Safely Stopping Screening for Cervical Cancer

Kenny Lin, MD, MPH
January 5, 2026

An article in the December 2025 issue of AFP reviewed considerations for discontinuing cancer screenings in older adults. For cervical cancer, the authors observed that 21% of new cases and 38% of deaths occur after 65 years, the usual age to stop screening. Notable, this stopping age applies only to patients without conditions that put them at high risk of cervical cancer (eg, HIV infection) who have adequate prior screening, defined as “three consecutive negative cytology results or two consecutive negative cotesting results within 10 years.”

In a recently published guideline, the American Cancer Society (ACS) clarified that the last negative test before exiting cervical cancer screening should occur “at an age no younger than 65 years,” with primary human papillomavirus (HPV) testing at 60 and 65 years of age being preferred. The ACS reiterated its previous recommendation that clinicians continue screening beyond 65 years in those with a history of grade 2 or greater cervical intraepithelial neoplasia within the past 25 years.

An analysis of data from the 2013 and 2015 National Health Interview Surveys found that nearly 1 in 5 women 61 to 65 years of age had not been screened for cervical cancer with a Papanicolaou test in the preceding 5 years. Even in those with a more recent test, determining eligibility to stop screening after 65 years can be challenging. A retrospective study of electronic health records of 42,000 patients older than 65 years in two health systems in Dallas and Boston determined that 69% were not eligible to stop screening because “too few screening tests were documented”; nonetheless, 84% of these patients received no further screening. Of the 16% who continued screening, 2% had high-grade precancerous lesions detected, and 0.7% were diagnosed with cervical cancer.

The cervical cancer screening studies did not enroll women older than 65 years, so the evidence for the stopping age is derived from a modeling study commissioned by the US Preventive Services Task Force (USPSTF) to support its 2018 recommendations. (The USPSTF released a draft recommendation update in December 2024 that continues to support stopping screening at 65 years in women with adequate prior screening who are not otherwise at high risk of cervical cancer.) A large cohort study sponsored by the National Institutes of Health adds to this evidence base by estimating the effects of stopping vs continuing screening after 65 years on cancer outcomes and medical complications resulting from diagnostic procedures and surgical interventions.