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Study: Cervical Cancer Screening Guidelines Underestimate Risk

Study: Cervical Cancer Screening Guidelines Underestimate Risk

May 13, 2014 — Current cervical cancer screening guidelines underestimate the incidence rate of the disease particularly among older women -- because they do not exclude women who have undergone hysterectomies, according to a new study, Medical News Today reports.

According to Medical News Today, the American Cancer Society recommends that women ages 21 through 29 be screened for cervical cancer every three years and that women ages 30 through 65 be screened every five years. Meanwhile, it recommends that women older than age 65 who have had normal results in their previous screenings discontinue the tests.

For the new study, researcher Anne Rositch of the University of Maryland School of Medicine and colleagues measured the incidence of cervical cancer and the prevalence of hysterectomies between 2000 and 2009. They aimed to determine the incidence rate for the disease among women who have not had the procedure.

Study Findings

The researchers found that the nationwide rate of cervical cancer increased from 11.7 cases per 100,000 women to 18.6 per 100,000 women after correcting for women who have had hysterectomies.

More specifically, they found that the age group with the highest rate of cervical cancer is not women ages 40 through 44, as previously thought, but women ages 65 through 69, with a rate of 24.7 cases per 100,000 women (Whiteman, Medical News Today, 5/12).

The study determined that the incidence among several other age groups surpassed 20 cases of cervical cancer per 100,000 women, including women ages 55 to 59 (20.5 cases), ages 60 to 64 (23.6 cases), ages 70 to 74 (24.2 cases), ages 75 to 79 (23.2 cases) and ages 80 to 84 (22.9 cases) (Bankhead, MedPage Today, 5/12).

In addition, the researchers found that, after adjusting for hysterectomies, black women have an 89% higher rate of cervical cancer than white women; previous unadjusted estimates had determined a 62% increased risk (Medical News Today, 5/12).

Overall, the study found that the "percent change in corrected versus uncorrected cervical cancer incidence increased steadily with age, up to 97% higher incidence after correction for hysterectomy among women [ages 80 to 84] years."

Recommendations

The researchers said that the "current recommendations on age for cessation of routine cervical cancer screening might be re-evaluated in light of these new results" (MedPage Today, 5/12). The results show that cervical cancer remains a widespread problem, despite improved detection through screenings, the researchers said, adding that broader uptake of the human papillomavirus vaccine is needed (Medical News Today, 5/12).

ACS' Debbie Saslow said that while all data will be considered the next time the organization updates its guidelines, the new figures are unlikely to have an effect. She noted that cervical cancer rates, "even when adjusted for hysterectomy, will still be low in older women who have been screened," while the potential for "false-positive is quite high."

She added that testing for cervical cancer in older women is "less effective mostly because it is more difficult to get a sample from the cervix" and that the modeling studies used as a basis for the recommendations "did adjust for hysterectomy" (MedPage Today, 5/12).