New Evidence Shows Benefit to Screening Older Women for Cervical Cancer

Screening women for cervical cancer into her 60s reduces the risk of developing the cancer in the decades following, according to research published in PLoS Medicine.

In women who stopped being screened for cervical cancer between the ages of 50 and 64 years, cervical cancer was 6 times more likely to develop in these women during ages 65 to 83 compared with women whose screening continued beyond ages 50 to 64 years, reported researchers from Queen Mary University of London, United Kingdom.

For the study, the researchers looked at data from 1,341 women, including all 65- to 83-year-old women in England and Wales with a diagnosis of cervical cancer between 2007 and 2012. The study was controlled with 2,646 women without cervical cancer.

The authors suggest their study supports screening women with adequate negative screenings for cervical cancer until at least age 60 and not beyond 69. But they also indicated that increased life expectancy could justify screening women even older than 69 years in the future.

"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,” the authors wrote. “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."

Women with adequate negative screening at age 65 years-consisting of at least 3 tests at age 50 to 64 years, with the last negative screening occurring after age 60-were at the lowest risk for cervical cancer (20-year risk of 8 cancers per 10,000 women) compared with unscreened women (20-year risk of 49 cancers per 10,000 women). In addition, the researchers reported that the risk of developing cervical cancer among adequately negatively screened women increased with age and with time since the last screen. Finally, the researchers estimated the rate of cervical cancer among women aged 65 to 79 years would be 23 cases per 100,000 woman-years, 2.4 times higher than the current rate, without any cervical screening.

Pertinent Points:
- Women who stopped being screened for cervical cancer between ages 50 and 64 years were 6 times more likely than women who were screened to have cervical cancer from ages 65 to 83 years.
- These results may support screening women with adequate negative screenings for cervical cancer until at least age 60 and not beyond age 69.

References:

Reference

1. Castañón A, Landy R, Cuzick J, Sasieni P. Cervical screening at age 50-64 years and the risk of cervical cancer at age 65 years and older: population-based case control study.

PLoS Med.

2014;11:e1001585. doi:10.1371/journal.pmed.1001585.