Affiliation:
1. Department of OBGYN, Swedish Medical Group
2. Department of OBGYN, Seattle Clinical Research, Seattle, Washington, USA
Abstract
Purpose of review
To review the recommendations for cervical cancer screening in older women and to determine the evidence upon which the current and emerging recommendations are based on. To evaluate the possible consequences of stopping cervical cancer screening in older women.
Recent findings
Recommendations are to space cervical cancer screening intervals for women aged 21–65 and stop in women older than 65. Cervical cancer incidence and mortality burden are significant in women over the age of 65. Human papillomavirus (HPV) vaccination rates are poor in older women. Advanced cervical cancer rates are increasing, including adenocarcinoma rates. Vulvar carcinoma rates are also increasing, and gynecological care and exams are less frequent when women are not getting routine pap testing.
Summary
The current review shows that there is limited evidence on which to base the recommendation to stop screening. There is confusion among patients and physicians, and other healthcare providers over who to screen and when, and this is exacerbating the already known difficulty accessing healthcare among racial and ethnic minorities, underinsured, and rural populations, but rates of cancer are also rising most rapidly in white women. Recommendations to space or stop screening are often based on the perceived psychological distress of women undergoing testing and the cost of population screening.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Obstetrics and Gynecology
Cited by
1 articles.
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