May 12, 2014
Rate Of Cervical Cancer Higher Than Previously Thought
Brett Smith for redOrbit.com - Your Universe Online
Cervical cancer rates may be higher than previously thought among some women, according to new research from Johns Hopkins University and the University of Maryland which was recently published in the journal Cancer.
While previous studies have found an age-standardized rate of approximately 12 instances of cervical cancer per 100,000 women in the United States - with a peak between 40 and 44 years old – these reports incorporated women who had hysterectomies involving the cervix being removed.
After eliminating these women, who are no longer vulnerable to cervical cancer, the scientists in the new study determined a rate of 18.6 cases of cervical cancer per 100,000 women. They discovered the incidence rose gradually with age and climaxed at a greater rate and at a more mature age, expressly in women between 65 and 69 years old.
"The higher rates of cervical cancer after correction for hysterectomy highlight the fact that, although a large proportion of cervical cancer has been prevented through early detection and treatment, it remains a significant problem," the study authors concluded.
The study authors emphasized the need for widespread vaccination against the Human papillomavirus (HPV), which causes virtually all cervical cancers. They also noted that existing US cervical cancer verification guidelines do not suggest regular Pap smears for women over 65 if their past results have been good.
The study found the rate of cervical cancer for women aged 65 to 69 was 27.4 instances per 100,000, 84 percent greater than the previous rate of 14.8 cases per 100,000. For white women aged 65 to 69, the incidence was 24.7 cases per 100,000, as opposed to an uncorrected rate of 13.5 cases per 100,000. The incidence for African-American women aged 65 to 69 was 53 cases per 100,000, as opposed to an uncorrected rate of 23.5 cases per 100,000 women. African-American women were found to have greater cancer rates at almost all ages, compared to white women, and the difference was more evident at older ages, likely due to African-American women reporting a greater incidence of hysterectomy than white women.
"Our corrected calculations show that women just past 65, when current guidelines state that screenings can stop for many women, have the highest rate of cervical cancer," said study author, Anne F. Rositch, an assistant professor of epidemiology and public health at the University of Maryland. "It will be important to consider these findings when reevaluating risk and screening guidelines for cervical cancer in older women and the appropriate age to stop screening."
The study team noted that excluding women who had undergone hysterectomy not only underrates the true incidence of cervical cancer, but also creates misleading race and age-specific comparisons.
"It will be important to clarify in future studies whether the continued increase in cervical cancer rates with age and the higher rates in African-American women represent a failure in our screening programs or a failure of the women to be screened so that appropriate interventions can be applied,” Rositch said.
"Although we have made tremendous progress in preventing and detecting cervical cancer in its earliest stages, we may not have fully understood the incidence among older women and African-American women,” added Dr. E. Albert Reece, vice president for medical affairs at the University of Maryland, who was not directly involved in the study. “This latest research underscores the importance of caring for a woman's obstetric and gynecological health throughout her entire life, and not only focusing on preventive health measures during her reproductive years."