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Cervical cancer screening — USMLE Step 3 MCQ

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HardAmbulatory Medicine / Primary CareCervical cancer screeningUSMLE Step 3

A 66-year-old underwent excision of CIN 3 at age 58. HPV-based tests at 6, 18 and 30 months were negative, and she asks to stop screening because she is older than 65. What is the best plan?

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Correct answer: A — Continue HPV-based testing every 3 years until 25 years after treatment

The best answer is “Continue HPV-based testing every 3 years until 25 years after treatment”. Prior CIN 3 creates persistent long-term cancer risk. After the initial negative post-treatment tests, HPV-based surveillance continues every 3 years for at least 25 years, even beyond the usual screening exit age if health permits.

Reference: ASCCP 2019 Risk-Based Management Consensus Guidelines: https://asccp.org/wp-content/uploads/2025/09/2019_ASCCP_Risk_Based_Management_Consensus.3.pdf