BREAKING! University Of California Study Alarmingly Finds That More Women Aged 65 And Above Are Dying From Cervical Cancer!
Researchers from University of California Davis Comprehensive Cancer Center – Sacramento have shockingly found that more women aged 65 and above are dying from cervical cancer. This occurrence is not just being witnessed in California or United States alone but also globally as well. Among the many reasons contributing to this occurrence is the current screening and follow up guidelines.
Thailand Medical News further adds that ignorance about the oncogenic effects of HPV infections and other viral infections are is also another contributing factor.
Utilizing data from the California Cancer Registry, the study team identified 12,442 patients ages ≥21 years with a first primary cervical cancer diagnosed during 2009–2018. Proportions of late-stage disease (stages II–IV) and early- and late-stage 5-year relative survival are presented by the age group. Among patients ages ≥65 years, multivariable logistic regression estimated associations of sociodemographic and clinical characteristics with late-stage cervical cancer.
The study findings showed that nearly one fifth of patients (n = 2,171, 17.4%) were ≥65 years. More women ages ≥65 years (71%) presented with late-stage disease than younger women (48% in patients ages <65). Late-stage 5-year relative survival was lower for women ≥65 years (23.2%–36.8%) compared with patients <65 (41.5%–51.5%). Characteristics associated with late-stage cervical cancer in women ≥65 years included older age [odds ratio (OR), 1.02; 95% confidence interval (CI), 1.01–1.04; each year], non-adenocarcinoma histologic subtypes, and comorbidities (OR, 1.59; 95% CI, 1.21–2.08).
The study findings showed a significant burden of advanced cervical cancer in women ≥65.
Health authorities should acknowledge and take efforts should be made to better understand how the current screening paradigm is failing women of 65 years and older. Future efforts should focus on determining past screening history, lapses in follow-up care, and non-invasive testing approaches.
The study findings were published in the peer reviewed journal: Cancer Epidemiology, Biomarkers & Prevention.
The study findings showed an alarming number of California women 65 and older are facing late-stage cervical cancer diagnoses and dying from the disease. This is despite guidelines that recommend most women stop screening for cervical cancer at this age.
Lead author, Julianne Cooley… a senior statistician at the University of California-Davis, told Thailand Medical News
, “Our study findings highlight the need to better understand how current screening guidelines might be failing women 65 and over. We need to focus on determining the past screening history of older women as well as lapses in follow-up care. We must utilize non-invasive testing approaches for women nearing age 65 or those who need to catch up on their cervical cancer screenings."
The study findings showed nearly one in five new cervical cancers diagnosed from 2009-2018 were in women 65 and older. More of these women (71%) presented with late-stage disease than younger women (48%), with the number of late-stage diagnoses increasing up to age 79.
The findings showed that 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%). Women 80 years and older had the lowest survival of all age groups.
Co-author Dr Theresa Keegan, a professor in the UC Davis Division of Hematology and Oncology added, "The research findings showed a worsening five-year relative survival from cervical cancer with each increasing age category for both early and late-stage diagnoses."
The research 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.
It was found that among women 65 and older, those who had comorbidities or were older were more likely to be diagnosed with late-stage disease.
The study team commented, "Interestingly, prior studies of younger women have found increased late-stage cervical cancer diagnoses among young Hispanic/Latina and Black women. Our study did not observe these associations and instead found that older Hispanic/Latina women were less likely than non-Hispanic white women to be diagnosed late-stage."
It was reported that 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 have plateaued since 2012, and rates of invasive cervical cancer have actually increased in recent decades.
It has already been established that 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.
Past studies have shown that 23.2% of women in the U.S. who are over 18 are not up to date on recommended cervical cancer screening. Disadvantaged women such as those who are uninsured or poor are the least likely to report being up to date with cervical cancer screening.
Co-author and senior epidemiologist, Dr Frances Maguire added, "Scheduled screenings may also decrease as women approach 65, increasing the likelihood that women have not been adequately screened prior to the upper age cutoff."
Numerous other factors may contribute to older women not receiving adequate screening such as:
-Specific type of hysterectomy. A supracervical hysterectomy leaves the cervix intact and some women do not realize they need to continue screening for cervical cancer.
-Some women may tire of PAP smears due to embarrassment and the intrusiveness of a speculum-based exam.
-Sometimes, Pap tests are less accurate. The screening may not be as accurate in post-menopausal women in detecting adenocarcinoma, which has been increasing in incidence (as compared to squamous cell carcinoma).
-HPV detection testing. Women in the older age group may not have received HPV testing, now the gold standard of cervical cancer screening, which wasn't widely available until 2003. The Centers for Disease Control reports that almost all cases of cervical cancer are HPV-related.
The study team stressed that current screening guidelines and follows ups health check-ups should be reviewed as a result of these findings.
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