So the old recommendation of when to begin Pap smear testing has changed. This testing should start either at age 21 or three years after the start of sexual activity. (“Premature” Pap smears can pick up minimal changes that won’t result in cancer, but will cause concern and lead to extensive, unnecessary testing.). So, for a young teenager who is not sexually active, her first visit to a gynecologist need not include a Pap smear. But other important health issues should be addressed at this critical juncture between adolescence and adulthood.