Why Many Older Women Get Pap Tests They Don't Need
About ten years ago, Andrea Clay went online to read the new revised cervical cancer screening guidelines.
No health care providers had mentioned that women over 65 who were at average risk of cervical cancer could stop getting Pap tests if they had done adequately screened until then.
But that's what the U.S. Preventive Services Task Force has recommended, learned Ms. Clay, as well as the American College of Obstetricians and Gynecologists and the American Cancer Society.
An Edison, Washington, nurse and emergency medical technician gently cheered Ms. Clay. After decades of being screened, she had never had an abnormal Pap result and was not in any high-risk group.
"I didn't want to do part of those more stirrups," she said. "I didn't see the need for it." She printed the guidelines, ready for a fight if a nurse practitioner or doctor insisted that she continue But no one did.
Now 74, she hasn't been tested for cervical cancer "I'm done," she said.
However, JB Lockhart, 70, a retired office worker in Lake Oswego, Oregon, still schedules an annual Pap.< /p>
Last year she moved to a new obstetrician-gynecologist. "She told me I don't I didn't need to get tested anymore," Ms. Lockhart recalls. "I thought 'you could still get cervical cancer after a certain age."
She told the doctor, "I prefer to calm down and be preventive. ”
Mrs. Lockhart is not deterred by the fact that the task force and medical groups recommend cervical cancer screening only every three to five years (depending on the tests patients undergo), or by the recommendation that women with a specified number of normal results can stop at 65.
uterus in older women, meaning "moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits," didn't deter her either.
Many more older women are continuing cervical cancer screening, according to a recent study published in JAMA Internal Medicine.
Using Medicare data to examine 15 million women over 20 years, researchers found that the proportion of those who had had at least one Pap or HPV (human papillomavirus) test had fallen from nearly 19 percent in 1999 to 8.5 percent in 2019 — a potential win for those worried about the virus. -testing and overtreatment in the elderly.
"We expected this trend," said the study's lead author, Jin Qin, an epidemiologist at the Centers for Disease Control and Prevention's Division of Cancer Prevention and Control. "But at this magnitude, at this level, it's a little surprising."
Recommendations state that women at average risk can stop cervical cancer screening after age 65 if, within the last 10 years, they have had three consecutive negative Pap tests or two consecutive negative HPV tests (which can be done at the same time as a Pap). The most recent negative tests must have been within five years.
Women who have had a hysterectomy and do not have previous precancerous lesions may also waive to screening.
Told they can quit, "many of my patients are thrilled," said Dr. Hunter Holt, a family physician at the University of 'Illinois in Chicago and co-author of the study. Few people looked forward to stripping naked and having a speculum inserted so a medical professional could scrape the cervical cells for testing.
About ten years ago, Andrea Clay went online to read the new revised cervical cancer screening guidelines.
No health care providers had mentioned that women over 65 who were at average risk of cervical cancer could stop getting Pap tests if they had done adequately screened until then.
But that's what the U.S. Preventive Services Task Force has recommended, learned Ms. Clay, as well as the American College of Obstetricians and Gynecologists and the American Cancer Society.
An Edison, Washington, nurse and emergency medical technician gently cheered Ms. Clay. After decades of being screened, she had never had an abnormal Pap result and was not in any high-risk group.
"I didn't want to do part of those more stirrups," she said. "I didn't see the need for it." She printed the guidelines, ready for a fight if a nurse practitioner or doctor insisted that she continue But no one did.
Now 74, she hasn't been tested for cervical cancer "I'm done," she said.
However, JB Lockhart, 70, a retired office worker in Lake Oswego, Oregon, still schedules an annual Pap.< /p>
Last year she moved to a new obstetrician-gynecologist. "She told me I don't I didn't need to get tested anymore," Ms. Lockhart recalls. "I thought 'you could still get cervical cancer after a certain age."
She told the doctor, "I prefer to calm down and be preventive. ”
Mrs. Lockhart is not deterred by the fact that the task force and medical groups recommend cervical cancer screening only every three to five years (depending on the tests patients undergo), or by the recommendation that women with a specified number of normal results can stop at 65.
uterus in older women, meaning "moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits," didn't deter her either.
Many more older women are continuing cervical cancer screening, according to a recent study published in JAMA Internal Medicine.
Using Medicare data to examine 15 million women over 20 years, researchers found that the proportion of those who had had at least one Pap or HPV (human papillomavirus) test had fallen from nearly 19 percent in 1999 to 8.5 percent in 2019 — a potential win for those worried about the virus. -testing and overtreatment in the elderly.
"We expected this trend," said the study's lead author, Jin Qin, an epidemiologist at the Centers for Disease Control and Prevention's Division of Cancer Prevention and Control. "But at this magnitude, at this level, it's a little surprising."
Recommendations state that women at average risk can stop cervical cancer screening after age 65 if, within the last 10 years, they have had three consecutive negative Pap tests or two consecutive negative HPV tests (which can be done at the same time as a Pap). The most recent negative tests must have been within five years.
Women who have had a hysterectomy and do not have previous precancerous lesions may also waive to screening.
Told they can quit, "many of my patients are thrilled," said Dr. Hunter Holt, a family physician at the University of 'Illinois in Chicago and co-author of the study. Few people looked forward to stripping naked and having a speculum inserted so a medical professional could scrape the cervical cells for testing.
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