirmed by biopsy
• cervical abnormalities found at the time of surgery
• having had the hysterectomy because of abnormal cells or cervical cancer.

When a woman has had a total hysterectomy, the smear (called a vaginal vault smear) is taken from the top of the vagina. If you are not sure whether you need to continue to have cervical smear tests after a hysterectomy, ask your doctor.

Women who are pregnant or who have just had a baby

Women who are pregnant or have a new baby and are due for a cervical smear test should check with their midwife, specialist or lead maternity carer (LMC) before having a smear.