Elderly women still see lifelong cervical cancer screening as important
Research Activities, July 2009, No. 347
Some guidelines recommend that women stop being screened for cervical cancer when they are older than 65 or 70, provided that earlier Pap screening tests have been normal. However, most women consider cervical cancer screening important over their entire lifetime, reveals a new study. Researchers conducted face-to-face interviews with 199 elderly women; most were nonwhite and 44.7 percent were Asian. In addition to English, interviews were conducted in Spanish, Cantonese, or Mandarin. None of the women had a previous hysterectomy, which usually includes removal of the cervix and rules out the need for cervical screening. All of the women had received regular cervical cancer screenings.
The majority of women participating in the study (68 percent) felt that lifelong screening was either important or very important. Compared with Asian and white women, black and Latina women were more likely to hold strongly to this belief. Most of the women (77 percent) planned on being screened for the rest of their lives. Also, 60 percent had never given thought to stopping their regular screenings. Even when given information about the benefits and harms of Pap testing, the women did not change their beliefs about lifelong screening or plans to continue getting screened. However, if recommended by their physicians, 68 percent of the women would stop screening.
According to the study, Asian women would be particularly persuaded by their physicians, with three-fourths saying they would accept the recommendation. Only 20 percent of women said they had talked with their physicians about ending screening. More than half of the women who had these conversations with their physician had received a recommendation to stop being screened, and 87 percent reported that they did, in fact, end cervical cancer screening. Independent predictors of ending screening included older age, having public insurance, and having no personal or family history of cancer. The study was supported in part by the Agency for Healthcare Research and Quality (HS10856).
See "Ending cervical cancer screening: Attitudes and beliefs from ethnically diverse older women," by George F. Sawaya, M.D., A. Yuri Iwaoka-Scott, M.A., Sue Kim, Ph.D., M.P.H., and others, in the January 2009 American Journal of Obstetrics & Gynecology 200(1), pp. 40.e1-40.e7.