Pelvic exam vs. Pap smear: What's the difference?


In 2012, after nearly 60 years of recommendations advocating for an annual Pap smear, the United States Preventative Services Task Force (USPSTF) updated its guidelines. Now, women should receive Pap smears every three years instead of annually.

While it may be a relief for many women to hear that they don’t have to undergo this screening every year, it doesn’t mean you’re off the hook for an annual visit to the gynecologist.

“Even if you do not need a Pap smear every year, you do need a pelvic exam. Many women find it easy to confuse the two, or mistakenly think that since they don’t need a Pap smear, there’s no point in visiting the gynecologist,” says Daria Yanez, MD, OB/GYN at Riddle Hospital. “A breast and pelvic exam are still a very important parts of a woman’s annual health check-up.”

So…besides needing one every year and one every three years, what are the differences between a Pap smear and a pelvic exam? Dr. Yanez explains below.

Pap smear

The purpose of a Pap smear is to screen for cervical cancer. During an annual visit, your gynecologist will test a small sample of cells from your cervix and screen for any abnormalities that may be indicative of cancer.

“Detecting cervical cancer at an early stage provides patients with a much better chance at early treatment and a cure,” says Dr. Yanez. “Pap smears, although they are now recommended less frequently, are still a very important cancer screening method.”

Since the USPSTF’s new guidelines were set forth in 2012, women should begin to have Pap smears done at age 21. Barring any abnormal results, Pap smears can continue every three years until your gynecologist advises that they are no longer needed, typically after age 65 or hysterectomy.

Some women may still require annual Pap smears, including those who receive abnormal results or who have a history of dysplasia, cancer, or HIV. Your physician can help you determine if you’re at an increased risk for cancer or require more frequent Pap smears.

Pelvic exam

While a Pap smear is perhaps the most-discussed component, an annual pelvic exam involves many more components. An annual visit to your gynecologist will include a full examination starting with your breasts and continuing to your vulva, vagina, cervix, uterus, rectum, pelvis, and ovaries.

“In addition to screening for cervical cancer, an annual pelvic exam is also a chance for us to detect abnormalities like ovarian cysts and uterine fibroids, as well as other cancers—like vulvar, vaginal, and uterine,” explains Dr. Yanez. “These types of cancers cannot be detected via a Pap smear.”

Skipping your annual pelvic exam—or worse, visiting every three years—can allow concerns like these to go unnoticed for an extended period of time, which can prevent early detection and treatment.

An annual visit also provides women the opportunity to talk to their gynecologist about lingering questions, whether it’s persistent pelvic pain, irregular periods, or breast pain, that they may have been shrugging off for awhile.

“It’s easy for women to put their health on the back burner and put others before themselves. An annual pelvic exam is necessary to ensure your best health,” says Dr. Yanez.

Main Line Health gynecologists provide expertise in a wide range of services, including contraceptive services, care during perimenopause, and preventative care in the post-menopausal years. Visit our website to learn more about our OB/GYN services.

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