Cervical cancer rates higher in older women than previously thought

Cervical cancer rates in American women are higher than previously thought, especially among African-American women and women between the ages of 65 and 69, according to a new study published on Monday.

The U.S. Centers for Disease Control and Prevention recommends regular cervical cancer screenings — which are done with Pap tests or HPV tests — for all women between the ages of 21 and 65.

Although preventive measures for cervical cancer are largely geared toward women under 65, the new findings perhaps call into question whether older women should also follow such guidelines.

For instance, those between the ages of 65 and 69 were found to have much higher rates of cervical cancer than previously calculated, according to the new study, conducted by researchers at the University of Maryland Medical Center.

Previous studies found a cervical cancer rate of around 12 cases per 100,000 women in the United States, with the rates peaking among women between the ages of 40 and 44 and then leveling off.

However, a “substantial fraction” of American women have undergone hysterectomies, according to the study — and the researchers wanted to know whether those women who had actually had their cervixes removed were still being counted in calculations of cervical cancer rates, thus artificially driving down cancer rates.

As it turned out, they were. So the researchers — in looking at cervical cancer data from 2000 to 2009 culled from the National Cancer Institute and a national survey on cervical cancer incidence conducted by the CDC between 2000 and 2010 — discounted the women who’d had hysterectomies and thus could no longer get cervical cancer.

“The highest rate is actually among the older women, the 65- to 69-year-old women,” contrary to previous conclusions that middle-aged women had the highest rates of cervical cancer, Anne Rositch, a public health and epidemiology professor at the University of Maryland’s School of Medicine and lead author of the study, told Al Jazeera. “There’s also a larger impact on black women.”

With the corrected cervical cancer data, researchers calculated that there were actually 18.6 cases of cervical cancer per 100,000 women — and the incidence actually increased with age, peaking in women between the ages of 65 and 69.

What’s more, cervical cancer incidence in 65- to 69-year-old women was 27.4 cases per 100,000 women, nearly 85 percent higher than the previous estimate of 14.8 cases. And for African-American women, the rates were even higher — 53 cervical cancer cases per 100,000 women instead of the 23.5 cases that had been previously reported, a 126 percent increase. 

That’s because more of the black women reported having had hysterectomies, Rositch explained.

The group’s conclusions were published Monday in the journal Cancer, which is published by the American Cancer Society.

Rositch emphasized that the results don’t point to any conclusions about current cervical cancer screening guidelines or treatment, since the data don’t indicate whether those women who had cervical cancer had been receiving regular screenings.

“These data are really just looking at patterns by age and they tell us something different than what we previously thought,” she said.

Rositch added, “We need to look into the screening behaviors of those women who are in the 65- to 69-year-old categories, and when it does come time to review those guidelines ... this is one piece of information that should be taken into account.”