Older Women and Cervical Cancer Screening

Cervical cancer screening was still important in women age 65 and older.

For many women, getting older has meant that they can stop having Pap smears. But there are some caveats to stopping cervical screening.

diagram of cervical cancer - stages 1 and 2A new study indicates that many older women may still need screening for cervical cancer, but that may not be happening consistently.

Cervical cancer can affect women of any age. During 2013, one-fifth of all cervical cancer cases and one-third of deaths from cervical cancer occurred in women aged 65 and older.

The US Preventive Services Task force recommends that women of average risk should be screened until age 65. Women at higher risk may need to be screened until they are older.

Lead investigator Mary C. White, ScD commented in a press release, “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. 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.”

Dr. White is currently Chief of the Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention (CDC).

Dr. White and colleagues used data from the 2013 and 2015 National Health Interview Survey (NHIS).

They found that although rates of cervical cancer declined after age 85, the rates actually increased with age until age 70. Older black women were particularly likely to have higher cervical cancer rates.

In addition, the researchers found that women approaching age 65 were not getting sufficient screening. More than 800,000 women between the ages of 61 and 65 had not been screened as recommended within the previous five years.

The current USPSTF guidelines state that a woman of average risk can stop screening at age 65 if she has had three consecutive negative cytology results or two consecutive negative co-test results within the last 10 years. The most recent test must have been performed withing the last five years.

“In the short term, efforts could be undertaken to clarify misperceptions about the risk of cervical cancer among older women and providers,” Dr. White stated in the press release. “Messages about a ‘stopping age’ need to emphasize the recommendation for an adequate screening history of previous negative tests before screening is discontinued, not just chronologic age.”

The study was published in the May issue of the American Journal of Preventive Medicine.

The study did not receive outside funding and none of the authors reported a conflict of interest.

Science Daily, “Women should continue cervical cancer screening as they approach age 65: Adjusted rates for cervical cancer do not decline until age 85, signaling a need for ongoing surveillance, according to a new study”
https://www.sciencedaily.com/releases/2017/05/170501155213.htm
American Journal of Preventive Medicine, “Cervical Cancer Screening and Incidence by Age: Unmet Needs Near and After the Stopping Age for Screening”
http://www.ajpmonline.org/article/S0749-3797(17)30175-7/abstract
Written by: Beth Greenwood, RN | Medically reviewed by: Dr. Robert Carlson, M.D.