Older Women Need Cervical Screening

Old habits and mindsets die hard, and sometimes that can have a real impact on our quality of life. For example, most every woman is under the impression, borne of generations of professional medical understanding and advice, that cervical cancer primarily affects younger women.

In fact, a new study indicates that incidence rates of cervical cancer do not begin to decline until 85 years of age among women without a hysterectomy. Furthermore, the data show that women over 65 who have not been recently screened may benefit from continued surveillance.

"An older woman who has not had her cervix surgically removed has the same or even higher risk of developing cervical cancer compared to a younger woman," said lead investigator Mary C. White, ScD, Chief of the Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, for the Centers for Disease Control and Prevention. "Women who have not had a hysterectomy need to continue to be screened until age 65, and possibly later if they have not been screened for many years or are at special risk, consistent with current U.S. Preventive Services Task Force recommendations."

Researchers examined data from the 2013 and 2015 National Health Interview Survey. They looked specifically at the use of screening tests and rates of cervical cancer for women 65 years of age and older. They learned that incidence rates of cervical cancer increased with age until 70 and did not begin to decline until age 85, once the data were corrected for hysterectomy. Moreover, the scientists discovered that many women approaching the "stopping" age of 65 were not getting sufficient screening. While only 12 percent of women in their 40s had no recent screening history, that number progressively increased for women in their 50s and 60s, until nearly 850,000 women aged 61-65 years had not been screened within the last five years.

"A recommended upper age limit for routine screening may lead women and providers to assume that cervical cancer is a younger women's disease," explained Dr. White. "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 research has been published in the American Journal of Preventive Medicine.