What is the recommended cervical cancer screening approach for women older than 65 if prior findings have been normal?

• A. Continue annual Pap smear
• B. Can stop testing if findings have been normal
• C. Screen every 10 years
• D. Switch to HPV testing only

Answer: (B)

The main idea is that screening can be stopped after age 65 if a woman has had adequate prior screening with normal results. When the prior screening has shown no problems—typically defined as either 3 consecutive negative cytology tests or 2 consecutive negative co-tests (cytology plus HPV) within the last 10 years, with the most recent test in the past 5 years—and there’s no history of cervical precancer or cancer in the past 20 years, the benefit of continued screening is very small. In this situation, stopping screening is recommended because the remaining risk is very low.

If these conditions aren’t met—for example, there’s a history of high-grade abnormalities, cervical cancer, or insufficient prior negative results—screening should continue according to guidelines. It’s also worth noting that more frequent or different-interval screening (like annual Pap tests or switching to HPV testing only) isn’t the standard recommendation for someone who meets the adequate prior-negative criteria and is older than 65.