A 29-year-old woman is evaluated during a routine examination. She is asymptomatic. Her last Pap smear was obtained 3 years ago and was normal. She completed the human papillomavirus (HPV) vaccine series at age 26 years. Medical and family histories are unremarkable. She takes no medications.

What is the most appropriate cervical cancer screening strategy at this time?

The recommended cervical cancer screening for a 29-year-old woman with a previous normal Pap smear and completed HPV vaccination is to have a Pap smear every three years. Co-testing with HPV DNA testing should start at age 30 with a 5-year interval if previous tests are negative. Vaccination does not negate the need for Pap smears since not all cancer-causing HPV types are covered.

Explanation:

The most appropriate cervical cancer screening strategy for a 29-year-old woman who had a normal Pap smear 3 years ago and completed the human papillomavirus (HPV) vaccine series at age 26 would be to continue routine Pap smears every three years. Because she is under 30, co-testing with HPV DNA testing is not generally recommended until the age of 30, at which point it would be advised to have Pap plus HPV testing every five years if previous tests were negative. This recommendation is based on current guidelines that optimize the detection of pre-cancerous changes while minimizing unnecessary interventions.

The use of the HPV vaccine does not eliminate the need for Pap smears because the vaccine does not protect against all types of HPV that can cause cervical cancer. Therefore, even vaccinated individuals are advised to follow regular screening protocols. Regular Pap testing can detect abnormal cells that may progress to cervical cancer, allowing for early treatment and a high cure rate.