Role of cervical screening in older women

Objective: To review the literature concerning the role of cervical screening in women 60 years and older.

Methods: Literature review was conducted using PubMed and the search terms cervical neoplasm, cancer, middle aged, elderly, aged, postmenopausal, cervical cytology and screening. To be included in the review, the article must have been in the English language. The search focused on publications from 2000 forward.

Results: The case control and modeling studies that addressed the role of cervical cytology screening in women 60 and older were reviewed. The outcomes of interest included: (1) the benefits of screening in terms of decrease rate of cervical cancer incidence (6 studies) and mortality (3 studies); (2) the duration of protection of the last screening test (4 studies); and (3) the harms of screening older women including false positive test results and cost.

Conclusions: Cervical cytology screening is beneficial for women over 60 years in terms of preventing the occurrence and death from cervical cancer. A negative cytology test appears to have 5 years of protection in this age group. Age of last screen with in an organized screening program may differ compared to the goals and wishes of individual women.