The availability of human papillomavirus (HPV) testing and vaccination raises questions regarding the cost-effectiveness of cervical cancer screening recommendations. To address these questions, we developed a 19-state Markov Microsimulation that modeled a US birth cohort from ages 13-85. The model analyzed the quality-adjusted life years (QALYs), lifetime screening and treatment costs, and incremental cost-effectiveness of different screening and vaccination strategies. The different strategies included: tri-annual screening (current USPSTF recommendation), HPV vaccination only, and vaccination with differing screening increments of 1, 2 and 5 years. Without vaccination, the current USPSTF recommendation of tri-annual screening provides 1050 more QALYs/10,000 for an incremental cost effectiveness of $12,000. With vaccination, a strategy of screening appears more cost effective with an incremental cost effectiveness of $18,000. These results indicate that if uptake of HPV vaccines are common, current cervical cancer screening strategies should be altered.