When should I get a Pap smear?

Q: Hi Dr. Tam! I'm 19 years old and never been to a gynecologist. I've had sex with two guys in the last year. I haven't yet gone to get a Pap smear and wondered when I should start?

A: Great question! A Pap smear is a test performed by your doctor in which a brush is gently inserted into the opening of the cervix and used to collect a sample of cells to check for cervical cancer.  Pap tests can allow for treatment of abnormal cells and help prevent cervical cancer related deaths.  The most important risk factor for cervical cancer is a virus called "HPV" (human papilloma virus). This virus is transmitted from skin-to- skin contact including any kind of sexual intercourse.  Most of the time, the virus never causes symptoms, which is why it is important to be screened.
While having multiple sexual partners is a risk factor for cervical cancer, the major women's health guideline groups in the U.S. recommend not starting screening until age 21, even if you are sexually active at an earlier age.  The reason for this is that most teenagers will have false positive results (a test reads "abnormal" but the disease isn't actually present) resulting in unnecessary procedures.  Additionally, the vast majority of these HPV infections are short-lived and never go on to cause problems.  (Of note, women who have sex with women are also at risk and should be screened!)
So while you are not due yet for Pap test, if you haven't already, you should consult your pediatrician regarding the HPV vaccine (which can reduce your risk of cervical cancer). For more information on current screening guidelines, check out the American College of Obstetricians and Gynecologists recommendations: http://www.acog.org/Patients/FAQs/Cervical-Cancer-Screening.