Some Older Women Still Need Cervical Cancer Screening

The number of women who undergo regular screening for cervical cancer drops as they get older, and while this is acceptable if women have been followed regularly until the age of 65 years, women who are not up to date with screening should be screened when they are older, according to a study published in the American Journal of Preventive Medicine.

The most common recommendation for cervical cancer screening for women who are at average risk of developing the disease is screening every 3 years with cytology (Pap smear). Women who wish to extend the period between testing could be screened every 5 years with the inclusion of human papillomavirus testing. If a woman has no known risks and has received three consecutive cytology reports or two consecutive negative co-test results within the previous 10 years, once she turns 65 years old, regular cervical cancer screening is no longer recommended.

The researchers noted that according to National Health Interview Survey data from 2015, an estimated 845,000 American women aged 61 to 65 years were not recently screened for cervical cancer. Unfortunately, many women are under the impression that there is a specific age, usually 65 years, when they can stop seeing their healthcare provider for cervical cancer screening, the researchers said. But they must understand the decision is not based on age, but on previous screening results.

According to the researchers, the incidence rate for cervical cancer among older women who had not undergone a hysterectomy did not decline until the women reached 85 years of age. “One-fifth of cervical cancer cases and one-third of cervical cancer deaths occurred among women aged ≥ 65 years in the US in 2013,” the authors wrote. Yet the proportion of women not recently screened increased with age, from 12.1% for women aged 41 to 45 years to 18.4% for women aged 61 to 65 years.

The researchers concluded that clinicians must take steps to clarify these misconceptions and help women understand that age itself is not a marker for cessation of cervical cancer testing, and that if women are over 65 years and have not been regularly tested before, they are at risk of developing cervical cancer that will not be caught in the earlier, easier to treat stages.