Is advice for older women to stop having Pap smears misguided?
New research from the University of Maryland Medical Center finds that cervical cancer rates are much higher in older women than previous estimates. About 1.9 cases occur for every 10,000 women — rather than the previous estimate of 1.2 cases per 10,000 women — and the rate peaks in women ages 65- to 69-years-old, rather than 25 years earlier, as was previously thought.
African-American women had the highest cervical cancer rates, at more than five cases for every 10,000 women in those ages 65 to 69 — an increase of 126 percent over the previous estimate.
Why the difference? The latest data, published last Monday in the journal Cancer, excluded the 20 percent of women who had hysterectomies to surgically remove their uterus and cervix, while previous estimates did not. Few, if any, of these women will develop cervical cancer but including them in an analysis skews the cervical cancer rates lower for women who never had hysterectomies.
Study leader Anne Rositch told me that women, for now, should continue to follow the guidelines and their doctor’s recommendations for cervical cancer screening. Pap smears and/or HPV testing should be performed every three to five years in women up to age 65 who have no cervical abnormalities or HPV infections. The American Cancer Society states that for women over age 65, “screening should not be resumed for any reason, including if a woman reports having a new sexual partner.” D.K.