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Older Women With Cervical Cancer Falling Through the Cracks

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WebMD Health News

March 14, 2001 -- Many older women who know they have cervical cancer are not receiving treatment for it -- treatment that could potentially save their lives, according to new information from the National Cancer Institute.

Baffled researchers say better efforts must be made to ensure women have access to surgery or radiation therapy, and they emphasize that regular Pap smears and appropriate follow-up care are the best ways to detect and keep check on cervical cancer.

Researchers at the National Cancer Institute estimate that women over age 65 account for 41% of all deaths from cervical cancer and one-quarter of all cervical cancer diagnoses. But half of women over age 65 have not had a Pap smear in the previous three years. Annually, close to 14,000 women learn that they have cervical cancer, and about 5,000 will die from it.

Edward Trimble, MD, and his colleagues at the NCI reviewed information on more than 10,000 women diagnosed with cervical cancer between 1992-1997. They looked at the forms of treatment the women received, which included surgery and radiation, and then totaled how many woman didn't get any treatment at all. The data were presented at a recent meeting of the Society of Gynecologic Oncologists.

When all the numbers were in, the researchers were dismayed to discover that 22% of the women 65 and older in this study with advanced-stage cancer were not undergoing treatment.

"We know there needs to be a special effort to explore with patients the barriers that stand between them and treatment," Trimble tells WebMD. "Is it the fear of treatment? Is it the cost? Is it geographic? Are they just too far away from a radiation oncology unit?" Trimble is the head of the surgery section of the cancer therapy and evaluation program at the NCI in Bethesda, Md.

"We still do a good job screening younger women with Pap smears because when they go to the doctor, they are going for obstetrical or gynecological care," Trimble says. "Unfortunately, as women age and they continue to see their physician, they are less likely to do a Pap. [Women] need to be reminded that they need a gynecological exam yearly and a Pap every three years. And the physician needs to be sure somebody is doing the Pap if they aren't."

He says that there are ways women with cervical cancer can overcome their concerns about the treatment and get assistance obtaining it. "This is a diagnosis for which we have a potentially curative therapy and the side effects are acceptable, so it's important to figure out where the treatment is available, ask whether there are ways of getting help from the American Cancer Society to get to the hospital," Trimble says. "Ask if you can talk to other people who've had the same treatment. Part of it is fear. People have heard horrible things about radiation treatment, but that is based on decades ago. Bring your family to the doctor with you so they can ask questions."

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