A new study confirms that routine Pap smears, a screening test to detect abnormal cells that can become cervical cancer) reduces the risk of developing the disease in women ages 65 or older.
But there is still some debate as to whether these tests should be conducted in older women. In fact, most U.S. health guidelines currently advise against Pap screenings unless there are pre-existing risk factors for the disease.
“While the incidence of cervical cancer is greater in adult women under the age of 65 years, those over 65 tend to have more fatal cases of the disease,” said Karin Rosenblatt, PhD, one of the authors of the study. “Some studies report that Pap smears are unnecessary in older age, while others show that there is a benefit in the over-65 age group.”
The study, “Case-Control Study of Cervical Cancer and Gynecologic Screening: A SEER-Medicare Analysis,” was published in Gynecologic Oncology.
To confirm whether there was a relationship between the screenings and a decrease in the risk of developing cervical cancer in older and elderly women, the authors compared the Medicare billing data from 1991-1999 of more than 1,200 women ages 65 or older who had been recently diagnosed with the disease, and approximately 10,000 control patients with matching ages and location that had no cancer diagnosis.
The authors analyzed which patients had received a Pap test two to seven years before diagnosis, and adjusted the results for race and income of the subjects.
“We found that the newly diagnosed cervical cancer group was 36 percent less likely to have had a Pap smear, compared with the control group,” Rosenblatt said. “The reduction in risk was 52 percent after taking into account women in the control group who may have had hysterectomies before age 65. Both of these results were statistically significant.”
These results confirmed the importance of early detection in preventing the disease.
Still, despite the benefit of the early diagnosis of cervical cancer, Rosenblatt said future studies should include a thorough analysis of the cost-benefit and risks of conducting Pap smears in older women, as these tests may be unnecessarily invasive.
“Medicare covered a Pap test every three years at the time of the study and now covers a Pap test every two years,” Rosenblatt added.
Certain factors should be considered, such as general life expectancy, comorbid illnesses, and the potential psychological consequences resulting from a pre-malignant diagnosis.
Rosenblatt believes these studies should shed some light on which health policies should be put in place for these cases.