Pap Smear Screening Guidelines

General Recommendation

• The Centers for Disease Control and Prevention (CDC) recommends postponing the Pap smear if the patient is menstruating and rescheduling at the earliest opportunity 3
• The American Cancer Society, as published in Ca-A Cancer Journal for Clinicians, suggests that the test is best performed in the absence of heavy menstrual flow to optimize specimen quality 1, 2

Important Exceptions - When to Proceed Despite Menses

• The American Cancer Society, as published in Ca-A Cancer Journal for Clinicians, advises not to defer the Pap smear in patients with abnormal bleeding patterns, including intermenstrual bleeding, postcoital bleeding, or postmenopausal bleeding 1, 2
• The American Cancer Society, as published in Ca-A Cancer Journal for Clinicians, recommends not to defer the Pap smear in cases where accessibility is a concern and the patient is unlikely to return for follow-up 1, 2
• The CDC recommends that the test can be performed after careful removal of mucopurulent discharge with a saline-soaked cotton swab 3

Clinical Pitfalls to Avoid

• The American Cancer Society, as published in Ca-A Cancer Journal for Clinicians, advises not to delay screening indefinitely waiting for the "perfect" timing if the patient has concerning symptoms or poor follow-up reliability 1, 2