Cervical cancer screening should continue after 50

HemOnc Today

Data from an observational prospective study of the incidence of cervical cancer indicates that age is not a good discriminative risk factor for early cutoff of cervical cancer screening. Researchers found that the risk for cervical cancer, even after several negative cervical smear tests by the age of 50, was still similar to that of women of younger ages.

The researchers analyzed data from a Dutch national registry of histopathology and cytopathology. They compared data from 218,847 women aged 45 to 54, and 445,382 women aged 30 to 44 at the time of a third negative smear test.

After 10 years, 105 women had developed cervical cancer within 2,595,964 woman-years at risk in the 30 to 44 age group, and 42 within 1,278,532 woman-years at risk in the 45 to 54 age group.

The incidence rate of cervical cancer was similar in both age groups at 41 per 100,000 (95% CI, 33-51) for the 30 to 44 years age group vs. 36 per 100,000 (95% CI, 24-52) in the 45 to 54 age group.

The findings suggested it would not be consistent to stop screening these women while also not relaxing the screening policy for younger women with similar screening histories, according to a press release.

“Our conclusion lends support to the current cervical cancer screening guidelines in England and other developed countries, which do not discriminate women by age up to 60 to 65,” the researchers wrote.

Modern computer technology may allow for individually tailored screening invitations, according to Björn Strander, MD, director at the Cervical Screening Oncology Center at Sahlgren’s University Hospital in Göteborg, Sweden.

“We have to pay close attention to developments in invasive cancer in age groups above the cut-off point for screening and be prepared to adjust the screening ages as we learn more,” he said in an accompanying editorial.

Rebolj M. BMJ. 2009;doi:10.1136/bmj.b1354.

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