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Cervical cancer: over-screening in older women?

“Cervical cancer screening and other preventive measures are extremely important in promoting healthy aging, yet screenings must follow evidence-based guidelines to avoid overspending and potential complications with overdiagnosis and overtreatment as well as to maintain patients’ quality of life,” says one of the authors, Dr. Hunter Holt, professor of family and community medicine at the University of Illinois at Chicago.

“Cancer screening is based on a careful risk-benefit analysis,” says another author, Dr. George Sawaya, professor of obstetrics, gynecology, and reproductive sciences at the University of California, San Francisco.

Uncertain clinical significance?

Guidelines: According to the recommendations of the U.S. Preventive Services Task Force, the American Cancer Society, and the American College of Obstetricians and Gynecologists, women who are considered to be at intermediate risk can stop having this routine screening for cervical cancer. uterus as soon as they reach the age of 65 if they have had regular and regular pre-examinations.

However, this decision to end cervical cancer screening after age 65 still needs to be regularly reviewed. In particular, the researchers point out that higher rates of screening among older women are of concern: “Maybe many women are being tested when they don’t need it, Or, these women are at a higher average risk, for example, because they were not adequately screened before the age of 65.”

studying It looked at health insurance claims data from 1999 to 2019 for caring women age 65 and older. The analysis reveals valuable data:

  • In 2019, more than 1.3 million women over the age of 65 underwent screening for cervical cancer, such as a Pap test, colposcopy and other cervical procedures;
  • Thus, about 3% of women over the age of 80 had at least one screening-related procedure — which may indicate “over-examination,” the authors write;
  • White women were more likely to be screened after the age of 65;
  • The rate of Pap smear testing among women over 65 decreased from 19% (2.9 million women) in 1999 to 9% (1.3 million women) in 2019, a decrease of 55%;
  • The rates of colposcopy and cervical surgery decreased by 43% and 64%, respectively;
  • However, women over the age of 65 still account for nearly 20% of cervical cancer diagnoses and 36% of deaths.
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Therefore these experts do not decide on the advisability of revising the guidelines for cervical cancer screening. Their analysis again emphasizes the importance of regular screening up to the age of 65, suggesting that many conditions diagnosed after this age may be associated with poor compliance with screening, earlier and throughout life.