Pap testing and sexual activity among young women in the United States

Obstet Gynecol. 2009 Dec;114(6):1213-1219. doi: 10.1097/AOG.0b013e3181be3db4.


Objective: To understand whether and how recency of sexual activity is associated with Pap testing rates among young women.

Methods: We analyzed data on self-reported receipt of Pap testing and initiation of sexual activity among young women and girls aged 15 to 24 years using the 2002 National Survey of Family Growth, an in-person, population-based survey of reproductive-aged men and women in the United States. The primary outcome was receiving a Pap test and its relationship to initiation of sexual activity. A multivariable model was used to predict the probability of having had a Pap test in the previous 12 months.

Results: Thirty-three percent of the 2,513 women had never had sex. Of these, 13.9% had had a Pap test in the previous year. Sixty-seven percent of sexually-active women aged 15-24 reported receiving a Pap test (corresponding to 13.1 million tests). Approximately 59% women aged 15-20 years old who reported having initiated sexual activity in the previous 3 years also reported a Pap test in the previous year.

Conclusion: The current guidelines recommend screening 3 years after initiation of vaginal intercourse or at age 21, whichever is earlier. Contrary to the current guidelines, many young women who have not had sex or who initiated sex within the previous 3 years reported having had a Pap test. Assuming that the patterns observed in this study persist, there is an urgent need for education regarding the need to adhere to guidelines to reduce the burden of potentially unnecessary Pap tests in young women.

Level of evidence: III.

MeSH terms

  • Adolescent
  • Age Factors
  • Coitus*
  • Female
  • Humans
  • National Center for Health Statistics, U.S.
  • United States
  • Vaginal Smears / statistics & numerical data*
  • Young Adult