Women’s gynecological care requires a number of routine tests. Recommendations can differ by age. 

Pelvic Examination 

A pelvic examination is the main physical exam used by healthcare providers to feel and see if a woman’s pelvic organs are healthy. The exam includes the vulva, vagina, cervix, uterus, rectum, pelvis, and ovaries. The healthcare provider checks for masses, growths or other abnormal tissues. 

Pap Smear

A Pap test, or Pap smear screens women for cervical cancer. The healthcare provider takes a swab of the tissue inside of the cervix. Up to 15 percent of cervical cancers occur in women over the age of 65. However, cervical cancer is rare in older women who have had routine Pap tests with no abnormal results.

In some cases, you do not need a pap test after age 65.

• If you have had normal pap tests every 3 to 5 years, you can stop having the tests after age of 65. This is ok because the risk of cervical cancer is very low.
• If you have had a hysterectomy for a reason other than cancer, pap tests are no longer needed. 

However, if you have never had a Pap test, you should be screened even if you are over the age of 65. (Also see Prevention.)

Mammogram

A mammogram is an X-ray of the breasts that screens women for breast cancer. Guidelines vary by age and health:

• Women aged 50-75 need a mammogram for breast cancer every 2 years.
• After age 75, the benefits of screening mammograms are less clear.
• Women who are in poor health and not expected to live for more than 10 years don’t need a mammogram. They are more likely to be harmed rather than helped due to unnecessary testing and treatment. (Also see Prevention.)

A woman needs to check with her healthcare provider to discuss the right cancer screening approach for her.

Many women will have an abnormal mammogram at some time. If you do, another mammogram may be needed to look more closely at the area. Or you may need an ultrasound of the breast, and a biopsy to see if the abnormal cells are cancer or are benign (not harmful).

Women used to be encouraged to do a breast self-exam every month to check for any unusual lumps or changes in the breasts. This is no longer recommended because this self-exam doesn’t offer benefits related to diagnosing breast cancer or improving survival from breast cancer.

Last Updated April 2023