Women should continue cervical cancer screening as they approach age 65

May 1, 2017

Cervical cancer is often thought of as a disease that primarily affects young women. Because of this, many older women fail to keep up with appropriate screening as they age. While current guidelines indicate that screening can be stopped for average risk patients after age 65, many women lack the appropriate amount of screening history to accurately assess their risk. A new study in the American Journal of Preventive Medicine found that incidence rates of cervical cancer do not begin to decline until 85 years of age among women without a hysterectomy and 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 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, Centers for Disease Control and Prevention (CDC), Atlanta, GA. "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."

In 2013, one-fifth of cervical cancer cases and one-third of cervical cancer deaths occurred among 65 years of age and older. Current recommendations say that screening can be stopped at age 65 if an adequate testing history indicates consistently negative results. Three consecutive negative cytology results or two consecutive negative co-test results within the last 10 years, with the most recent test within the last 5 years, are considered sufficient reason to stop screening average risk women after age 65.

Using data from the 2013 and 2015 National Health Interview Survey (NHIS), investigators looked at the use of screening tests and rates of cervical cancer for women 65 years of age and older. They found that when corrected for hysterectomy, of cervical cancer increased with age until 70 and did not begin to decline until age 85.

The data also revealed that many women approaching the "stopping" age of 65 were not getting sufficient screening. Researchers established that the proportion of women not recently screened increases with age. While only 12% of women in their 40s had no recent screening history, that number progressively increased for women in their 50s and 60s. Nearly 850,000 women aged 61-65 years had not been screened within the last five years.

"A recommended upper age limit for 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 and deaths."

Cervical cancer can affect women of all ages. This new study highlights the importance of regular screening for who are at high risk or without documentation of adequate prior screening in order to help prevent cervical cancer deaths. Going forward, given increases in life expectancy and the high rates of cervical cancer after 65, women in midlife need to continue with routine cervical cancer screening to look for changes that may need further follow-up.

"In the short term, efforts could be undertaken to clarify misperceptions about the risk of cervical among older women and providers," concluded Dr. White. "Messages about a 'stopping age' need to emphasize the recommendation for an adequate screening history of previous negative tests before is discontinued, not just chronologic age."

Explore further: ACOG: New recommendations for cervical cancer screening

More information: Mary C. White et al, Cervical Cancer Screening and Incidence by Age: Unmet Needs Near and After the Stopping Age for Screening, American Journal of Preventive Medicine (2017). DOI: 10.1016/j.amepre.2017.02.024

Related Stories

ACOG: New recommendations for cervical cancer screening

December 23, 2015
(HealthDay)—In a practice bulletin published in the January issue of Obstetrics & Gynecology, new recommendations are presented for cervical cancer screening and prevention.

More than two-thirds of cervical cancer deaths prevented by screening

September 19, 2016
Cervical screening prevents 70 per cent of cervical cancer deaths and if all eligible women regularly attended screening this would rise to 83 per cent, according to research led by Queen Mary University of London (QMUL).

Low incidence of cervical cancer, CIN3+ for HPV-negative women

October 7, 2016
(HealthDay)—Human papillomavirus (HPV)-negative women have low long-term incidence of cervical cancer and cervical intraepithelial neoplasia (CIN) grade 3 or worse (CIN3+), which supports an extension of the cervical screening ...

Screening, HPV vaccine can prevent cervical cancer: FDA

February 8, 2017
(HealthDay)—Women can reduce their risk of cervical cancer through vaccination and screening, the U.S. Food and Drug Administration says.

Cervical cancer mortality rates may be underestimated

January 23, 2017
A woman's risk of dying of cervical cancer is higher than long believed, particularly among older and black women, new Johns Hopkins Bloomberg School of Public Health-led research suggests.

Screening helps prevent cervical cancer in older women

January 14, 2014
New research from Queen Mary University of London reveals women over the age of 50 who don't attend cervical screening are four times more likely to be diagnosed with cervical cancer in later life.

Recommended for you

Cell-weighing method could help doctors choose cancer drugs

November 20, 2017
Doctors have many drugs available to treat multiple myeloma, a type of blood cancer. However, there is no way to predict, by genetic markers or other means, how a patient will respond to a particular drug. This can lead to ...

Lung cancer triggers pulmonary hypertension

November 17, 2017
Shortness of breath and respiratory distress often increase the suffering of advanced-stage lung cancer patients. These symptoms can be triggered by pulmonary hypertension, as scientists at the Max Planck Institute for Heart ...

Researchers discover an Achilles heel in a lethal leukemia

November 16, 2017
Researchers have discovered how a linkage between two proteins in acute myeloid leukemia enables cancer cells to resist chemotherapy and showed that disrupting the linkage could render the cells vulnerable to treatment. St. ...

Computer program finds new uses for old drugs

November 16, 2017
Researchers at the Case Comprehensive Cancer Center at Case Western Reserve University School of Medicine have developed a computer program to find new indications for old drugs. The computer program, called DrugPredict, ...

Pharmacoscopy improves therapy for relapsed blood cancer in a first clinical trial

November 16, 2017
Researchers at CeMM and the Medical University of Vienna presented a preliminary report in The Lancet Hematology on the clinical impact of an integrated ex vivo approach called pharmacoscopy. The procedures measure single-cell ...

Wider sampling of tumor tissues may guide drug choice, improve outcomes

November 15, 2017
A new study focused on describing genetic variations within a primary tumor, differences between the primary and a metastatic branch of that tumor, and additional diversity found in tumor DNA in the blood stream could help ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.