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SGO 2018: New Data Suggest Cervical Cancer Age-Based Screening Guidelines Should Be Reconsidered

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Key Points

  • 19.7% of cervical cancer cases were diagnosed in women age 65 or older from 2000–2014, according to the Surveillance, Epidemiology and End Results (SEER-18) program database.
  • 18.9% of cervical cancer cases were diagnosed in women over the age of 65 from 2004­­–2014, according to the National Cancer Database.
  • When stratified by age, 22.9% of African American women who are diagnosed with cervical cancer are age 65 or older, compared to 20.5% of non-Hispanic white women.

One in five women diagnosed with cervical cancer in the United States will be diagnosed after the age of 65, suggesting that the recommended age to stop cervical cancer screening should be reconsidered, according to research presented at the Society of Gynecologic Oncology’s (SGO) 2018 Annual Meeting on Women’s Cancer (Abstract 55).

The American Cancer Society, American Society for Clinical Pathology, and American Society of Colposcopy and Cervical Pathology currently recommend that cervical screening stop after women turn 65 years of age—as long as they have had adequate screening and are at low risk. The guidelines do not currently address how to stratify risk of cervical cancer in women over the age of 65.

Findings

Lead researcher Sarah Dilley, MD, MPH, fellow in gynecologic oncology at The University of Alabama at Birmingham, presented findings showing 19.7% of cervical cancer cases were diagnosed in women age 65 or older from 2000–2014, according to the Surveillance, Epidemiology and End Results (SEER-18) program database. Dr. Dilley also used the National Cancer Database to investigate cervical cancer rates based on age and found that 18.9% of cervical cancer cases were diagnosed in women over the age of 65 from 2004­­–2014.

When stratified by age, 22.9% of African American women who are diagnosed with cervical cancer are age 65 or older, compared to 20.5% of non-Hispanic white women.

The data are especially interesting when compared to women diagnosed from ages 20 to 29. Only 5.1% of cervical cancer cases were diagnosed from age 20 to 29, while 8% were diagnosed from age 70 to 79. “This data point contradicts the misperception that women usually only are diagnosed with cervical cancer at a younger age,” Dr. Dilley said.

“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.”

While age outcomes need to be addressed with cervical cancer screening, Dr. Dilley said that health disparities are still very much evident with cervical cancer patients.

The results of this study suggest that some women over the age of 65 years may still benefit from screening to prevent age-based disparities in cervical cancer diagnoses, and emphasize the importance of informed shared decision-making between patient and her doctor.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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