WOMEN IN THEIR 50s STILL AT RISK FOR CERVICAL CANCER

NEW YORK (Reuters Health) Apr 23 - The risk for invasive cervical cancer is as high after age 50 as it is younger women, even when the older women have had several negative Pap smears, according to a prospective study conducted in the Netherlands. Therefore, routine screening should be continued among those in their 50s, the research team advices in the April 24 issue of BMJ Online First.

The incidence of preinvasive cervical lesions appears to be lower in older women with negative screening histories, Dr. Matejka Rebolj, at Erasmus Medical Center in Rotterdam, and her associates note. For the current study, however, rather than looking for cervical intraepithelial neoplasia, the researchers analyzed the incidence of invasive cancer, which "enables a more conclusive evaluation of whether there is more reason to relax screening" in older women than in younger women with similar histories of negative screening exams.

Their analysis involved data from the Dutch registry of histopathology and cytopathology (PALGA) from roughly 218,000 women aged 45-54 and 445,000 women aged 30-44 who had three consecutive negative smear tests.

During 10 years of follow-up, the difference in the cumulative incidence rate between age groups never reached significance, the report indicates. Overall, 42 older women and 105 younger women developed cervical cancer. Cumulative incidences at 10 years were 36/100,000 in the older group and 41/100,000 in the younger women (p = 0.46).

"The continued risk for cervical cancer is consistent with the considerable rate of (apparently) incident human papillomavirus infections throughout the age span we focused on," the authors point out.

They caution, however, that their data "do not permit a simple extension of our study to older ages."

In a linked commentary, Dr. Bjorn Strander, from Sahlgren's University Hospital in Goteborg, Sweden, advises researchers to "pay close attention to developments in invasive cancer in age groups above the cut-off point for screening and be prepared to adjust the screening ages as we learn more."