For community-dwelling older women with cancer, which cancer screening is recommended?

• A. Annual Pap smears
• B. Mammograms
• C. Pap smears and mammograms
• D. None of the above

Answer: (C)

Screening decisions in older adults hinge on balancing benefit with risks and life expectancy. When a community-dwelling older woman with cancer is reasonably healthy and has not had adequate prior screening, continuing tests for the two most common cancers in women—cervical and breast cancer—can catch new problems early and improve outcomes. A Pap smear screens for cervical cancer and remains indicated if the cervix is present and prior screening has been inadequate or there's ongoing risk. A mammogram screens for breast cancer and remains appropriate as long as life expectancy and overall health suggest benefit. Because these test supplies target two different organs with separate risk profiles, offering both provides broader protection. If the patient has had a total hysterectomy with cervix removal, Pap screening would not be needed, but in the typical scenario described, both screenings are recommended.