skip to main content

Cervical cancer screening age 24 — USMLE Step 3 MCQ

Instant feedback + full explanation. One question, done properly.

HardOB/GYNCervical cancer screening age 24USMLE Step 3

A 35-year-old immunocompetent woman undergoes primary HPV screening. Testing is positive for HPV type 16, and reflex cervical cytology is negative for intraepithelial lesion or malignancy. She has no prior abnormal screening result and is not pregnant. Which management is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Perform colposcopy with directed biopsy of any visible lesion

The best answer is “Perform colposcopy with directed biopsy of any visible lesion”. HPV-16 carries sufficient immediate risk of CIN3+ and occult cancer that colposcopy is recommended even when reflex cytology is negative. Negative cytology does not neutralize genotype-specific risk. Excisional treatment requires a much higher immediate-risk result or histologic confirmation, and vaccination prevents new infection but does not treat the current HPV-16 infection or replace indicated evaluation.

Reference: 2019 ASCCP Risk-Based Management Consensus Guidelines: https://pmc.ncbi.nlm.nih.gov/articles/PMC7147428/