Cervical cancer is a preventable disease, but if we stop screenings at age 65, many more Black women will die from the disease as a result. That is because we are already diagnosed at later stages and have a lower five-year survival rate overall. The American Society of Clinical Oncology says, “For Black women, the 5-year relative survival rate is 56%. Older women also have lower survival rates. Women who are 65 or older have a 46% relative survival rate.”
Several regional studies have proved that these guidelines may need further examination. At the University of California Davis Comprehensive Cancer Center, researchers found that 1 in 5 cervical cancers diagnosed from 2009-2018 were 65 and over. A large majority, 71%, of these women received a diagnosis at a late stage. The patient’s 5-year survival rate for late-stage patients 65 and over was between 23.2%-36.8%. However, that percentage shrank the older the patient, with the lowest survival rate for women over 80.
According to Human Rights Watch, In Georgia, data shows that from 2014 to 2018, Black women had cervical cancer mortality rates almost one and a half times as high as white women, even though overall cervical cancer rates for both groups are nearly the same. While in that state, Black women over 70 are almost three times as likely to die. Researchers believe that guidelines that end screenings at age 65 represent missed opportunities to save lives. Racial disparities are especially glaring in rural areas where Black women face a cervical cancer incidence rate almost 50 percent higher than white women. In Appalachian Kentucky, the cervical cancer rate is also twice the national average.
Last year, The American Cancer Society said that:
- About 13,960 new cases of invasive cervical cancer will be diagnosed.
- About 4,310 women will die from cervical cancer.
While most diagnoses are caught between the ages of 35-44, the average age for a cervical cancer diagnosis is 50.
In a previous study, researchers found that the incidence of cervical cancer rose steadily with age, peaking at ages 65 to 69. In fact, in this study, the incidence of cervical cancer among women ages 65 to 69 was 84 percent higher than previously reported.
For black women, the numbers are even more alarming. In this study, black women had higher cervical cancer rates than white women at nearly every age, with the most significant difference among the 65 to 69 set.
“Our corrected calculations show that women just past 65 when current guidelines state that screenings can stop for many women, have the highest rate of cervical cancer,” study lead author Anne Rositch, an assistant professor of epidemiology and public health at the University of Maryland School of Medicine, said in a release. “It will be important to consider these findings when re-evaluating risk and screening guidelines for cervical cancer in older women and the appropriate age to stop screening.”
According to Rositch, we need further studies to determine “whether the continued increase in cervical cancer rates with age and the higher rates in African-American women represent a failure in our screening programs or a failure of the women to be screened so that appropriate interventions can be applied.”
Many women in our community don’t consider the importance of gynecological screenings when they are no longer of childbearing years. But, a study found that women over 65 were less likely to be screened for cervical cancer. The Centers for Disease Control says, “The only way to know it is safe to stop being tested after age 65 is if you have had several tests in a row that didn’t find cancer within the previous ten years, including at least one in the previous five years.”
- You should have three normal tests in a row for the Pap test alone.
- You should have two normal tests in a row for the Pap-HPV co-test.
- Women at high risk should talk with their doctors about how often to get screened and at what age.
- The CDC says screening after age 65 may be appropriate for some women at high risk, including women with a history of cervical lesions or cancer, women whose mothers took a hormone called diethylstilbestrol (DES) while pregnant, or women who have a weakened immune system.
If you or a loved one is approaching 65 or they are all older, make sure you ask about whether continued screening for cervical cancer is appropriate.
