Cervical cancer may be more prevalent in individuals over 60 than previously believed, raising questions about current screening guidelines which often discontinue routine checks after age 65. As research unveils more about this disease, it underscores the need for older individuals to carefully evaluate their health risks and screening options.
Cervical Cancer in Older Adults
Cervical cancer typically begins in the cervix's lining, often caused by human papillomavirus (HPV). While HPV infections don't always progress to cervical cancer, regular screenings and vaccinations play a key role in early detection and prevention. Traditionally, the average age for a cervical cancer diagnosis is 50, with most cases identified between ages 35 and 44. However, recent studies show that nearly 20% of cervical cancer diagnoses occur in individuals over 65, with a substantial number diagnosed at later stages.
How Common is Cervical Cancer After Age 60?
The American Cancer Society estimates 13,820 new cervical cancer diagnoses in 2024. Typically, diagnoses peak between 35 and 44, but recent findings indicate that 12.5% of cases occur between 65 and 74. Furthermore, the highest percentage of cervical cancer deaths are seen among individuals aged 55 to 64, followed closely by those aged 65 to 74. This trend is likely due to the increased likelihood of late-stage diagnoses among older women.
Cervical Cancer Screening Guidelines
Currently, the National Cancer Institute recommends three main screening types for cervical cancer:
1. HPV Test: Detects high-risk HPV infections linked to cervical cancer.
2. Pap Test: Examines cervical cells for changes associated with HPV.
3. HPV/Pap Co-test: Combines both tests to identify HPV and any abnormal cervical cell changes.
Guidelines for screening by age are as follows:
Ages 21-29: Begin screening at 21 with a Pap test every three years.
Ages 30-65: Regular screenings using one of the following:
- HPV test every five years
- Pap test every three years
- HPV/Pap co-test every five years
Over 65: Speak with a healthcare provider to determine if screening is still necessary based on past results.
What Research Says About Screening Past 65
A 2021 study found that the risk of developing cervical cancer between ages 60 and 84 was notably reduced among those who continued screenings between ages 50 and 64. Another study suggested extending screening past 65, particularly as people live longer and remain sexually active later in life. This recommendation aligns with data showing that HPV-related cervical cancer risk is not solely linked to recent partners but to lifetime number of partners, indicating potential for late-life HPV infections to cause cervical cancer.
The Centers for Disease Control and Prevention (CDC) also supports considering screenings for individuals beyond 65. It advises that screening can only be safely discontinued after multiple consecutive clear tests over the previous decade, with at least one clear result within the last five years. Despite this, research shows that 1 in 20 individuals aged 66-70 may never have been screened.
Next Steps for Older Adults
The CDC encourages those over 65 who haven’t had regular screenings or who are unsure about their risk to consult healthcare providers about continuing tests. With early detection remaining crucial for successful outcomes, extending screenings for older populations may be a key step toward reducing the incidence and mortality of cervical cancer among people over 60.
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