Cervical Cancer Screening Timing for a 58-Year-Old Woman
This patient should have her next Pap smear in 3 years from her last test, since she had Pap testing alone without HPV co-testing. 1
Screening Recommendations for Women Aged 30-65 Years
For women in this age group, there are two acceptable screening strategies 2, 1:
- Preferred approach: Co-testing with Pap plus HPV testing every 5 years 2, 1
- Acceptable alternative: Pap testing alone every 3 years 2, 1
Since this patient had Pap testing alone without HPV co-testing, she falls into the "acceptable alternative" category and should continue screening every 3 years. 1
Critical Consideration: Breast Cancer History
The patient's history of breast cancer and lumpectomy does NOT alter cervical cancer screening recommendations. 2 Breast cancer history is not a risk factor that modifies cervical cancer screening intervals or protocols. 2 The screening schedule remains based solely on her age and the type of cervical cancer screening test performed. 1
When Screening Can Stop
This patient can discontinue cervical cancer screening after age 65 if she meets specific criteria 1, 3:
- Either ≥3 consecutive negative Pap tests alone within the last 10 years 1, 3
- Or ≥2 consecutive negative co-tests (Pap plus HPV) within the last 10 years, with the most recent test within the last 5 years 1, 3
Important Caveats
Do not screen annually - annual screening with any method is not recommended and increases harms without additional benefit. 2
Consider switching to co-testing - at her next visit, discuss transitioning to the preferred strategy of Pap plus HPV co-testing every 5 years, which would reduce screening frequency while maintaining equivalent or superior cancer detection. 1
Exceptions that would require continued screening past age 65 include 1, 4: