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Pap smears on patients who are not sexually active

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Christina S. Chu, MD
Last Modified: April 14, 2002

Dear OncoLink "Ask The Experts,"
I work with developmentally disabled individuals. Several local doctors see no need in doing Pap tests on our ladies since they aren't sexually active and some would have to be anesthetized to do the procedure. What is your opinion?  

Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:

This is a difficult question! If a patient has never been sexually active, the risk of cervical dysplasia and cervical cancer (while not zero) is low. In my opinion, if a patient can cooperate with a pelvic exam, it may be worth doing. The American College of Obstetricians and Gynecologists recommends that after 3 normal yearly tests, testing can be performed "less frequently" in a low risk individual at the discretion of her physician. However, if anesthesia would be required, performing a Pap in a woman who has never been sexually active is probably not worth the effort, risk, and disturbance for the patient. This is only my opinion, and if you have additional questions or specific patients in mind, I would encourage you to address them with your healthcare provider.