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Cervical cancer incidence highest among women outside screening parameters
A review of SEER data suggests incidence of cervical cancer is higher than previously reported, particularly among older women.
“Our corrected calculations show that women just past 65 — when current guidelines state that screenings can stop for many women — have the highest rate of cervical cancer,” researcher Anne F. Rositch, PhD, MSPH, assistant professor of epidemiology and public health at the University of Maryland School of Medicine and researcher at the Marlene and Stewart Greenebaum Cancer Center, said in a press release. “It will be important to consider these findings when re-evaluating risk and screening guidelines for cervical cancer in older women and the appropriate age to stop screening.”
The results also show a growing disparity in cervical cancer incidence between black and white women.
Rositch and colleagues reviewed SEER data from 2000 to 2009, as well as hysterectomy prevalence estimates from the Behavioral Risk Factor Surveillance System, to calculate hysterectomy-corrected rates of cervical cancer.
Results showed the prevalence of hysterectomy among all women aged older than 20 years was 20.1%, with the highest prevalence observed among women aged 75 to 84 years.
After correcting for hysterectomy prevalence, the average annual age-standardized rate of cervical cancer increased from 11.7 cases per 100,000 women (95% CI, 11.5-11.8) to 18.6 cases per 100,000 women (95% CI, 18.3-18.9).
Uncorrected incidence rates plateaued at 15.6 cases per 100,000 women aged 40 to 44 years; however, corrected incidence rates increased steadily, peaking at 27.4 cases per 100,000 women aged 65 to 69 years.
Researchers then stratified data by race. Among white women, cervical cancer incidence peaked at a rate of 24.7 cases per 100,000 women aged 65 to 69 years, which represented an 83% increase from uncorrected data. Cervical cancer incidence in black women also peaked among those aged 65 to 69 years, with the corrected rate of 53 cases per 100,000 women representing a 126% increase from uncorrected rates.
“It will be important to clarify in future studies whether the continued increase in cervical cancer rates with age and the higher rates in African-American women represent a failure in our screening programs or a failure of the women to be screened so that appropriate interventions can be applied,” Rositch said.
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Although we have made tremendous progress in preventing and detecting cervical cancer in its earliest stages, we may not have fully understood the incidence among older women and African-American women. This latest research underscores the importance of caring for a woman's obstetric and gynecological health throughout her entire life, and not only focusing on preventive health measures during her reproductive years.