Cytology: how often?

Women should start cytological tests no later than the age of 25 (in Poland, usually between 18 and 21 years of age) and no later than 3 years after the start of sexual intercourse.

Cytology may be performed every 3 years if the two previous results were normal, the smears were satisfactory and contained both disc and cervical canal cells, and there are no risk factors.

Pap smears should also be performed in the following situations: taking and starting oral contraception, inserting an intrauterine device, taking and starting HRT, becoming pregnant and after the end of pregnancy, after diagnosis of condyloma acuminata or other venereal diseases.

The risk factors that require more frequent cytological tests include: abnormal results of previous cytological smears, condition after oncological treatment due to precancerous conditions or cancer of the cervix and/or vagina and vulva, infection with the human papillomavirus HPV, especially the highly oncogenic subtype, risky sexual behavior and frequent changes of partners, heavy smoking, long-term use of two-component hormonal contraception, concomitant infectious diseases in the reproductive organs (genital herpes virus, chlamydia), immunosuppression (both congenital and acquired and iatrogenic, after the use of drugs that lower immunity in the case of organ transplants or tissues), HIV infection, proven HPV infection of the reproductive organs in a sexual partner. Women with at least one of the risk factors should have cytological tests performed more frequently.