Screening Older Women
As noted above, cervical cancer mortality increases with age (maximum mortality for white women aged 45 to 70 years and for black women in their 70s). Predominantly, however, these are women who have not had recent screening.[1,2] (Also available online.) Among women who have had negative cytologic screening, mortality at all ages is low.
The prevalence of cervical intraepithelial neoplasia (CIN) is highest among women in their 20s and 30s. High-grade squamous intraepithelial lesions are rare among women older than 65 years who have been previously screened. Fewer than 1 woman in 1,000 (in some studies as few as 2–6 in 10,000) who were aged 60 years and older at the time of a negative Papanicolaou test had a new diagnosis of CIN 3+ on repeat screening.[3]
References
-
Saslow D, Runowicz CD, Solomon D, et al.: American Cancer Society guideline for the early detection of cervical neoplasia and cancer. CA Cancer J Clin 52 (6): 342-62, 2002 Nov-Dec.
[PUBMED Abstract]
-
National Institutes of Health Consensus Development Conference Statement: cervical cancer, April 1-3, 1996. National Institutes of Health Consensus Development Panel. J Natl Cancer Inst Monogr (21): vii-xix, 1996.
[PUBMED Abstract]
-
Sawaya GF, Grady D, Kerlikowske K, et al.: The positive predictive value of cervical smears in previously screened postmenopausal women: the Heart and Estrogen/progestin Replacement Study (HERS). Ann Intern Med 133 (12): 942-50, 2000.
[PUBMED Abstract]
Back to Top
< Previous Section | Next Section > |