Call for urgent change to cervical cancer risk perception in older women

As Cervical Screening Awareness Week begins, a Keele University academic is calling for cervical screening programmes and perceptions of cervical cancer to be reviewed urgently, to encourage more older women to get regularly screened.

The review, led by Dr Sue Sherman, senior lecturer in Psychology at Keele University, found that on average 20 per cent of the 3,121 new cases diagnosed each year, and 50 per cent of deaths from cervical cancer were in women aged 65 and over – the age at which the screening programme in the UK currently ends. This is compared to 64 new diagnoses under the age of 25, accounting for just 2% of all diagnoses.

The research also suggests that the cancer is perceived as being a young woman's disease, with the screening cut off at 64 implicitly suggesting to older women that they are no longer at risk. Figures show that uptake of cervical screening is declining after age 50, and that breast screening uptake actually increases from 50 to 64. In 2013, 82% of 50-54 year old women had been screened for cervical cancer in the past five years, dropping to 76% of 55-59 year olds, and then to 73% of 60-64 year olds.

The report – published in the British Medical Journal Monday, 15 June – also reveal in the 20 years following 65, just 8 in 10,000 women with negative test screenings between 50 and 64 are likely to contract cervical cancer. This compares to 49 in 10,000 for those who are not screened between the ages of 50 and 64, showing that being regularly screened greatly reduces the risk of diagnosis. This means women with three negative screenings for cervical cancer between the ages of 50 and 64 are six times less likely to contract the disease in later life.

A recent survey completed by Jo's Cervical Cancer Trust, the cervical cancer charity behind Cervical Screening Awareness Week (15-21 June 2015), backs this up. It found that a lack of knowledge about the cause of cervical cancer and who can be affected seems to be contributing to women aged 50-64 not attending cervical screening. Almost two thirds (60%) of women aged 50-64 do not know HPV causes cervical cancer and many failed to link historic sexual activity as a threat to the virus laying dormant and developing into cervical cancer later in life.

Dr Sue Sherman, senior lecturer in Psychology at Keele University and lead author of the report, says: "This review suggests that older women not getting themselves screened for cervical cancer has become a significant contributor to the number contracting the disease. Despite all the attention on younger women – in part due to the Jade Goody effect – 20 per cent of new diagnoses and nearly 50 per cent of cervical cancer deaths occur in women over the age of 65. We need to change the perception of cervical cancer so it is thought of just like breast and bowel cancer – that it can affect women well into old age.

"Encouragingly we found that women with three negative tests for cervical cancer between 50 and 64 are considerably less likely to get the disease in the next 20 years. So regular screenings have the potential to catch the disease early and reduce the victims of cervical cancer dramatically. Jo's trust has also backed this up with its own investigation, and during Cervical Cancer Awareness Week from 15 -21 June we want to encourage more older women to get themselves screened for cervical cancer."

Robert Music, Chief Executive of Jo's Cervical Cancer Trust said: "This research from Keele University backs up our own investigations that there is an urgent need to not only increase survival rates for women in this age group but decrease the numbers diagnosed altogether. It's absolutely vital that women of all ages are educated around the cause of cervical cancer and their risk of HPV. Responses from women questioned in our research were worrying with some citing they had been 'celibate' for several years and therefore did not consider themselves to be at risk. We must remind all women that HPV is very common and can lie dormant for very long periods of time, and that the best way of reducing one's risk of cervical cancer is to attend screening promptly whilst eligible.

"We also found that almost a quarter said this was a disease that was most likely to affect women aged 25-34, which suggests many people associate it as a predominantly young person's cancer. Whilst it is the most common cancer in women under 35, it still affects women of all ages and we are particularly concerned that if women delay their screening over the age of 50, they increase their chances of not only a diagnosis after they have left the programme, but a later stage diagnosis with a poorer outlook."