That may be why despite guidelines recommending screening, a shocking number of California women 65 and older are facing late-stage cervical cancer diagnoses and dying from the disease. Following the introduction and widespread adoption of the Papanicolaou (Pap) smear test in the 1940s, cervical cancer incidence and mortality have fallen significantly. However, incidence rates plateaued once the Affordable Care Act went into full effect, and rates of invasive cervical cancer have actually increased since.
Through adequate screening and follow-up, cervical cancer can be prevented or detected at an early stage, which leads to excellent survival. However, current guidelines recommend discontinuing screening for women 65 or older who have had a history of normal Pap and/or Human Papillomavirus (HPV) tests, potentially leaving this age group vulnerable.
The analysis found nearly one in five new cervical cancers diagnosed from 2009-2018 were in women 65 and older. More of these women (71 percent) presented with late-stage disease than younger women (48 percent), with the number of late-stage diagnoses increasing up to age 79. Late-stage five-year relative survival was lower for women 65 and over (23.2%-36.8%) compared to patients under 65 (41.5%-51.5%).
Less surprising, women 80 years and older had the lowest survival of all age groups. Worrisome is that once young people no longer have private health insurance, retired or otherwise on Medicare, their prospects dive.
The study utilized a large set of population-based data from the California Cancer Registry. This state-mandated cancer surveillance system has collected cancer incidence and patient demographic, diagnostic, and treatment information since 1988. The data was used to identify all women 21 years and older who were diagnosed with a first primary cervical cancer in California from 2009-2018, the 10 most recent years that complete data was available.
Among women 65 and older, those who had comorbidities or were older were more likely to be diagnosed with late-stage disease.
The only good news was that unlike some other claims of higher mortality for young Hispanic/Latina and Black women, data in California show no increased late-stage cervical cancer diagnoses but instead lower incidents.
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