Heavy Cervical Cancer Burden in Elderly Women: How Can We Improve the Situation?

Abstract

Objectives: The American Cancer Society, the American College of Obstetricians and Gynecologists and the US Preventive Services Task Force recommend discontinuation of cervical cancer screening between 65 and 70 years of age in women with no abnormal test results in the preceding 10 years. This population-based study was undertaken to determine the incidence of cervical cancer in different age groups as a means to establish if current screening recommendations need reevaluation. Study Design: Data from the SEER database were used to compute incidence rates for cervical cancer diagnosed between 2000 and 2006 by age and disease stage. Results: We identified 18,003 women with cervical cancer. 12.18% were above the age of 69. The incidence in this age group was 8.7/100,000. Women younger than 30 comprised 5.7% of patients with an incidence of 5/100,000 and were most commonly diagnosed with stage IA1 disease. Women above 70 were most frequently diagnosed with stage IIIB. 79% of patients younger than 30 were diagnosed with an early disease (stage IA1–IIA) as opposed to only 41.2% of patients aged 69 or above. Conclusions: The incidence of cervical cancer does not decrease significantly in older women. Women over the age of 70 are frequently diagnosed with advanced stage disease which limits their treatment options. Failure to apply uniform screening across all at-risk age groups may account for the discrepancy.

Poor Cervical Cancer Screening Attendance and False Negatives. A Call for Organized Screening

“…On the other hand, advanced age was confirmed to be associated with under screening and with advanced stage which is consistent with the literature [18]. In other studies, both advanced age and advanced stages at diagnosis were associated with limited treatment options, an increase in suboptimal treatment rates and a decrease in survival [19, 20]. In our data, 81.5% of women aged 65 years or older did not have any prior screening history and 72.5% had an advanced stage of cancer (≥II) at diagnosis.…”

Hysterectomy‐corrected cervical cancer mortality rates in Denmark during 2002‐2015: A registry‐based cohort study

“…Previous studies from the USA have reported disparities in cervical cancer screening and in the treatment of and survival from cervical cancer by health insurance status . The difference in overall mortality does not seem to be explained by a higher cervical cancer incidence in Denmark than in the USA, as the hysterectomy‐corrected cervical cancer incidence rates are nearly identical and a higher proportion of advanced stage disease in Denmark than in the USA is not supported by the current literature (Denmark: 19.8% vs USA: 30.0%) . Other explanatory factors could be differences between the two counties in terms of screening recommendations, referral rates, cervical cancer treatment and registration of cervical cancer deaths.…”

Outcome and toxicity of radical radiotherapy or concurrent Chemoradiotherapy for elderly cervical cancer women

“…However, the data from China showed that women older than 60 years old accounted for 23.8% of all the cervical cancer patients [ 1 ], probably associated with the aged tendency of population. Despite the dramatical decrease of incidence of cervical cancer in US during the recent years, incidence in elderly women has no significant reduction [ 2 ]. A more tough situation concerning is that the incidence of cervical cancer was still increasing in China [ 1 ].…”