Nearly one in five new cervical cancers diagnosed between 2009 and 2018 were in women 65 and older, according to a new study from UC Davis. But what worries experts is that, according to the study, more older women (71%) had advanced-stage cancer than younger women (48%), which is consistent with survival rates and weaker ones that only get worse with age.
In general, if cervical cancer is diagnosed after it has spread to nearby tissues, organs, or lymph nodes, the five-year relative survival rate is 59%, according to the National Cancer Institute (NCI ). However, the study found that the five-year relative survival rate in the advanced stage was lower in women over 65 – only 23.2% to 36.8% – compared to women under 65. (41.5% to 51.5%). (In comparison, when cervical cancer is diagnosed at an early stage, the five-year relative survival rate is 92 percent, according to the NCI.)
Current screening guidelines from the American Cancer Society (ACS) recommend that people over the age of 65 who have had cervical cancer screenings with normal results within the past 25 years and who have tested negative during the 10-year period before age 65 should not be screened. Cervical cancer. Once the screening has stopped, write down the instructions, they must not be started again.
But, as this study shows, the risk of cervical cancer does not simply disappear at age 65.
Julianne Cooley, the lead author of the study and senior statistician at UC Davis, told Yahoo Life that the American Cancer Society predicts that 13,960 women in the United States will be diagnosed with cervical cancer in 2023. “and that 20% will be over 65”. she says.
Cooley says the study results are “extremely concerning” because “cervical cancer is preventable through screening, and no one should die from this disease.”
Dr. Connie Liu Trimble, professor of gynecology and obstetrics at Johns Hopkins Medicine, agrees, calling it a “travesty”. She tells Yahoo Life, “That shouldn’t happen these days.”
So what can older women do to protect their health? Here’s what the experts say.
First, what causes cervical cancer?
Almost all cervical cancers are caused by HPV (human papillomavirus), which is an extremely common virus. About 13 million Americans are infected with HPV each year, according to the Centers for Disease Control and Prevention (CDC).
HPV is transmitted through vaginal, anal, and oral sex, as well as skin-to-skin contact with an infected person’s genitals. “If you’ve had sex, you’ve been exposed to HPV — period,” says Trimble.
There are over 200 types of HPV, including low-risk types that can cause genital warts, and 14 high-risk types (specifically, HPV16 and HPV18) that can cause multiple types of cancer — not just cervical cancer, but also cancers of the vagina, vulva, penis, anus and back of the throat, according to the CDC.
In most cases, “the immune system can eliminate HPV, but the body’s ability to do so decreases over time,” Dr. Renata Urban, gynecologic oncologist at UW Medicine, tells Yahoo Life.
But in some cases, HPV lingers for several years — a precancer can take “10 to 15 years to turn into cancer, if it does,” says Trimble — causing abnormal changes in cervical cells that can lead to cancer.
Are current screening guidelines for older women insufficient?
Although more than 20% of cervical cancer cases are in women over the age of 65, these cancers “rarely occur” in those who have had regular cervical cancer screenings before. Sarah Diemert, 65, nurse practitioner and director of medical standards integration and assessment for Planned Parenthood Federation of America, tells Yahoo Life.
According to Urban, because it can take a decade or more for cervical cells infected with HPV to turn into cancer, combined with the fact that there is an increase in late-stage cervical cancer in this older age group, it “means that women are not getting proper screening. .” What’s not clear is why – are patients not keeping their doctor’s appointments and missing years of cervical cancer screening, or are doctors not don’t they carry out screenings? Or should screenings be extended beyond 65?
Cooley says the results of her study don’t help determine whether screening should continue past age 65 “because we didn’t have data to know whether women over age 65 who were diagnosed with breast cancer cervix were screened before they were 65.
However, she says, “we know that up to 23% of women over the age of 18 are not up to date on cervical cancer screening and many do not follow up on screening results. irregular. Therefore, screening guidelines may be adequate, but older women did not follow screening guidelines until they were 65, making them vulnerable to cervical cancer diagnoses at an advanced stage.
Older women may also underestimate their risk. Cervical cancer is most commonly diagnosed in women between the ages of 35 and 44, with the average age at diagnosis being 50, Diemert notes. “Many older women don’t realize that the risk of developing cervical cancer continues as they get older,” she says.
How is advanced cervical cancer treated?
Treatment is usually a combination of chemotherapy and radiation therapy, as well as a specialized treatment called brachytherapy, in which the radiation source is placed inside the vagina, according to the ACS.
However, Trimble says it can be “really difficult” to treat advanced cervical cancer, especially in older patients. Urban points out that as patients age, “they may have higher rates of hypertension or diabetes, which can affect kidney function and affect their ability to receive the most common type of chemotherapy given with radiation therapy.” . Also, some of the side effects may include loose stools or diarrhea, but older women may be much more susceptible to dehydration and fatigue,” so these side effects may hit them harder.
What can older women do to protect their health?
“These study results reinforce the need for anyone with a cervix to undergo regular cervical cancer screening and other types of cancer screening,” says Diemert.
For Cooley, she says determining whether women have met screening guidelines before they turn 65 is important before stopping regular screening. “If older women weren’t getting tested regularly before they turned 65, they should schedule a catch-up test as soon as possible,” she says. Trimble adds that if your GP doesn’t or won’t screen for cervical cancer, you should find a gynecologist who will.
Although the guidelines recommend that most people stop screening for cervical cancer before the age of 65, there are cases where screening after this age is recommended – namely, for people with higher risk, including those with “a history of high-grade cervical lesions or cancer, people who have not been adequately screened, people whose mothers have taken a hormone called diethylstilbestrol (DES) during pregnancy or people with weakened immune systems,” says Diemert, who adds that people should discuss with their health care providers how often to get tested and until at what age.
It’s also important to go to the doctor if you have symptoms of cervical cancer, Cooley notes. According to the NCI, early-stage symptoms include vaginal bleeding after sex, between periods, or after menopause, as well as pelvic pain or pain during sex. Late-stage symptoms include difficult or painful bowel movements, rectal bleeding during bowel movements, difficult or painful urination, and dull back pain.
Older people should know the general risks of cervical cancer and their own personal risk, Diemert says. These risks include a personal history of dysplasia (abnormal cell growth) of the cervix, vagina, or vulva; a family history of cervical cancer; smoking; and other infections, including chlamydia.
The good news is that if a precancer is found during screening, it can be treated, Diemert says, “preventing it from developing into cervical cancer.”
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