Cervical Cancer Screening Tests in Older Women
Researchers say their results support screening women up to age 65 and beyond
By Robert Preidt
TUESDAY, Jan. 14, 2014 (HealthDay News) -- Cervical cancer screening beyond age 50 saves lives and remains beneficial to women up to age 69, a new British study suggests.
Both the U.S. Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force recommend that cervical cancer screening end at age 65.
In this new study, researchers examined data from all 1,341 women aged 65 to 83 in England and Wales who were diagnosed with cervical cancer between 2007 and 2012, and compared them to women in the same age group who did not have cervical cancer.
The results showed that women who did not undergo cervical cancer screening after age 50 were six times more likely to be diagnosed with cervical cancer than those who had regular screenings between ages 50 to 64 and had no abnormalities. There were 49 cancers in the first group versus eight cancers in the second group per 10,000 women over 20 years, found the study in the journal PLoS Medicine
The rate of cervical cancer was 86 per 10,000 over 20 years among women who were screened regularly between ages 50 to 64 and found to have abnormalities, according to a journal new release.
The findings suggest that cervical cancer screening in older women has a substantial impact in reducing cervical cancer risk, said researchers Peter Sasieni and colleagues from Queen Mary University of London.
"Screening up to age 65 years greatly reduces the risk of cervical cancer in the following decade, but the protection weakens with time and is substantially less 15 years after the last screen. In the light of increasing life expectancy, it would seem inappropriate for countries that currently stop screening between the ages 60 and 69 years to consider reducing the age at which screening ceases," the researchers concluded.
This type of new data from older women can help experts determine whether current guidelines that recommend a halt to cervical cancer screening at age 65 meet all women's needs, Anne Rositch, from the University of Maryland School of Medicine, and colleagues wrote in an accompanying editorial.
Here are the cervical cancer screening guidelines from the U.S. Centers for Disease Control and Prevention:
- Start getting regular Pap tests at age 21. The Pap test is one of the most reliable and effective cervical cancer screening tests. If your Pap test results are normal, your doctor may tell you that you can wait three years until your next Pap test.
- If you are 30 years old or older, you may want to have a human papillomavirus (HPV) test along with the Pap test. Both tests can be performed by your doctor at the same time. If your test results are normal, your chance of getting cervical cancer in the next few years is very low. Your doctor may then tell you that you can wait as long as five years for your next screening. But you should still go to the doctor regularly for a checkup.
- If you are 21 to 65 years old, it is important for you to continue getting a Pap test as directed by your doctor, even if you think you are too old to have a child or are not having sex anymore. If you are older than 65 and have had normal Pap test results for several years, or if you have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids, your doctor may tell you that you do not need to have a Pap test anymore.
Here are the cervical cancer screening guidelines from the U.S. Preventive Services Task Force:
- Women aged 21 to 65 years should have a Pap test every three years. Women aged 30 to 65 who want to lengthen the screening interval can undergo screening with a combination of Pap and HPV testing every five years.
- Screening is not recommended for women younger than 21, or for women older that 65 "who have had adequate prior screening and are not otherwise at high risk for cervical cancer."
- Screening is not recommended for women who have had a hysterectomy with removal of the cervix and who do not have a history of a high-grade precancerous lesion or cervical cancer.
- HPV testing, alone or in combination with a Pap test, should not be used for cervical cancer screening in women younger than 30.