03 May Cervical Cancer Is Not Just a Young Woman’s Disease: Older Women Should Have PAP Smears Too
MedicalResearch.com Interview with:
Mary C. White, ScD
Epidemiology and Applied Research Branch
Division of Cancer Prevention and Control, CDC
Atlanta GA 30341
MedicalResearch.com: What is the background for this study?
Response: For women between the ages of 21 to 65, Pap testing every three years, or Pap testing with HPV co-testing every five years, can prevent cervical cancers and deaths.
Current recommendations state that women 65 and older and not otherwise at special risk can skip Pap tests, but only if they have had three consecutive negative Pap screening tests or two consecutive negative co-tests over the past 10 years, with the most recent done within the past five years.
We used data from two federal cancer registry programs to examine how cervical cancer risk changes with age, after excluding women who have had a hysterectomy. We also examined data from a federal national health survey to examine the proportion of women who either had never been tested or had not been tested in the last 5 years.
MedicalResearch.com: What are the main findings?
Response: We found that 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. A substantial number of women near the “stopping” age for screening have not been screened for many years.
MedicalResearch.com: What should readers take away from your report?
Response: Cervical cancer is not just a young woman’s disease. Women who have not had a hysterectomy remain at risk for cervical cancer as they grow older.
It’s important to reach out to women who have not had a hysterectomy and have not been screened for many years, including many older women, to prevent cases of – and deaths from – cervical cancer.
Women over 65 who have not been screened for many years still may need to be screened.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Research could examine perceptions about cervical cancer and cervical cancer screening among older women and their providers.
MedicalResearch.com: Is there anything else you would like to add?
Response: This study focused on women at average risk for cervical cancer. Screening after age 65 may be appropriate for some women at special or high risk, including women with a history of cervical lesions or cancer, women whose mothers took DES while pregnant, or women who are immunocompromised. Women at special risk should talk with their health care providers about their screening needs.
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Mary C. White, Meredith L. Shoemaker, Vicki B. Benard. 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
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