This article is more than 5 years old. Information may no longer be current.

Cervical cancer screening should be conducted in older women

Ongoing surveillance for cervical cancer is necessary in women aged older than 65 years, as incidence rates for the disease do not decrease until age 85 years, according to a study published in the American Journal of Preventive Medicine.

“One-fifth of cervical cancer cases and one third of cervical cancer deaths occurred among women aged [65 years and older] in the U.S. in 2013,” Mary C. White, ScD, from the division of cancer prevention and control at the CDC, and colleagues wrote. “Cervical cancer screening is effective at preventing invasive cases and deaths from cervical cancer among older women.”

Leading professional organizations currently indicate that cervical cancer screening may be discontinued in average-risk women older than 65 years, the researchers noted.

White and colleagues analyzed data from the 2013 and 2015 National Health Interview Survey to determine the prevalence of screening tests and incidence rates of cervical cancer among women aged 41 to 70 years who have not had a hysterectomy (n = 12,518). Data revealed that among the participants, the incidence rate of cervical cancer increased with age until 70 years and did not decline until age 85 years. In addition, the proportion of women who were not recently screened, defined as never having a Pap test or having their most recent Pap test more than 5 years ago, increased with age from 12.1% for women aged 41 to 45 years to 18.4% in women aged 61 to 65 years. These findings indicate that many women are not receiving sufficient or up-to-date routine cervical cancer screening prior to reaching the “stopping” age of 65 years, according to the researchers.

“A recommended upper age limit for routine screening may lead women and providers to assume that cervical cancer is a younger women’s disease,” White said in a related press release. “After adjustment for hysterectomy, some of the highest cervical cancer incidence rates occur among women older than 65 years, with notably higher rates among older black women. Premature discontinuation of routine screening among women in the years before age 65 could contribute to preventable cases of invasive cervical cancer and deaths.”

The researchers emphasized that women in midlife should continue routine cervical cancer screening.

“In the short term, efforts could be undertaken to clarify misperceptions about the risk of cervical cancer among older women and providers,” White concluded. “Messages about a ‘stopping age’ need to emphasize the recommendation for an adequate screening history of previous negative tests before screening is discontinued, not just chronologic age.” – by Alaina Tedesco

Disclosure: The researchers report no relevant financial disclosures.