News from SGO annual meeting: Cervical cancer screening should not be stopped at age 65

One in every 5 women diagnosed with cervical cancer is above the age of 65 years in the USA, which suggests a reconsideration of current cervical cancer screening guidelines which advice to stop the screening at the age 65 years for women who are at low risk and have received adequate screening in the past.

The data was presented by the lead researcher Sarah Dilley, MD, MPH, a fellow in gynecologic oncology at The University of Alabama at Birmingham at the Society of Gynecologic Oncology’s 2018 Annual Meeting on Women’s Cancer.

The current recommendations by American Cancer Society, American Society for Clinical Pathology and American Society of Colposcopy and Cervical Pathology advice that cervical screening should stop after women turn 65 years of age if they have had adequate screening and are at low risk. The guidelines do not address the risk stratification for cervical cancer in women over the age of 65. 

The researchers analyzed the 2014-15 data Surveillance, Epidemiology and End Results (SEER-18) program database which showed that 19.7 percent of cervical cancer cases were diagnosed in women age 65 or older.

Analysis of the National Cancer Database for the year 2014-15 showed that 18.9% of cervical cancer were diagnosed in women who were who were 65 years or older.

Risk stratification by ethnicity showed that in 22.9 percent of African American women were age 65 or older, compared to 20.5 percent of non-Hispanic white women at the time of diagnosis of cervical cancer.

When the incidence was analyzed by age, only 5.1 percent of cervical cancer cases were diagnosed from age 20 to 29, while 8 percent were diagnosed from age 70 to 79.

Dr. Dilley said in a news release, “This data point contradicts the misperception that women usually only are diagnosed with cervical cancer at a younger age.”

“Our data suggest that a considerable proportion of women are diagnosed with cervical cancer after age 65, which suggests that patients are being aged out too soon or not getting screened at all,” Dr. Dilley continued. “Professional societies should consider extending the age screening requirements to improve outcomes for this older population of women.”

The results of this study suggest that the decision to stop cervical cancer screening should only be taken after an informed shared decision-making between patient and her doctor and some women over the age of 65 years may still benefit from screening to prevent age-based disparities in cervical cancer diagnoses.

News Release 

Media courtesy: LA times and JAMA