A recent study has found that women 65 and older are dying of cervical cancer at an increasing rate, and researchers are beginning to raise their eyebrows at screening guidelines for older women.
The study, conducted by UC Davis Comprehensive Cancer Center researchers, shows that despite the guidelines that recommend most women stop screening at 65, an alarming number of California women are facing late-stage cervical cancer diagnoses and dying from the disease.
“Our findings highlight the need to better understand how current screening guidelines might be failing women 65 and over,” said Julianne Cooley, a UC Davis senior statistician. “We need to focus on determining the past screening history of older women as well as lapses in follow-up care. We must utilize non-invasive testing approaches for women nearing age 65 or those who need to catch up on their cervical cancer screenings.”
The study, published in January in Cancer Epidemiology, Biomarkers & Prevention, showed that almost one in five new cervical cancers diagnosed from 2009-2018 was in women 65 and older. 71% of older women presented with the late-stage disease compared to 48% of younger women. The number of late-stage diagnoses increased up to age 79.
The five-year relative survival rate for late-stage was lower for women 65 and over (23.2%-36.8%) compared to patients under 65 (41.5%-51.5%). Women 80 years and older had the lowest survival of all age groups.
“Our study found worsening five-year relative survival from cervical cancer with each increasing age category for both early and late-stage diagnoses,” said co-author Theresa Keegan, a professor in the UC Davis Division of Hematology and Oncology.
The study applied large population-based data from the California Cancer Registry. This state-mandated cancer surveillance system has collected data on cancer incidence, patient demographic, and diagnostic and treatment information since 1988. It identified all women 21 years and older diagnosed with a first primary cervical cancer in California from 2009-2018 — the 10 most recent years complete data was available.
Among women 65 and older, those with comorbidities were more likely to be diagnosed with late-stage disease.
“Interestingly, prior studies of younger women have found increased late-stage cervical cancer diagnoses among young Hispanic/Latina and Black women,” Cooley said. “Our study did not observe these associations and instead found that older Hispanic/Latina women were less likely than non-Hispanic white women to be diagnosed late-stage.”
Unsurprisingly, women who are uninsured or poor, are less likely to report being up to date with cervical cancer screening. Previous studies have shown that 23.2% of women in the U.S. who are over 18 are not up to date on recommended cervical cancer screening.
“Scheduled screenings may also decrease as women approach 65, increasing the likelihood that women have not been adequately screened prior to the upper age cutoff,” co-author and senior epidemiologist Frances Maguire said.
The American Cancer Society recommends cervical cancer screening with an HPV test alone every FIVE years for women from age 25 until age 65.
Like all cancers, cervical cancer is more treatable when it is detected early! Make regular screenings a part of your health habit. There are too many cancers we simply can’t screen for on a regular basis. Don’t let this one, that can easily be caught, go undetected!