Does the current standard of care call for stopping Pap smears after age 65 in women with negative Pap histories? Should human papillomavirus (HPV) testing be routine with Pap smears?
—Jack Zoldan, MD, Chicago

If a woman older than aged 65 years has had three normal Pap smears in the past five years, Pap smear screening is no longer necessary. HPV testing should not be performed routinely at the time a Pap smear is performed because of the high prevalence of this virus in young women of reproductive age. Women older than 30 may elect to have HPV testing. In addition, women older than 30 who wish to increase the interval between Pap smears from one year to three years may do so if they have a negative HPV test and a negative Pap smear.
—Daniel R. Mishell Jr, MD