Cervical cancer incidence declines after age 85

Women should stop attending their cervical screening appointments at the recommended age of 65 and over only if they have an adequate prior screening history with negative results, researchers have warned.

“Messages about a ‘stopping age’ should emphasize the recommendation for an adequate screening history of previous negative tests before screening is discontinued, not just chronological age,” wrote the study authors. The report was published in the American Journal of Preventive Medicine (2017 May 1. doi: 10.1016/j.amepre.2017.02.024).

Leading professional organizations recommend “average-risk” women should be screened for cervical cancer between the ages of 21 and 65 years.

However, the authors, led by Mary C. White, ScD, of the Centers for Disease Control and Prevention, Atlanta, and her colleagues noted that data from 2013 showed that one-fifth of cervical cancer deaths occurred in women in the United States who were over the age of 65 years.

In the current study, the research team looked at data from the cross-sectional household National Health Interview Surveys from 2013 and 2015 to determine the number of women aged 41-70 years who had never had a Pap test or had not had one for 5 years or more.

After correcting for women who had undergone a hysterectomy, the researchers found that the incidence rate for cervical cancer increased with age until about 70 years and then declined after the age of 85.

Yet the proportion of women who had not been screened recently increased with age, from about 12% for women in their 40s to nearly 24% for women aged 66-70 years.

Efforts should be made to clarify misperceptions about the risk of cervical cancer among older women and health care providers, the investigators said.

“A recommended upper age limit for routine screening may lead women and providers to assume that cervical cancer is a younger woman’s disease,” they said.

Catch-up screening might be needed for underscreened women after the age of 65 years, although the physical and psychological issues associated with this should be taken into account, the study authors said.

“Age itself may need to be reconsidered, given high cervical cancer incidence rates after the age of 65 years, increases in life expectancy, and different human papillomavirus exposures by birth cohort,” they concluded.

Women should stop attending their cervical screening appointments at the recommended age of 65 and over only if they have an adequate prior screening history with negative results, researchers have warned.

“Messages about a ‘stopping age’ should emphasize the recommendation for an adequate screening history of previous negative tests before screening is discontinued, not just chronological age,” wrote the study authors. The report was published in the American Journal of Preventive Medicine (2017 May 1. doi: 10.1016/j.amepre.2017.02.024).

Leading professional organizations recommend “average-risk” women should be screened for cervical cancer between the ages of 21 and 65 years.

However, the authors, led by Mary C. White, ScD, of the Centers for Disease Control and Prevention, Atlanta, and her colleagues noted that data from 2013 showed that one-fifth of cervical cancer deaths occurred in women in the United States who were over the age of 65 years.

In the current study, the research team looked at data from the cross-sectional household National Health Interview Surveys from 2013 and 2015 to determine the number of women aged 41-70 years who had never had a Pap test or had not had one for 5 years or more.

After correcting for women who had undergone a hysterectomy, the researchers found that the incidence rate for cervical cancer increased with age until about 70 years and then declined after the age of 85.

Yet the proportion of women who had not been screened recently increased with age, from about 12% for women in their 40s to nearly 24% for women aged 66-70 years.

Efforts should be made to clarify misperceptions about the risk of cervical cancer among older women and health care providers, the investigators said.

“A recommended upper age limit for routine screening may lead women and providers to assume that cervical cancer is a younger woman’s disease,” they said.

Catch-up screening might be needed for underscreened women after the age of 65 years, although the physical and psychological issues associated with this should be taken into account, the study authors said.

“Age itself may need to be reconsidered, given high cervical cancer incidence rates after the age of 65 years, increases in life expectancy, and different human papillomavirus exposures by birth cohort,” they concluded.

Women should stop attending their cervical screening appointments at the recommended age of 65 and over only if they have an adequate prior screening history with negative results, researchers have warned.

“Messages about a ‘stopping age’ should emphasize the recommendation for an adequate screening history of previous negative tests before screening is discontinued, not just chronological age,” wrote the study authors. The report was published in the American Journal of Preventive Medicine (2017 May 1. doi: 10.1016/j.amepre.2017.02.024).

Leading professional organizations recommend “average-risk” women should be screened for cervical cancer between the ages of 21 and 65 years.

However, the authors, led by Mary C. White, ScD, of the Centers for Disease Control and Prevention, Atlanta, and her colleagues noted that data from 2013 showed that one-fifth of cervical cancer deaths occurred in women in the United States who were over the age of 65 years.

In the current study, the research team looked at data from the cross-sectional household National Health Interview Surveys from 2013 and 2015 to determine the number of women aged 41-70 years who had never had a Pap test or had not had one for 5 years or more.

After correcting for women who had undergone a hysterectomy, the researchers found that the incidence rate for cervical cancer increased with age until about 70 years and then declined after the age of 85.

Yet the proportion of women who had not been screened recently increased with age, from about 12% for women in their 40s to nearly 24% for women aged 66-70 years.

Efforts should be made to clarify misperceptions about the risk of cervical cancer among older women and health care providers, the investigators said.

“A recommended upper age limit for routine screening may lead women and providers to assume that cervical cancer is a younger woman’s disease,” they said.

Catch-up screening might be needed for underscreened women after the age of 65 years, although the physical and psychological issues associated with this should be taken into account, the study authors said.

“Age itself may need to be reconsidered, given high cervical cancer incidence rates after the age of 65 years, increases in life expectancy, and different human papillomavirus exposures by birth cohort,” they concluded.