Should a virgin get a Pap smear?

Pap smears are very effective screening tools for cervical cancer, which is primarily caused by the sexually transmitted human papillomavirus (HPV).

Recommendations for when women should begin getting Pap smears always reference sexual activity.

Lisa B. Bazzett, MD, a gynecologic oncologist (cancer specialist) at Ochsner Medical Center in New Orleans, states:

“The current recommendation for initiation of Pap smears from the American College of Obstetricians and Gynecologists is that girls and women should begin cervical cancer screening approximately three years after initiation of sexual intercourse, but no later than age 21 years.”

Where do virgins fit in here as far as Pap smears?

Every single time we see something about women and Pap smears for cervical cancer, there never seems to be any mention about how this may or may not apply to virgins. So I began wondering, Should virgins get a Pap smear?

Or are virgins exempt from HPV transmission? I posed this very interesting question of whether or not virgins should get Pap smears, to Dr. Bazzett.

Do virgins need to get Pap smears?

Dr. Bazzett: It is true that HPV is transmitted during intercourse, but it can also be transmitted during other, non-penetrative, sexual acts.

This is due to the mode of spread of the virus being different than other sexually transmitted diseases that are transmitted in bodily fluids. HPV is not transmitted in bodily fluids, but in skin to skin, or surface to surface contact.

Therefore, if two individuals engage in close contact of the genitals, but don’t actually have “penetrative intercourse,” the virus can still be transmitted.

This is why it’s safer to simply choose an arbitrary age to begin screening, even if a women is a “virgin,” because there are other sexual acts that may transmit the virus that a patient would not necessarily consider “sex” when her sexual history was being taken by a healthcare provider.

But if a woman is a virgin, chances are pretty high that she also abstains from any close contact of the genitals.

A woman who chooses to stay a virgin (regardless of reason) will typically avoid all close contact with the genital area.

So, to refine my question, should committed virgins, or nuns, for that matter, get Pap smears?

Dr. Bazzett: It is reported that 99% of all cervical cancers are caused by HPV. There is a very rare type unrelated to HPV that most gynecologic cancer specialists will see only once or twice in their careers, as opposed to the unfortunately all too common HPV-induced cervical cancers.

HPV is also responsible for other female gynecologic cancers including the vagina, the vulva and the anus.

Therefore, it is certainly much safer to include virgins in the standard cervical cancer screening recommendation, with yearly Pap smears, than to miss an HPV related disease in its precancerous, curable state.

So this means that virgins, i.e., women who have never even been on a date, should nevertheless get Pap smears?

Dr. Bazzett: The recommendation from ACOG is yes, at age 21, and I would never go against that recommendation. 

As I stated, there is a very rare type of cervical cancer unrelated to HPV, and to simply not do Pap smears, or exam of the cervix or genitalia in a woman, could put her at risk, so I would still recommend a Pap smear at age 21.

If a woman is a virgin and not engaging in any sexual activity, it is always up to the discretion of her and her physician what is best for her.

She may not need a Pap every year, but should still be getting a pelvic exam, as there are other problems that can arise from the uterus, the ovaries, that require yearly pelvic exams.

Dr. Bazzett specializes in the treatment of malignancies of the female reproductive organs including that of the ovary, uterus, cervix, vagina and vulva. 
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.