Women ≥ 65 Years: When to Screen for Cervical Cancer

Maurie Markman, MD


July 17, 2023

This transcript has been edited for clarity.

I'm Dr Maurie Markman from Cancer Treatment Centers of America.

Let me briefly discuss a very important, provocative paper and topic. The paper is Cervical Cancer Stage at Diagnosis and Survival Among Women ≥65 Years in California. It was recently published in Cancer Epidemiology, Biomarkers & Prevention.

In this particular analysis, researchers looked at data from the California Cancer Registry, a total of 21,442 patients over the age of 21, with their first primary diagnosis of cervical cancer between 2009 and 2018. Of considerable interest and concern, 17% of this population was over the age of 65.

In addition, and perhaps most concerning, patients over 65 who were diagnosed with cervical cancer had a higher risk of having advanced-stage disease. In fact, of women over the age of 65, 71% of patients presented with late-stage disease compared with only 48% of women under the age of 65. Obviously, those numbers are all too high, but it's notable that women over the age of 65 were even worse than the whole population.

The point to be made here is that there have been solid recommendations based on data that women over the age of 65 may not need routine screening for cervical cancer. It's always been clear when these statements have been made that this relates to a population of women who have had routine screening throughout their much younger years for decades, and if all the screening has been negative, then perhaps you can stop after the age of 65. That does not relate to women who have not had proper screening.

It's clear to emphasize that if one encounters in an ob/gyn practice, a primary care practice, or a family medicine practice, a woman who is older — 65 years or in that range — who has not had proper screening, she needs screening for cervical cancer because of the risk of this disease in that population, which is real and potentially very serious.

This analysis is important and the data are quite relevant. Perhaps we need to modify some of the recommendations we made for screening or at least emphasize what those screening recommendations mean in terms of discontinuing screening for an older population.

I encourage you to read this paper if you encounter this population in your own practices. I think it's an important paper and an important analysis. Thank you for your attention.

Maurie Markman, MD, is president of medicine and science at Cancer Treatment Centers of America in Philadelphia. He has more than 20 years of experience in cancer treatment and gynecologic oncology research.

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