Cervical cancer screening still important as women age
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Cervical cancer – typically associated with affecting women younger than age 50 – is a disease that can also be found within women who have not had a hysterectomy or her cervix surgically removed. This is news from a recent study published in American Journal of Preventive Medicine called Cervical Cancer Screening and Incidence by Age: Unmet Needs Near and After the Stopping Age for Screening.
Even though most cervical cancers do develop in younger women, many older women do not realize that the risk of developing cervical cancer is still present as they age. Yet more than 15% of cases of cervical cancer are found in women over age 65. In 2017, it is estimated that around 12,820 new cases of invasive cervical cancer will be diagnosed and around 4,210 women will die from this disease. Cervical pre-cancers are diagnosed far more often than invasive cervical cancer.
At one time cervical cancer was one of the most common causes of cancer death for American women. But thanks to increased use of the Pap test, over the last 40 years, the death rate for cervical cancer has dropped by more than 50%. The Pap test is named after Georgios Papanikolaou, the doctor who determined that this was a useful method of detecting signs of cervical cancer. A Pap smear, also called a Pap test, is a screening procedure for cervical cancer that is used to test for precancerous or cancerous cells on the cervix. What makes the Pap test so valuable to women is that it can find cervical cancer early when it is in its most curable stage.
Currently, guidelines for cervical cancer screening, is that they can be stopped for the average risk patient after age 65 if a woman has regularly been screened with an adequate testing history that has had consistent negative results for no cancer. What is considered consistent negative results is if a woman has had three consecutive negative results or two consecutive negative co-test results within the last 10 years, with the most recent within the last 5 years. But the problem has been that many women may have either stopped getting screened for cervical cancer by having a Pap test or they lack the appropriate amount of screening history to accurately assess their risk.
This recent study found that the incidence rates of cervical cancer do not begin to decline until age 85 among women who have not had a hysterectomy or their cervix surgically removed and women over age 65 who have been recently screened. The study concluded that these women are at the same risk or even higher risk of developing cervical cancer compared to younger women. That is why the study is recommending that women who have not had a hysterectomy should continue to be screened for cervical cancer until age 65 and possibly even longer if it has been several years since they were screened for the disease.
By using data from the 2013 and 2015 National Health Interview Survey (NHIS), researchers reviewed screening tests used and the rates of cervical cancer for women 65 years or older. What was revealed was the incidence rates of cervical cancer increased with age until 70 and did not begin to decline until after age 85.
Also found was that as a woman ages, she may not be going in to have a Pap test done, believing that she no longer needs to. Only 12% of women in their 40s had not been screened but that number increased progressively for women in their 50s and 60s. Almost 850,000 women aged 61-65 had not had a screening within the last five years.
The speculation is that many women may believe that as they age, their risk for cervical cancer is minor and they no longer need to be screened for it. But cervical cancer can occur in a woman of any age. By prematurely discontinuing screening in women during their 50s or 60s, it could lead to women getting overlooked who could still be at risk of developing cervical cancer.
The researchers stated that “messages about a ‘stopping age’ needs to emphasize the recommendation for an adequate screening history of previous negative tests before screening is discontinued, not just chronological age.”
All women should discuss the need for cervical cancer screening with their doctor and to have a complete understanding of how long and at what age they can safely discontinue being screened for it.