Background: To evaluate the consequences of USPSTF recommendation to stop pap testing in well-screened women age ≥65 years on cervical cancer incidence and mortality. Methods: In 2003, the USPSTF recommended that women age ≥65 years with prior normal cervical cancer screening could discontinue screening. Using nationally-representative survey data from the Behavioral Risk Factor Surveillance System, we constructed a joinpoint model to evaluate if the guideline affected pap smear discontinuation (defined as no pap for ≥5 years). We performed interrupted time-series to evaluate whether guideline-related pap-smear discontinuation affected stage-specific cervical cancer incidence and mortality in women ages ≥65, using women ages 30-64 as controls. Incidence and mortality rates were obtained from the Surveillance, Epidemiology, and End Result program, and adjusted for age and hysterectomy prevalence. Results: After declining from 1992 to 2004, the proportion of women reporting no pap smear for ≥5 years increased from 2004 to 2014 among women age ≥65 years and 30-64 years (p < 0.001 for both). However, the proportion of women who discontinued screening was greater in those age ≥65 years (10.7 versus 2.7 percentage points from 2004 to 2014, p < 0.001). Despite this, women age ≥65 had greater-than-expected declines in the incidence of localized (-2.3% per year, p = 0.05) and regional (-3.0% per year, p = 0.03) cervical cancer after 2004, compared with 30-64-year-old women. Incidence of distant cancer increased slightly in both groups, but the magnitude of the change did not differ between groups (p = 0.23). Cervical cancer mortality rates declined in both groups throughout the study period (p < 0.001), and there was no evidence that guideline-related pap-smear discontinuation led to excess mortality among women ≥65 compared to those 30-64 years. Conclusions: Compared to women unaffected by the USPTF guidelines, women age ≥65 years had larger declines in the incidence of locally- and regionally-confined cervical cancer, and no difference in the incidence of metastatic cancer. Recommendations to stop pap testing in women age ≥65 did not appear to have led to increased cervical cancer mortality.