An Obstetrician-Gynecologist (OB/GYN) is a physician specializing in female reproductive health, pregnancy, and childbirth. Their practice centers on comprehensive care for women across the lifespan. OB/GYNs routinely perform Pap smears as a standard part of their preventative healthcare services and routine gynecological examinations.
The Primary Role of the OB/GYN
The Pap smear, formally known as a Pap test or cervical cytology, is a screening procedure designed to detect potentially precancerous or cancerous cells on the cervix. The cervix is the lower, narrow part of the uterus that opens into the vagina. The procedure is typically carried out during a routine pelvic examination in the OB/GYN’s office.
During the exam, a speculum is gently inserted into the vagina to allow the physician to visualize the cervix. A small brush or spatula is then used to collect a sample of cells from the surface of the cervix. These collected cells are preserved and sent to a laboratory for microscopic analysis.
The Pap test often includes co-testing, especially for women aged 30 and older, for the presence of the human papillomavirus (HPV). HPV is a common sexually transmitted infection that is the primary cause of nearly all cervical cancers. The OB/GYN’s specialized knowledge makes them ideally suited to perform this procedure and manage any abnormal findings, which may require follow-up procedures such as a colposcopy.
Understanding the Screening Schedule
Modern screening guidelines have evolved to reduce the frequency of testing for average-risk individuals. The screening schedule depends on age and the type of test performed. Major medical organizations recommend starting cervical cancer screening at age 21.
For women aged 21 to 29, the recommendation is to have a Pap test alone every three years. HPV testing is not typically recommended in this age group because HPV infections are common and often clear up naturally without intervention.
Screening practices change for women aged 30 to 65, who have three accepted options:
- A Pap test alone every three years.
- High-risk HPV testing alone every five years.
- Co-testing (a Pap test combined with an HPV test) every five years.
Screening can typically stop after age 65 if a woman has had adequate negative prior screening results. This includes three consecutive negative Pap tests or two consecutive negative co-tests within the last 10 years. Women with a history of a high-grade precancerous lesion or a compromised immune system may require more frequent or lifelong screening.
Other Providers Who Offer Pap Smears
While OB/GYNs are the specialists most associated with the procedure, they are not the only healthcare professionals who can perform Pap smears. Many primary care providers are qualified to offer this service as part of a routine physical or well-woman exam.
This includes Family Medicine physicians and Advanced Practice Providers such as Nurse Practitioners (NPs) and Physician Assistants (PAs). These providers receive training in women’s health during their medical education.
Receiving a Pap smear from a primary care provider offers the convenience of integrating preventative screening with overall health management. However, patients with a history of abnormal Pap results or complex gynecological concerns are typically referred to an OB/GYN for specialized management and follow-up procedures.